Fibromyalgia: Difference between revisions

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Fibromyalgia is a chronic medical condition that is characterised by widespread pain, fatigue, waking unrefreshed and cognitive disorders. The diagnostic criteria are subjective, and teh condition remains controversial in some circles due to this. Recent work has found that 40-50% of patients have [[Small Fibre Neuropathy|small fibre neuropathy]].


==Epidemiology==
Fibromyalgia is present across the world, and has a prevalence ranging between 2% to 4%.
==Diagnosis==
The current criteria for fibromyalgia were established in 2010 by the American College of Rheumatology (ACR). There is no requirement for a tender point examination like in the ACR 1990 classification. Three criteria must be met for the diagnosis
The current criteria for fibromyalgia were established in 2010 by the American College of Rheumatology (ACR). There is no requirement for a tender point examination like in the ACR 1990 classification. Three criteria must be met for the diagnosis
#Widespread Pain Index (WPI) ≥ 7/19 and Symptom Severity Scale (SSS) Score ≥ 5/12 or WPI between 3–6/19 and SSS ≥ 9/12
#Widespread Pain Index (WPI) ≥ 7/19 and Symptom Severity Scale (SSS) Score ≥ 5/12 or WPI between 3–6/19 and SSS ≥ 9/12

Revision as of 18:49, 31 March 2021

This article is a stub.

Fibromyalgia is a chronic medical condition that is characterised by widespread pain, fatigue, waking unrefreshed and cognitive disorders. The diagnostic criteria are subjective, and teh condition remains controversial in some circles due to this. Recent work has found that 40-50% of patients have small fibre neuropathy.

Epidemiology

Fibromyalgia is present across the world, and has a prevalence ranging between 2% to 4%.

Diagnosis

The current criteria for fibromyalgia were established in 2010 by the American College of Rheumatology (ACR). There is no requirement for a tender point examination like in the ACR 1990 classification. Three criteria must be met for the diagnosis

  1. Widespread Pain Index (WPI) ≥ 7/19 and Symptom Severity Scale (SSS) Score ≥ 5/12 or WPI between 3–6/19 and SSS ≥ 9/12
  2. Symptoms being present at a similar level for at least 3 months
  3. The patient does not have another disorder that would otherwise sufficiently explain the pain.

Conditions 1 and 2 are assessed by the Fibromyalgia Survey Questionnaire.

Small Fibre Neuropathy and Widespread Pain Syndromes

Oaklander et al found that in 41 patients with unexplained widespread pain that started before the age of 21, 59% of children at definite small fibre neuropathy (SFN), 17% had probable SFN, and 22% had possible SFN.[1] They then found that in a group of 27 fibromyalgia patients and 30 matched controls, 41% of fibromyalgia patients had definite SFN, compared to 3% in the control group.[2] Following this research in the early 2010s, there has been numerous further research in this area, which has reinforced that a proportion of fibromyalgia patients actually have SFN - a neuropathic pain syndrome. Overall it appears that around 40-50% of fibromyalgia patients have SFN.

See Also

References

Literature Review

  1. Oaklander & Klein. Evidence of small-fiber polyneuropathy in unexplained, juvenile-onset, widespread pain syndromes. Pediatrics 2013. 131:e1091-100. PMID: 23478869. DOI. Full Text.
  2. Oaklander & Klein. Evidence of small-fiber polyneuropathy in unexplained, juvenile-onset, widespread pain syndromes. Pediatrics 2013. 131:e1091-100. PMID: 23478869. DOI. Full Text.