Early Screening and Early Intervention Strategy for Fibromyalgia

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Moldofsky, in personal communication advocated for early intervention of fibromyalgia patients by screening for it shortly after accidents. Such patients are seen by a variety of health care professionals including family doctors, orthopedic surgeons, chiropractors, physiotherapists, massage therapists and various alternative medicine practitioners. It would be wise if all were trained should be trained to screen for fibromyalgia early the diseases process.

The higher the risk of fibromyalgia, the greater the need for early screening. Screening targets should include anyone developing poor sleep and widespread unexplained muscle pains after an accident.

One screening questionnaire to that is very brief, called the FiRST.

Physical examination of tender points with the thumb is a useful, but not essential part of screening. This can be done by inexpensive hand-held algometers which as of 2020 readily available online through retailer including Walmart. In the absence of an algometer is advisable to at least palpate with the thumb one or two of the more common tender points such as the left and right lateral epicondyles or the left and right trapezium Diagrams show the locations are readily available online.

If a screener had only 30 seconds to screen a patient in the weeks and month after an accident, and if they could only ask two questions, the author suggests the following: “Since your accident have you found that you have developed muscle pains in multiple areas of your body that are not easily explained (e.g. pains in areas that were not clearly directly injured)? Are these pains made worse by stress or poor sleep the night before?

If a patient screens positive, then they should do a more detailed test, such as the American College of Rheumatology 2016 test for fibromyalgia.

It is likely that early screening will intercept patients early on. Once formally diagnosed, then early treatment is advisable.