FIBROMYALGIA
FSIGNIFICANT CAUSE OF DISABILITY OR
REFUGE OF THE WORKSHY & AND THE
WORRIED WELL?
Dr Tony Clarke
FIBROMYALGIA
A LITTLE HISTORY
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Fibrositis
Yunis, 1981, & Smythe
Views on causation
Approaches to treatment
Interaction with Chronic Pain & Chronic Fatigue
Syndrome
FIBROMYALGIA
PRIMARY DISAGNOSIS
• Pain
• Sleep disturbance
• Trigger spots
FIBROMYALGIA
FIBROMYALGIA
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SECONDARY OR ASSOCIATED
PROBLEMS
Blushing
Brisk Jerks
Irritable bowel syndrome
Poor concentration
Polysymptomatology
FIBROMYALGIA
AMERICAN COLLEGE OF
RHEUMATOLOGY CRITERIA
1990
• Designed to assist with research
• Take no account of clinical variability
• Considerable overlap with other conditions
FIBROMYALGIA
MANAGEMENT
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Positive diagnosis
Attention to underlying pain problem
Improve sleep hygiene
Pacing
FIBROMYALGIA
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PACING
‘Boom & Bust’ does not work
Stepwise pacing will get a quicker result
It requires significant self-discipline
Better results are obtained with
supervision
FIBROMYALGIA
Chronic fatigue
Fibromyagia
Chronic pain
FIBROMYALGIA
TIMESCALE
• The quicker it is treated, the quicker it will
get better
• If properly treated, it will get better
• If neglected, then chronic pain, associated
with significant illness behaviour, will result