A 45-year-old woman presents with chronic widespread pain, fatigue and non-restorative sleep. Examination shows multiple tender points but no synoviti...

Question

A 45-year-old woman presents with chronic widespread pain, fatigue and non-restorative sleep. Examination shows multiple tender points but no synovitis. Routine blood tests are normal. What is the most appropriate initial management strategy?

Accepted Answer

Provide education about fibromyalgia, encourage graded aerobic exercise and consider low-dose Amitriptyline

Answer

Start high-dose opioids for chronic pain control

Answer

Reassure that tests are normal and discharge with no follow-up

Answer

Refer for urgent rheumatology opinion for suspected inflammatory arthritis

Answer

Start long-term systemic steroids

uk-plab-1 MCQ (SBA): Fibromyalgia – initial management

A 45-year-old woman presents with chronic widespread pain, fatigue and non-restorative sleep. Examination shows multiple tender points but no synovitis. Routine blood tests are normal. What is the most appropriate initial management strategy?