Fibromyalgia is a chronic disorder characterized by widespread muscle pain, tenderness, and stiffness. It predominantly affects women between 25-55 years old. Common symptoms include fatigue, headaches, sleep disturbances, and abnormal pain sensation. While the cause is unknown, genes and physical trauma may play a role. Treatments include exercise, acupuncture, massage, medications, and psychotherapy to manage pain and fatigue.

1. Fibromyalgia
Laura Dunn

2. Introduction
Definition:
A chronic disorder characterized by widespread pain, tenderness, and
stiffness of muscles and associated connective tissue structures that is
typically accompanied by fatigue, headache, and sleep disturbances—called
also fibromyalgia syndrome, fibromyositis.
Merriam-Webster (2015)

3. Who does it affect?
• Affects 7x more women than men (Causes of Fibromyalgia, 2005)
• Typically develops between 25 and 55
• 1 in 25 people affected
Risk factors
• Genes (Driver, 2016)
• Comorbidities
• Physical trauma (Fibromyalgia causes | arthritis foundation)

4. Signs and symptoms
(Johnson and Pacific, 2016)

5. Tender points
18 tender points for the diagnosis of fibromyalgia
(Fibromyalgia tender points diagram)

6. Abnormal pain sensation
• Hyperalgesia- heightened sensitivity to pain
• Allodynia- pain caused by stimuli which doesn’t normally cause pain
(Jahan et al., 2012)

7. Case study
HPC
• Fatigue
• Pain-burning
• stiffness
PMH
• Depression
• Diabetes
• Chronic LBP
NRS 10/10
Aggs
• Stress
• Over doing activities
Eases
• swimming
DH
Gabapentin
Citalopram

8. Treatments
Physiotherapy
• Exercise (aerobic/relaxation/stretching/ strengthening)
Acupuncture (Márquez-Zurita et al., 2016)
• Massage (Yuan, Matsutani, and Marques, 2015)
Other treatments
• OT- (CBT, pacing, pain management)
• Medication- Amitriptyline, pregabalin,gabapentin, tramadol
• Psychotherapy
(Fibromyalgia - Physiopedia, universal access to physiotherapy knowledge)

9. References
• Causes of Fibromyalgia (2005) Available at:
http://www.webmd.com/fibromyalgia/guide/fibromyalgia-causes (Accessed: 26 October
2016).
• Choices, N. (2016) Fibromyalgia. Available at:
http://www.nhs.uk/Conditions/Fibromyalgia/Pages/Introduction.aspx (Accessed: 26 October
2016).
• Driver, C.B. (2016) Fibromyalgia symptoms, treatment, causes - is fibromyalgia
hereditary?Available at: http://www.medicinenet.com/fibromyalgia_facts/page2.htm
(Accessed: 26 October 2016).
• Fibromyalgia causes | arthritis foundation (no date) Available at:
http://www.arthritis.org/about-arthritis/types/fibromyalgia/causes.php (Accessed: 26
October 2016).
• Fibromyalgia - Physiopedia, universal access to physiotherapy knowledge . Available at:
http://www.physio-pedia.com/Fibromyalgia (Accessed: 26 October 2016).
• Fibromyalgia tender points diagram (no date) Available at:
https://www.google.co.uk/search?q=fibromyalgia+tender+points+diagram&biw=1280&bih=9
23&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwi2xqWSvPjPAhWRhRoKHWeyA0AQ_
AUIBigB&dpr=1&safe=active&ssui=on#imgrc=NdyTGjIF70V6hM%3A (Accessed: 26 October
2016).

10. References
• Jahan, F., Nanji, K., Qidwai, W. and Qasim, R. (2012) ‘Fibromyalgia syndrome: An overview of
Pathophysiology, diagnosis and management’, Oman Medical Journal, 27(3), pp. 192–195.
doi: 10.5001/omj.2012.44.
• Johnson, R.K. and Pacific (2016) ‘Yoga as an effective therapy to reduce symptoms in patients
with Fibro’ by Rachel K. Johnson. Available at:
http://commons.pacificu.edu/pa/558/?utm_source=commons.pacificu.edu%2Fpa%2F558&u
tm_medium=PDF&utm_campaign=PDFCoverPages (Accessed: 26 October 2016).
• Márquez-Zurita, C., Santos-Rey, K., Navarro-Pablo, R., Modesto, M., Aguilar, I., Vas, J., Aguilar-
Velasco, J.F., Romero, M., Párraga, P., Hervás, V., Santamaría, O. and Campos, Á.M. (2016)
‘Acupuncture for fibromyalgia in primary care: A randomised controlled trial’, Acupuncture in
Medicine, , pp. 10950–2015. doi: 10.1136/acupmed-2015-010950.
• Merriam-Webster (2015) Definition of FIBROMYALGIA. Available at: http://www.merriam-
webster.com/dictionary/fibromyalgia (Accessed: 26 October 2016).
• Yuan, S.L.K., Matsutani, L.A. and Marques, A.P. (2015) ‘Effectiveness of different styles of
massage therapy in fibromyalgia: A systematic review and meta-analysis’, Manual Therapy,
20(2), pp. 257–264. doi: 10.1016/j.math.2014.09.003