31st January 2024

Presentation

Fibromyalgia

Fibromyalgia is a somatic syndrome consisting of a wide range of symptoms. The principal feature of fibromyalgia is widespread pain. Generalised hypersensitivity to stimuli, sleep disturbance, fatigue, cognitive impairment such as memory loss or poor concentration, and bladder and bowel abnormalities can also occur. There is overlap between fibromyalgia and other functional somatic syndromes, such as chronic fatigue syndrome.

CRPS

CRPS is a painful condition affecting a limb. It commonly arises after injury to the limb; however, there may be no precipitating trauma. Injuries precipitating CRPS include sprains, surgical wounds, fractures, burns or even venepuncture or cannula sites. Symptoms of CRPS usually develop at the time of injury or days to weeks later, and occasionally, it can occur months later. The symptoms tend to start within one month of the trauma. The syndrome usually affects one limb, but in a small number of cases, it spreads to involve additional limbs. In addition to pain, symptoms include:

• Functional motor impairment, for example, reduction in handgrip 
• Sensory disturbance with hyperalgesia and allodynia
• Autonomic features such as differences in sweat, skin colour, temperature or oedema
• Trophic changes, including skin atrophy, changes in hair growth and contractions of joints

References

• British Society for Rheumatology. Fibromyalgia Syndrome (FMS) Parliamentary Briefing. [Internet]. rheumatology.org.uk [cited 29 April 2022]. Available from: https://www.rheumatology.org.uk/news/details/Briefing-Fibromyalgia 
• UpToDate [Internet]. Complex Regional Pain Syndrome in Adults: Pathogenesis, Clinical Manifestations and Diagnosis. Uptodate.com. 2021 [cited 29 April 2022]. Available from: https://www.uptodate.com/contents/complex-regional-pain-syndrome-in-adults-pathogenesis-clinical-manifestations-and-diagnosis?search=chronic%20regional%20pain%20syndrome&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
• Medscape [Internet]. Complex Regional Pain Syndromes. medscape.com. 2018. [cited 29 April 2022]. Available from: https://emedicine.medscape.com/article/1145318-clinical#b1