Fibromyalgia

1. What are the clinical features of fibromyalgia?
2. What are the ARA criteria for diagnosis of fibromyalgia?
3. What is the treatment of fibromyalgia?

Answers:
1. Diffuse aching stiffness, tender points, headaches, neck/upper trap discomfort, UE paresthesias, fatigue. May be associated with IBS, RA, Lyme, hyperthyroidism.
2. Widespread pain in left and right side of body above and below waist with axial involvement. Also must have at least 11/18 tender points (occiput, lower cervical, traps, supraspinatus, second rib, lateral epicondyle, gluteal, greater trochanter, knee).
3. Nortriptyline, NSAIDs, steroids, combination therapy, biofeedback, tender point injection, acupuncture, aerobic exercise.