Connective Tissue Disorders: Fibromyalgia and Myofascial Pain Syndrome

Comprehensive practice question-and-answer flashcards based on lecture notes covering Fibromyalgia and Myofascial Pain Syndrome.

How was Fibromyalgia (FM) defined by the American College of Rheumatology in $1990$?

It was defined as a chronic condition characterized by widespread pain that affects multiple body regions, including the identification of $11$ of $18$ tender points at specific sites throughout the body.

What diagnostic criteria did Wolfe and associates add for Fibromyalgia in $2010$?

They developed preliminary diagnostic criteria in addition to the ACR-specific criteria, including the measurement of symptom severity using the Symptom Severity (SS) scale.

What items are included in the Symptom Severity (SS) scale for Fibromyalgia?

Somatic symptoms, not feeling refreshed after sleeping, fatigue, and cognition.

What is the estimated prevalence of Fibromyalgia in the general population?

Approximately $2\text{\%}$ of the population, representing nearly $3.5\text{ million}$ people.

What is the prevalence rate of Fibromyalgia among women ages $70$ to $79$?

$$7.4\text{\%}$$

How do Fibromyalgia symptoms differ between men and women regarding intensity and duration?

Women have greater pain intensity, while men report a longer duration of symptoms.

At what age do the first symptoms of Fibromyalgia typically appear, and what events often precede them?

Symptoms usually appear during early to middle adulthood, often developing after physical trauma (such as a motor vehicle accident) or a viral infection.

In which body regions is Fibromyalgia pain predominantly reported?

In the scapula, head, neck, chest, and low back.

What associated conditions have a higher incidence in individuals with Fibromyalgia?

Tendonitis, headaches, irritable bowel, temporal mandibular joint dysfunction, restless leg syndrome, mitral valve prolapse, anxiety, depression, and memory problems.

How is Fibromyalgia characterized regarding inflammation, degeneration, and progression?

It is a noninflammatory, nondegenerative, nonprogressive disorder.

What environmental, physical, and emotional factors can contribute to Fibromyalgia flare-ups?

Environmental stresses (weather changes, barometric pressure changes, cold, dampness, fog, rain), physical stresses (repetitive activities like typing or vacuuming, prolonged sitting/standing, rotating shifts), and emotional stresses (family, financial, or work-related issues).

What exercise parameters are recommended when initiating an exercise program for a patient with Fibromyalgia?

Begin at lower levels than those recommended by the American College of Sports Medicine (ACSM) for aerobic benefit and strengthening, and slowly increase the activity.

What should be done if exercise leads to an increase in Fibromyalgia symptoms?

Reduce the intensity of the exercise while encouraging continued participation.

How is Myofascial Pain Syndrome (MPS) defined?

MPS is defined as a chronic, regional pain syndrome.

What is the hallmark classification of Myofascial Pain Syndrome (MPS)?

Myofascial trigger points (TrPs) in a muscle that have a specific referred pattern of pain, along with sensory, motor, and autonomic symptoms.

What is a myofascial trigger point (TrP) and how is the pain described?

A trigger point is a hyperirritable area in a tight band of muscle, and the pain is described as dull, aching, and deep.

What is the difference between an active trigger point and a latent trigger point?

An active trigger point produces a classic pain pattern, whereas a latent trigger point is asymptomatic unless palpated.

According to Figure 11.8, what designation represents the most common trigger point location in the right piriformis muscle?

The lateral X, designated as TrP1.

What potential factors can cause myofascial trigger points (TrPs)?

Chronic muscle overload, acute muscle overload, poorly conditioned muscles, postural stresses (such as non-ergonomic workstations or leg length differences), and poor body mechanics.

What impairments are associated with myofascial trigger points besides pain?

Decreased range of motion (ROM) when the muscle is stretched, decreased strength in the muscle, and increased pain with muscle stretching.

What three main components make up the treatment plan for Myofascial Pain Syndrome?

1. Correct chronic overload. 2. Eliminate the trigger point. 3. Strengthen muscle using a muscle endurance protocol.

What options can be used to eliminate a myofascial trigger point?

Contract-relax-passive stretch done repeatedly until the muscle lengthens, contract-relax-active stretch in repetition, trigger point release, modalities, and dry needling.

Which muscle groups are typically targeted for muscle endurance protocols in MPS treatment?

Core and scapular stabilizing muscle groups to improve overall muscle performance.