Lucinda Bateman MD Feb 2017

3395 persons, Ontario, Canada The prevalence of FM: The prevalence of FM: 2.0% of adults both sexes 3.3% of adults both sexes 3.4% of women 4.9% of women 0.5% of men 1.6% of men Prevalence increased with age Prevalence rises with age from highest values were in 1% of women 18-30 to > 7.0% of women 60 and 79 years 8% in women 55-64. [...] The prevalence of fibromyalgia by: 1990 ACR FM criteria = 1.7% modified 2010 ACR criteria = 5.4% The ratio of females to males was: 1990 ACR FM criteria = 13:1 2010 ACR FM criteria = 2:1 ACR FM 2010 raises prevalence by 3X compared to 1990 The Prevalence of Fibromyalgia in the General Population:A Comparison of the American College of Rheumatology 1990, 2010, and Modified 2010 Classi. [...] (PAIN/doi/10.1016/j.pain.2013.06.001) treatment would be a great accomplishment." Pain symptoms ofSFPN cold-like pain, tingling or a pins and needles burning pain transient electric shock–like pain may worsen during periods of rest and at night Small nerve fiber neuropathies also may resultin autonomic dysfunction and multisystemillness symptoms, including orthostatic intolerance… dry ey. [...] Physical activity: the right amount Not too little Not too much FM PAIN Utilize CNS-pain modulating drugs: Drugs (FDA approved) for FM Anticonvulsant: pregabalin (Lyrica) SNRI: duloxetine and milnacipran (Savella) Drugs (non-FDA approved) used for FM gabapentin ○ Other anticonvulsants: topiramate, zonisamide Low dose TCA: amitriptyline, doxepin, cyclobenzaprine SNRI: levomilnac. [...] In very low doses (4.5 mg) LDN may paradoxically decrease pain due an increase in the release of endogenous opioids with transient blockade calm microglial cell activation in the CNS (anti-inflammatory or neuroinflammatory agent) Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing.