Physio East Grinstead, Fibromyalgia

• At the suboccipital muscle insertions (close to where rectus capitis posterior minor inserts)
• At the anterior aspects of the inter-transverse spaces between C5 and C7
• At the midpoint of the upper border of upper trapezius muscle
• At the origins of supraspinatus muscle above the scapula spines
• At the second costochondral junctions, on the upper surface, just lateral to the junctions
• 2cm distal to the lateral epicondyles of the elbows
• In the upper outer quadrants of the buttocks in the anterior fold of gluteus medius
• Posterior to the prominence of the greater trochanter (piriformis insertion)
• On the medial aspect of the knees, on the fatty pad, proximal to the joint line
• DIAGNOSTIC CRITERIA
  To confirm the diagnosis the concomitant systemic diseases should be ruled out and common coexisting conditions should be recognized.
  Time rule
  According to American College of Rheumatology criteria, there should be chronic widespread of pain for at least 3 months on a more or less continuous basis.3
  Sign and symptoms
  Pain should be present at multiple fibromyalgia tender points when pressure (approximately 4 kg/cm2) is applied manually, with pressure increases gradually at the rate of 1 kg per second over 4 seconds, as depicted in the image below. The pressure should cause no referred pain.5
  Besides pain and fatigue fibromyalgia symptom often include:
  • Unrefreshing sleep – waking up tired and stiff
  • Headaches – ranging from ordinary to a migraine
  • Irritable bowel frequent diarrhea or constipation sometimes accompanied by gas in the abdomen or nausea
  • Cognitive disturbance including lack of concentration and word mix up
  • Clumsiness and dizziness
  • Sensitivity to changes in the weather and to noise, bright light, smoke and other environmental factors
  • Allergies

  PHYSIOTHERAPY ASSESSMENT TOOLS

   

   
  Numerous instruments have been used in clinical trials of fibromyalgia syndrome. Pain – Vastly used and validated methods are
  • Visual Analog Scale (VAS)
  • Numeric rating scale
  • McGill Pain Questionnaire
  • CLASSIFICATION
    Many rheumatologists recognize 2 types of fibromyalgia6
    • Primary
    • Secondary
    Primary fibromyalgia is the most universally accepted form of fibromyalgia and is normally diagnosed when no underlying causes are present (such as arthritis, lupus etc) and at least 11 of 18 designated points are confirmed. The cause of primary fibromyalgia syndrome is unknown but it can be induced by trauma, infection, stress, inflammation or their factors.
    Secondary fibromyalgia may be triggered by conditions such as RA, Lupus, hypothyroidism, HIV. It may also be triggered by physical trauma. Secondary fibromyalgia is sometimes referred to as post-traumatic fibromyalgia. It is also known as regional fibromyalgia and is present in the patient who experiences pain at fewer than 11 of the 18 positive tender points
    Physio East Grinstead and Horsham- for more details please visit www.anrc-uk.com.

  • ANRC Physiotherapy clinic East Grinstead and Horsham

    ETIOLOGY AND PATHOGENESIS

    The etiology of fibromyalgia is multifactorial and includes both environmental and genetic factors.

    Biologic variablesCertain biologic variables contribute to the development and persistence of fibromyalgia (eg, physical trauma, exposure to toxins).

    Inheritance

    FMS has a genetic predisposition. First degree relatives of individuals with FMS display an eightfold greater risk of developing fibromyalgia than those in the general population.

    Gender

    Sex-related effects are important in fibromyalgia and with pain in general. Aversive stimuli and stressful tasks are more likely to evoke SNS, HPA axis, and psychological responses in females than in males.

    Sleep

    Almost all patients with fibromyalgia sleep poorly, and a night of poor sleep is followed by a more painful day. This contributes to negative mood and cognitive difficulties.

    Other variables

    Age is a variable; most cases occur between the ages of 20 and 50 years. Physical de-conditioning is also a variable.

    Physiotherapy management of Fibromyalgia please contact Physio East Grinstead

    Physiotherapist near to me- contact us on info@anrc-uk.com, for more details please visit www.anrc-uk.com 

    Medical tourism – Physiotherapy