Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, stiffness, paresthesia, and non-restorative sleep. It affects 2-8% of the population, predominantly women. While the causes are unknown, fibromyalgia is diagnosed based on a patient history meeting the 1990 American College of Rheumatology diagnostic criteria of widespread pain and tenderness in at least 11 of 18 tender point sites. Treatments include medications, exercise, cognitive behavioral therapy, and supportive group therapy to manage symptoms.

1. FIBROMYALGIA
BY:
OLUKOYA OLUFEMI CHISOM

2. WHAT IS IT?
A disorder characterized by:
Widespread musculoskeletal pain
Stiffness
Paresthesia
Non restorative sleep
Easy fatigability
Any fibromuscular tissues may be involved especially those of
the:
Occiput
Neck
Shoulder
Low back
thighs

3. INCIDENCE
 More common in women than men with ratio 8:1, especially in
post-menopausal women
 Affect 2–8% of the population
 May not be diagnosed in up to 75% of affected people

4. PRECIPITATING FACTORS
 Environmental or emotional stress
 Poor sleep
 Trauma
 Exposure to dampness or cold
 A physician who implies the disorder is “all in the head”

6. DIAGNOSTIC
 no specific diagnostic test
 Diagnosis involves first ruling out other potential causes and
verifying that a set number of symptoms are present.
 History of widespread pain +
 Demonstration of at least 11 of the 18 tender point sites on digital
palpation

7. ACR CRITERIA OF FIBROMYALGIA

9.  Amazingly, the results of joint and muscle examinations including
biopsies are normal. Also no laboratory abnormalities
 FM may occur in patients with
 other connective tissue disorders such as RA
 other medical illnesses

10. DIFFERENTIAL DIAGNOSIS
 SLE
 Chronic fatigue syndrome
 Polymyalgia rheumatica

11. TREATMENTS
 DMARDs
 TCAs
 Glucocorticoids
 Exercise
 Cognitive-behavioural therapy (CBT)
 Psychoeducation (specifically, sleep hygiene)
 Supportive group therapy
 NSAIDs

13. REFERENCES
 http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-
Conditions/Fibromyalgia
 Mease P. Fibromyalgia syndrome: review of clinical presentation,
pathogenesis, outcome measures, and treatment [published
correction appears in J Rheumatol Suppl. 2005;32:2063]. J Rheumatol
Suppl. 2005;75:6-21.
 Wolfe F, Smythe HA, Yunus MB, et al. The American College of
Rheumatology 1990 Criteria for the Classification of Fibromyalgia:
report of the Multicenter Criteria Committee. Arthritis
Rheum. 1990;33:160-172.
 Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia
syndrome: analysis of referrals.Rheumatology
(Oxford). 2003;42:263-267.