Fibromyalgia

• Characterized by
  • diffuse myofascial aching
  • multiple "tender points"
  • stiffness
  • fatigue
  • a non-restorative sleep pattern.
• The combination of diffuse aches and a tender point count of 18 or more is sufficient for diagnosis.
• Symptoms are influenced by fatigue, tension, cold or humid weather, excessive work, and inactivity.
• Stiffness is diffuse, avoiding specific joint areas.
• May have morning stiffness but does not last as long as in JRA.
• Often have a sleep disorder with abnormalities in stage 4 non-REM sleep.
• May have parasthesias but normal exam.
• Labs are normal.
• Treatment involves reconditioning/exercise. Drug therapy for sleep (e.g.,amitriptyline) may also help

CHLA Board Review 2005