Fibromyalgia

Fibromyalgia is a chronic pain syndrome ACR (American College of Rheumatology 1990 ) classification criteria state the presence of widespread pain in combination with 11 or more of 18 specific tender point sites. Widespread pain was defined as 3 out of 4 quadrant pain including left-and right and upper and lower segment pain and axial pain.

Better understanding of disease since initial ACR criteria ( 1990 ) Examination of tender point - found to be barrier in primary care Erroneous impression - that it is a peripheral musculoskeletal disease .Fibromyalgia usually diagnosed in primary care Diagnosis often not considered initially

Pain for at-least three months affecting both sides of the body , both above and below the waist Palpation of tender points not required Body divided into 19 regions and score how many regions are painful

Epidemiology-Common with a prevalence of 2 % Seen in all ethnic and socio-economic groups Prevalence ↑↑ in females Age of onset between 20-60 average age of 35 Diagnosis & management remains a challenge Often takes > 2 yrs to diagnose and an average 3.7 consultations with different physicians

Causes -Not known what exactly causes fibromyalgia - several mechanisms proposed○ central sensitisation - maladaptive pain...