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Fibromyalgia M79.7 729.1

Fibromyalgia trigger point image

synonyms: fibromyalgia, fibromyositis, fibrositis, idiopathic myalgia

Fibromyalgia ICD-10

  • M79.7 - Fibromyalgia

Fibromyalgia ICD-9

  • 729.1 Myalgia and myositis, unspecified

Fibromyalgia Etiology / Epidemiology / Natural History

  • Fibromyalgis = Pain in all 4 quadrants of the body, as well as in the axial skeleton continuously for at least 3 months and the presence of at least 11 of 18 anatomically specific tender points. Tender points are painful areas when pressure (4 kg) is applied, without referred pain.
  • Disturbances within the central nervous system (CNS) known as central sensitization represent the most likely etiology.
  • Patients have demonstrated biochemical changes in the CNS, low levels of serotonin, 4-fold increase in nerve growth factor, elevated levels of substance P.
  • Affects 2% of the general population. 3.4% of women and 0.5% of men.
  • Women/male = 5/1, any age. Most common 20-50 y/o

Fibromyalgia Anatomy

  • Tender Points

Fibromyalgia Clinical Evaluation

  • "I hurt all over all the time." Constant burning, aching, and soreness. Location migrates and intensity varies.
  • Digital palpation performed with 4 kg force causing pain in 11 of 18 Tender Pointsindicates Fibromyalgia.
  • Fatigue, nonrestorative sleep, paresthesias, memory difficulties.

Fibromyalgia Xray / Diagnositc Tests

  • No tests diagnose fibromyalgia
  • All routine labs will be normal including ESR, CRP.

Fibromyalgia Classification / Treatment

  • Referral to Rheumatologist / PMR / Primary care
  • Physical therapy, trigger-point injections, cognitive behavioral therapy, relaxation training, group therapy, biofeedback, stress management, exercise.
  • Tricyclic antidepressants, serotonin/norepinephrine reuptake inhibitors, NSAIDs.

Fibromyalgia Associated Injuries / Differential Diagnosis

  • Sleeping Disorders (60%)
  • Restless-legs syndrome (25%)
  • Myofascial pain syndrome
  • Irritable bowel syndrome
  • Dysmenorrhea
  • Depression
  • Lyme Disease
  • Premenstrual syndrome
  • Hypothyroidism
  • Muliple sclerosis
  • And many many more

Fibromyalgia Complications

  • Recurrent flare-ups
  • Depression

Fibromyalgia Follow-up Care

  • No cure exists. Education, lifestyle changes, stress reduction, increased physical activity can significantly improve symptoms.

Fibromyalgia Review References