A short presentation on fibromyalgia, the commonest orthopaedic outdoor complaint.

1. Fibromyalgia
Dr. Humayun Israr
Resident orthopaedic Surgery
DHQ Teaching Hospital, Sahiwal

2. Introduction
• It is not much of a diagnosisbut a descriptive term for a condition in
which patients complain of widespread pain and tenderness in the
muscles and other soft tissues around the back of the neck and
shoulders and across the lower part of the back.
• Complete absence of demonstrable pathological changes in the affected
tissues sets it apart from other rheumatic diseases.

3. Diagnosis
• The criteria for diagnosis was put forward by American college of
rheumatology
• These included symptoms of widespread pain in all four quadrants of
body, together with at least nine pairs of designated tender points on
physical examination..
• However, the diagnosis is often made in patients with much more
localized symptoms.

4. Etiology
• The precise cause remains unknown.
• It has been suggested that the sufferers have low pain threshold due to
abnormalities in sensory processing. Patients sometimes do exhibit
hyperalgesia in other parts of body.
• Its suggested that the condition is related to stress responses which can
be activated by sudden accidents or traumatic life accidents..

5. Association
• Some patient do exhibit association with psychological depression and
anxiety. But diagnosis cannot be excluded by psychological testing
alone.

6. Treatment
• In mild cases treatment can be limited to physiotherapy and healthy
exercises on their own to improve muscle and mental health
• Analgesics help with symptom control rather than cure and amitriptyline
helps with sleep.
• Gaba pentin and pregabalin can also be helpful.
• Patients with more distressing symptoms may benefit with
psychotherapy.

7. THANK YOU