Fibromyalgia: System and Patient Topic of the Day

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I have decided to start a new series to educate and help you in studying for the BCPS coming up this Fall 2015. My goal is to find a topic every single day to cover and hopefully help prepare you! If you have any comments you want to add on topics you want covered, feel free to leave a comment. 

fibromyalgia2

Fibromyalgia

What is fibromyalgia? Pain all over the body and other symptoms

Chronic. Tenderness to touch or pressure to joints and muscles. Fatigue. Sleep problems. Problems with memory or thinking clearly. Some have depression or anxiety. Migraines. Tension headaches. IBS, GERD. Irritable or overactive bladder. Pelvic pain, TMJ.

How do doctors diagnose?

·         Patient’s relevant symptoms (what they feel)

·         NO test to detect but based on ruling out everything else

·         NO cure but meds may help alleviate

Sometimes runs in families. Causes unclear. Sometimes maybe physical or emotional stress triggers this illness.

Some think that the volume control is turned up too high in the brain’s pain processing centers.


fibromyalgia

 

TREATMENT

  •  FDA Approved:      

1.    Cymbalta (duloxetine): (serotonin and norepinephrine) that help control pain levels

2.    Savella (milnacipran): (serotonin and norepinephrine)

3.    Lyrica (pregabalin): blocks the overactivity of nerve cells involved in pain transmission


  • Non FDA Approved:

1.    Amitriptyline (Elavil)

2.    Cyclobenzaprine (Flexeril)

3.    Venlafaxine (Effexor)


  • Other Non FDA Approved (not first line):

1.    Tramadol (Ultram): opioid narcotic

**Note:  Doctors don’t suggest using other opioids for treating this disease not due to dependence but due to evidence that shows that these drugs may actually increase pain sensitivity or make pain persist.

Treatment of Sleep Problems

  • Cyclobenzaprine (Flexeril)
  • Amitriptyline (Elavil)
  • Gabapentin (Neurontin)
  • Pregabalin (Lyrica)

**Note: Ambien and benzodiazepines are NOT recommended for insomnia in fibromyalgia

 

Treatment of Pain

  • APAP
  • NSAIDs like ibuprofen/naproxen