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→Fibromyalgia
=Fibromyalgia=
=Fibromyalgia=
*H&P: Older women, history of depression or trauma, or IBS; widespread chronic muscle pain in pre-defined areas, insomnia, weakness, fatigue
*H&P: Older women, history of depression or trauma, or IBS; widespread chronic muscle pain in pre-defined areas, insomnia, weakness, fatigue
*Dx: WPI 3-6 and SSI > 9, or WPI ≥ 7 and SSI ≥ 5, labs are all negative
*Dx: WPI 3-6 and SSI > 9, or WPI ≥ 7 and SSI ≥ 5, labs are all negative. Order '''CBC, TSH, ESR''' to rule out anemia, hypothyroidism, or inflammatory arthropathy, which can look like fibromyalgia.
*Tx: TCAs, SSRIs, Gabapentin, Pregabalin, exercise, PT, hydrotherapy, heat, pain psych
*Tx: TCAs, SSRIs, Gabapentin, Pregabalin, exercise, PT, hydrotherapy, heat, pain psych