Fibromyalgia

Fibromyalgia is a chronic, non-inflammatory musculoskeletal syndrome (one of the manifestations of extra-articular rheumatism) characterized by area pain with stiffness + pressure-sensitive points that has no apparent cause in synovitis and / or myositis.


 * Primary x secondary (usually associated with RA, SLE , spondyloarthropathy, etc.).
 * prevalence 3–10% with a significant predominance of women, hl. aged 40-70 years.
 * cause unknown.

Clinical Picture

 * Area musculoskeletal pain + stiffness in various parts of the body unrelated to the joints; maximum problems in the morning + evening, especially after workload,
 * feeling tired and exhausted,
 * sleep disorders, memory ,
 * irritable bowel syndrome ,
 * headache
 * similar manifestations as in Raynaud's phenomenon.

Diagnostics
The American College of Rheumatology (ACR) determined the duration of pain as longer than 3 months, the location of pain above and below the waist, and the axial nature of the pain ( neck, anterior chest, thoracic and lumbar spine) as diagnostic. Another diagnostic criterion is positivity (pressure pain) of at least 11 out of 18 defined pair points: suboccipitalis attachment, in the cervical spine area in the plane of inter transverse spaces in front, middle part of the upper edge of the trapezius muscle , medial edge of the supraspinatus muscle above the scapula ridge, second rib at the skeletal junction - laterally at the upper edge of the junction, lateral epicondyl elbow - distal to the epicondyls, large trochanter behind the apex of the prominence distally, gluteal point in the upper outer quadrant, medial part of the knee - proximal to the cleft, in the fat pad.

Differential diagnostics

 * Overlapping fibromyalgia with other diseases (chronic fatigue syndrome),
 * pretending / concealing.

Therapy

 * Gain the patient's trust (get rid of the fear of serious illness),
 * anxiety + sleep disorders → TCA (amitriptyline),
 * pain relief → NSAID s, paracetamol (also in the form of gels / ointments),
 * RHB, exercise.

Prognosis

 * The possibility of a permanent cure unlikely x can significantly affect the quality of life of a patient with fibromyalgia.

Related articles

 * Back pain, root syndromes of the lower limbs / PGS