Fibromyalgia: a growing problem in rehabilitation

Introduction. Fibromyalgia is a syndrome characterized by a chronic widespread pain, patients also present a range of other symptoms, including sleep disturbance, fatigue, irritable bowel syndrome, headache, and mood disorders (1). The aim of our study is to define the functional level of fibromyalgia patients. Materials and methods. We observed, in the period between July 2011 and March 2012, 41 patients with fibromyalgia. All patients were classified with the Brief ICF Core Set for chronic widespread pain and evaluated with the following questionnaires: Fibromyalgia Impact Questionnaire (FIQ); Brief Pain Inventory (BPI); Widespread Pain Index (WPI); Symptom Severity Score (SS score); Medical Outcome Study (MOS) Sleep scale; Hospital Anxiety and Depression Scale (HADS); Short Form 12 (SF-12). Results. The mean age of the 41 women observed was 45 y.o. (range 23-75). Using the Brief ICF Core Set for chronic widespread pain, the most affected categories for Body functions was the “sensation of pain” (b280); for Activities and Participation, “lifting and carrying objects” (d430). As for Environment factors, all that examined categories were mostly perceived as a facilitator rather than barrier. At the FIQ: 9 of our patients (22%) had mild disability, 14 (35%) a moderate disability, and 17 (43%) severe. All our patients resulted anxious and depressed at the HADS. The mean Pain Severity score at BPI was 6.75 and the mean Interference Index was 6.46. The evaluation of the quantity and quality of sleep was done with the MOS scale, it resulted that the time to fall asleep was about 15 min for 52% of patients, 16-30 min for 14% of patients, 31-45 min for 10% of patients, and 46-60 min for 24% patients. The quality of life of people with fibromyalgia resulted to be significantly reduced, evaluated by the SF-12, in fact the mean value of PCS was 28.08 and MCS 41.62. Conclusions. Fibromyalgia is a syndrome characterized not only by a chronic widespread pain, but by many other symptoms as well. The unpredictable and fluctuating course of symptoms interfere with patients’ ability to plan work or social activities, patients change also their perception of self. In agreement with previous literature data our results report that women affected by fibromyalgia present a reduction in the performance of daily life activities. Bibliography 1. Neha Garg, MD Atul Deodhar, MD. New and Modified Fibromyalgia Diagnostic Criteria Ambiguity, uncertainty, and difficulties complicate diagnosis and management. The Journal of Musculoskeletal Medicine. Vol. 29 No. 1 February 8, 2012. 2. Alarcos Cieza, Gerold Stucki, Martin Weigl, Lajos Kullmann, Thomas Stoll, Leonard Kamen, Nenad Kostanjsek and Nicolas Walsh. ICF Core set for chronic widespread pain. J Rehabil Med 2004; Suppl. 44: 63–68. 3. D. A. Williams and Lesley M. Arnold. Measures of Fibromyalgia. Fibromyalgia Impact Questionnaire (FIQ), Brief Pain Inventory (BPI), Multidimensional Fatigue Inventory (MFI-20), Medical Outcomes Study (MOS) Sleep Scale, and Multiple Ability Self-Report Questionnaire (MASQ) Vol. 63, No. S11, November 2011, pp S86–97