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WIMBLEDON 020 3772 5440
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  • Home
  • Private GP
  • Blood Tests
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  • Skin Surgery
    • Skin Surgery London
    • Skin Tag Removal
    • Mole Removal
    • Sebaceous Cyst Removal
    • Lipoma Removal
    • Earlobe Repair
  • More GP Services
    • Ear Wax Microsuction
    • Wart Removal
    • Ultrasound Scan
    • Echocardiogram
      (Heart Scan)
    • Dermatology
    • Lifestyle Services
      • Cervical Smear + HPV Testing
      • Hay fever and Allergy Injection
      • Ear Wax Syringing
      • ECG
      • Harmony® NIPT Test
      • Spirometry (Lung Function)
      • Other Lifestyle Services
    • Cortisone Injections
    • STD Testing
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Fibromyalgia

Diagnosis:

American college of rheumatology criteria –

Widespread pain for more than 3 months (pain left and right body, above and below waist, axial skeleton pain)

Trigger point tenderness (more than 11 out of 18 trigger points):

  • trigger points – occiput (bilateral, suboccipital), low cervical (bilateral C5-7), trapezius (bilateral, midline upper), supraspinatus (bilateral, above scapula spine medial border), second rib (bilateral, 2nd chostochondral junctions), lateral epicondyle (bilateral), gluteal (bilateral, upper outer quadrant), greater trochanter (bilateral, posterior to trochanteric process), knee (bilateral, medial fat pad proximal to joint line).
fibromyalgia

Fatigue – very common and disabling. May have some emotional/ psychological trauma.

Vegetative/ functional disorders – non restorative sleep, depression/ anxiety.

Differential Diagnosis:

SLE (systemic lupus erythematosus), polymyositis/ dermatomyositis, PMR (polymyalgia rheumatica) [elderly – mainly stiffness], Carcinoma.

Investigations needed:

FBC, ESR, ANA (DsDNA, ENA- anti centromere/ antiscl70), Immunoglobulins, Rheumatoid factor, CK, thyroid function tests.

Management:

  • Multidisciplinary/ inter-professional – Central sensitisation, cognitive beliefs.
  • Predictors of chronicity – previous pain, trigger points positive, distress, somatisation, fatigue, non restorative sleep, increased age, family history of chronic pain, low socioeconomic status. Also obesity, smoking, hypermobility and sedendary lifestyle.
  • Pharmacological –
    • Analgesia – nocioceptive pain – often normal analgesia does not help.
    • Tricyclics (amitriptyline) or SSRI’s or gabapentin/ pregabalin.
  • Non pharmacological –
    • Physical exercise – graduated exercise programme reduces pain/ increases function, improves sleep pattern, reduces fatigue/ low mood.
    • CBT (cognitive behavioural therapy) – active self management helps.
    • Acupuncture – not enough evidence.
  • Good predictors of prognosis – very distressed patients with significant deleterious effects on activities of daily living ( especially with CBT therapy). Short history of disease. Treatment started ASAP.
info@thegpsurgery.co.uk
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Wimbledon

21-23
Wimbledon Hill Road,
Wimbledon SW19 7NE
Phone: 020 3772 5440

Monday9:00 AM - 7:00 PM
Tuesday9:00 AM - 7:00 PM
Wednesday9:00 AM - 7:00 PM
Thursday9:00 AM - 7:00 PM
Friday9:00 AM - 7:00 PM
Saturday9:00 AM - 1:30 PM
SundayClosed

Fulham

117-121
Wandsworth Bridge Road,
Fulham SW6 2TP
Phone: 0208 049 6525

Monday9:00 AM - 1:30 PM
Tuesday9:00 AM - 1:30 PM
Wednesday9:00 AM - 1:30 PM
Thursday9:00 AM - 1:30 PM
Friday9:00 AM - 1:30 PM
Saturday9:00 AM - 1:30 PM
SundayClosed

Copyright © The GP Surgery - Care Quality Commission Regulated – 1-1313499070 - TERMS & CONDITIONS
Wimbledon Doctors: 21-23 Wimbledon Hill Road, Wimbledon, SW19 7NE, United Kingdom. Fulham Doctors: 117-121 Wandsworth Bridge Road, Fulham SW6 2TP
The GP Surgery Ltd. UK Company number 08398762 - Registered office address: 19-20 Bourne Court Southend Road, Woodford Green, Essex, United Kingdom, IG8 8HD . Website by DIGIBRU

No Result
View All Result
  • Home
  • Private GP
  • Blood Tests
  • Travel Vaccinations
  • Skin Surgery
    • Skin Surgery London
    • Skin Tag Removal
    • Mole Removal
    • Sebaceous Cyst Removal
    • Lipoma Removal
    • Earlobe Repair
  • More GP Services
    • Ear Wax Microsuction
    • Wart Removal
    • Ultrasound Scan
    • Echocardiogram
      (Heart Scan)
    • Dermatology
    • Lifestyle Services
      • Cervical Smear + HPV Testing
      • Hay fever and Allergy Injection
      • Ear Wax Syringing
      • ECG
      • Harmony® NIPT Test
      • Spirometry (Lung Function)
      • Other Lifestyle Services
    • Cortisone Injections
    • STD Testing
    • Specialist Clinics
    • Summary of Services and Fees
  • Your Team
  • Why Us
    • Why The GP Surgery?
    • Why a Private GP Surgery?
    • Join Us
    • Doctors Learning
    • Blog
  • Contact Us
    • Contact Form & Details
    • New Patient Registration
    • Blood Test and Investigation Consent Form

Copyright © The GP Surgery - Care Quality Commission Regulated – 1-1313499070 - TERMS & CONDITIONS
Wimbledon Doctors: 21-23 Wimbledon Hill Road, Wimbledon, SW19 7NE, United Kingdom. Fulham Doctors: 117-121 Wandsworth Bridge Road, Fulham SW6 2TP
The GP Surgery Ltd. UK Company number 08398762 - Registered office address: 19-20 Bourne Court Southend Road, Woodford Green, Essex, United Kingdom, IG8 8HD . Website by DIGIBRU

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