Rationale
Complaints of non-articular generalized pain are common, often chronic and can be difficult to manage.
Causal Conditions
(list not exhaustive)
- Fibromyalgia / Chronic fatigue syndrome
- Polymyalgia rheumatica (PMR)
- Mental health disorders (e.g., depression, somatic symptom disorders)
Key Objectives
Given a patient with a generalized pain disorder, the candidate will differentiate articular from non-articular pain, diagnose the cause, severity, and complications, and will initiate an appropriate management plan.
Enabling Objectives
Given a patient with generalized pain disorder, the candidate will
- list and interpret critical clinical findings, including
- findings on history and physical examination which
- differentiate fibromyalgia from other generalized pain syndromes and specific articular disease;
- suggest other pain syndromes which may be associated with serious complications;
- PMR and temporal arteritis;
- Depression and suicide;
- findings on history and physical examination which
- list and interpret appropriate investigations (e.g., erythrocyte sedimentation rate, temporal artery biopsy), including
- recognizing that many generalized pain disorders are associated with normal investigations;
- construct an effective initial management plan appropriate for the working diagnosis, including
- when appropriate, take a multidisciplinary approach (e.g., physiotherapy, psychosocial support);
- determine if the patient requires specialized care.