Sunday, March 27, 2011

Fibromyalgia

Information to patients.

Up to 5% of the population suffers from fibromyalgia, which is a syndrome characterised by chronic body pain, fatigue, anxiety or depression, sleep disturbances.
Commonly seen in patients between 20 to 50, more in females than males at 9:1 ratio.
primary : not associated with other conditions.
secondary: associated with rheumatoid arthritis or SLE
Common symptoms associated with fibromyalgia with decreasing frequency are:
Condition                                % of FMS Symptoms
Muscular Pain                                         100
Fatigue                                                     96
Insomnia                                                   86
Joint Pains                                                72
Headaches                                               60
Restless Legs                                           56
Numbness and Tingling                            52
Impaired Memory                                    46
Leg Cramps                                             42
Impaired Concentration                            41
Nervousness                                            32
Depression (Major Depression)               20
can also be associated with irritable bowel syndrome, paraesthesia, genitourinary symptoms.
Diagnosis : There is no single test which can establish the diagnosis. It is more a diagnosis by exclusion. Do investigations to rule out all other rheumatological conditions.
Criteria used for diagnosis according to ACR are:
1. Wide spread presence of pain throughout the body present for more than 3 months.
2. Presence of tender spots throughout the body. At least 11 out of 18.
                            Tender_points_fibromyalgia
Treatment: Mostly symptomatic treatment, options available are:
1. Medications: Tramadol, pregabalin, ketamine, gabapentin and others.
2. Exercises: Most important part of treatment. Aerobics, stretching and strengthening exercises, etc
3. Relaxation techniques to reduce the effects of stress: meditation, pranayama etc.
4. Antidepressants and muscle relaxants can also used.
5. Psychotherapy.