Chronic Pain Syndrome

Aka: Chronic Pain Syndrome

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II. 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

III. 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

IV. 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

V. Evaluation

  1. See Chronic Pain Evaluation

VI. Management

  1. See Chronic Pain
  2. See Chronic Pain Resources
  3. Medications
    1. Amitriptyline (Elavil) at bedtime
    2. Selective Serotonin Reuptake Inhibitor (SSRI)

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