Pain

Chronic Pain Syndrome

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Chronic Pain Syndrome

  • Diagnosis of exclusion
  1. See Chronic Pain Causes
  2. Diffuse Arthralgia and myalgia
  3. No organic signs
    1. No Joint Swelling
    2. No Muscle Weakness
    3. No weight loss
    4. No fever
  • Precautions
  1. Avoid ordering too many labs
  2. Patient may obsess over a mild abnormality
  3. Diagnostic tests with common mild abnormalities
    1. Serologies
    2. Electromyogram (EMG)
    3. CT or MRI Imaging
  • Differential Diagnosis
  1. Fibromyalgia
  2. Myofascial Pain Syndrome
  3. Chronic Fatigue Syndrome
  4. Eosinophilia-Myalgia Syndrome
  5. Temporomandibular Joint Dysfunction syndrome
  6. Multiple chemical sensitivity
  7. Post Traumatic back pain or Neck Pain
  8. Reflex Sympathetic Dystrophy (RSD)
  9. Chronic Pelvic Pain
  • Evaluation
  1. See Chronic Pain Evaluation
  • Management
  1. See Chronic Pain
  2. See Chronic Pain Resources
  3. Medications
    1. Amitriptyline (Elavil) at bedtime
    2. Selective Serotonin Reuptake Inhibitor (SSRI)