Contents Part I Background Introduction Fibromyalgia Definition and Epidemiology Pathophysiology of Fibromyalgia

Transcription

1 Contents Part I Background Introduction... 3 Summary... 7 References Fibromyalgia Definition and Epidemiology... 9 Defining Fibromyalgia EpidemiologyofFibromyalgia Co-morbidConditions FibromyalgiaBurden Summary References Pathophysiology of Fibromyalgia Nerve Abnormalities Structural Changes Functional Changes Neurotransmitters Musculoskeletal Abnormalities MuscleDysfunction Cervical Spine Abnormalities Hormonal Factors GrowthHormone Thyroid Function Neuroendocrine Abnormalities InflammatoryMarkers Genetics Free Radicals and Antioxidants Trauma PredictiveFactors Summary References vii

2 viii Contents Assessment and Diagnosis AssessmentofFibromyalgia PainAssessment AssessmentofTreatableCo-morbidSymptoms Diagnosis of Fibromyalgia Summary References Part II Common Co-morbidities and Fibromyalgia Headache Pathophysiology of Headache and Fibromyalgia Evaluation and Diagnosis Migraine Treatment Acute Treatment for Migraine and Tension-Type Headache Prevention Treatment for Frequent Migraine or Tension-Type Headache. 67 InjectionsandAlternativeTreatments Cluster Headache Treatment Summary References Chronic Fatigue Syndrome Defining Chronic Fatigue Syndrome Epidemiology of Chronic Fatigue Syndrome Co-morbidity Pathophysiology of Chronic Fatigue Syndrome Role of Immune Deficiency in Chronic Fatigue Syndrome Assessment of Chronic Fatigue Syndrome Treatment of Chronic Fatigue Syndrome Summary References Irritable Bowel Syndrome Irritable Bowel Syndrome (IBS) Definition and Epidemiology Evaluation and Diagnosis Treatment Summary References Sleep Disturbance Consequences of Sleep Disturbance CardiovascularDisease Obesity Diabetes Pain Sensitivity

3 Contents ix Sleep Disturbance in Fibromyalgia MeasuringSleepDysfunctioninFibromyalgiaPatients Treating Sleep Disturbance in Fibromyalgia Medication BehavioralInventions SleepHygieneMeasures Cognitive-BehavioralTherapy NaturalRemedies Summary References Depression and Anxiety Epidemiology Evaluation and Diagnosis of Co-morbid Mood Disorders Self-Efficacy and Locus of Control Treatment Summary References Obesity and Metabolic Syndrome Obesity ObesityinFibromyalgia Consequences of Obesity TreatmentofObesity Metabolic Syndrome Metabolic Syndrome in Fibromyalgia Treatment of Metabolic Syndrome Summary References Part III Treatment Published Recommendations Ottawa Panel Evidence-Based Exercise Guidelines European League Against Rheumatism (EULAR) GermanInterdisciplinaryAssociationofPainTherapy LimitationsofCurrentGuidelines Summary References Medication Treatments EffectiveMedications Antidepressants Antiepileptics SleepTherapy Moderate Efficacy Medications

4 x Contents Minimal Efficacy Medications General Fibromyalgia Medication Recommendations EmergingTherapies Summary References Non-medication Treatments PhysicalTreatments Exercise Hydrotherapy Manual Therapy Yoga WorkSimplificationandPacing Acupuncture Psychological Treatments Cognitive-BehavioralTherapyandOperant-BehavioralTherapy LifestyleModifications SmokingCessation SleepHygiene Weight Management DevelopingaTreatmentProgram Summary References Nutritional Supplements Intravenous Nutrient Therapy Chlorella Pyrenoidosa Methionine Melatonin Vitamins VitaminC VitaminD Minerals Coenzyme Q Carnitine Omega-3FattyAcids Summary References Clinical Handouts Charting Assessment and Treatment Documentation Forms Charting Documentation Form 1: Fibromyalgia Tender Point Examination Charting Documentation Form 2: Fibromyalgia Patient Assessment Recording Sheet

5 Contents xi Charting Documentation Form 3: Revised Fibromyalgia Impact Questionnaire [FIQR] Charting Documentation Form 4: Screening for Psychological Distress. 191 Charting Documentation Form 5: Screen for Locus of Control Patient Educational Handouts Patient Handout 1: Understanding Fibromyalgia Patient Handout 2: Whole Body Stretches for Fibromyalgia Patient Handout 3: Exercise for Fibromyalgia Patient Handout 4: Pain Management Techniques Patient Handout 5: Relaxation Techniques Patient Handout 6: Sleep Management for Fibromyalgia Patients Patient Handout 7: Nutritional Supplements for Fibromyalgia References Part IV Special Populations Fibromyalgia and Pregnancy Epidemiology of Fibromyalgia During Pregnancy Fibromyalgia and Pregnancy FibromyalgiaPost-partum Fibromyalgia and Breastfeeding Treating Fibromyalgia Throughout Pregnancy Pre-conception Planning Pregnancy Modifying Non-medication Treatments During Pregnancy SafetyRatingSystems Analgesics Antidepressants Antiepileptics Sodium Oxybate Anti-emetics Labor and Delivery Safety Determinations with Breastfeeding Analgesics Antidepressants Sodium Oxybate Antiepileptics Planning for Nursing Success Summary References Fibromyalgia in Seniors FibromyalgiaAssessment Fibromyalgia Treatment in Seniors Non-medicationTherapy Medications

6 xii Contents Summary References Gender and Ethnic Issues Gender Differences in Fibromyalgia Symptoms and Treatment Response FibromyalgiaSymptoms Consultation Treatment Response Ethnic Differences in Fibromyalgia Symptoms and Treatment Response Fibromyalgia Prevalence Treatment Response Summary References Index

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