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Fibromyalgia — SCE Rheumatology MCQ

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HardExercise PrescriptionFibromyalgiaSCE Rheumatology

A 38-year-old woman with fibromyalgia avoids activity because previous bursts caused symptom flares. She wants a plan that feels safe. What is the most appropriate management?

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Correct answer: A — Start low and progress gradually using pacing and shared goals

The best answer is “Start low and progress gradually using pacing and shared goals”. Start low and progress gradually using pacing and shared goals is the most appropriate next step after the disease phenotype, previous treatment and safety constraints in the stem are considered. The remaining choices—“Prescribe maximal exercise to override pain, with clinical reassessment”, “Advise complete avoidance of physical activity, within a rheumatology pathway”, “Use immobilisation as the main treatment, after safety review”, “Increase training volume after every flare, after specialist assessment”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: EULAR fibromyalgia recommendations: https://ard.bmj.com/content/76/2/318