“I have pain all over my body” is a challenging response after you’ve asked a new patient what brings them in for their visit. You immediately suspect that this patient has fibromyalgia. The prevalence of fibromyalgia in the U.S. is 5 million people, and it is among the most common conditions in many rheumatology practices….
(Reuters Health)—Spinal manipulation may work as well for easing lower back pain as anti-inflammatory medications, a research review concludes. Based on data from 15 previously conducted trials involving a total of 1,711 adults, the study team found that spinal manipulation achieved meaningful reductions in pain and improvements in function after six weeks of treatment. The…
Take the challenge. CPT: 99203 This encounter is coded as 99203, because it included: History—The history of present illness was extended. The review of systems was complete, and the past medical, family and social were documented. This makes the history comprehensive. Examination—Expanded detailed. Medical decision making—The diagnosis was a new problem with no additional workup…
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
WASHINGTON, D.C.—Successful management of pain remains a challenge for rheumatologists. Five research abstracts presented at the 2016 ACR/ARHP Annual Meeting in a session titled Pain—Basic and Clinical Aspects offered new insights on pain sensitization, and the risks and effects of various pain therapies. Knee Pain After Surgery Can we predict which patients will have longer-term…
Brain imaging can distinguish fibromyalgia patients from healthy controls with high sensitivity and specificity, according to two papers published nearly simultaneously in Pain late last summer, by groups at the Universities of Colorado and Michigan, respectively. Somewhat surprisingly to the authors and others, in the Colorado study, which used both painful and nonpainful stimuli, the…
In the good old days, physicians routinely made house calls. The decision to visit the literal bedside of a patient was practical: hospital services were primitive and often offered too little benefit to justify an emergency journey by the patient. These physicians carried leather bags, sometimes called Gladstones, that were filled with instruments for eventualities…
If left untreated, low back pain can cause long-term disability. To aid its diagnosis and management, the National Institute for Health and Care Excellence has released revised guidance. Recommendations include the use of risk stratification tools for diagnosis, as well as physical activity or a comprehensive program that addresses biomechanical, aerobic and/or psychological needs…
WASHINGTON, D.C.—Despite the value of guidelines, they often “are not read,” said N. Lawrence Edwards, MD, professor of medicine specializing in rheumatology at the University of Florida, at the 2016 ACR/ARHP Annual Meeting talk titled, New & Emerging Therapies for Gout, as part of the ACR Review Course. Or if they are read, they aren’t…
(Reuters Health)—People should try non-drug treatment options like massage or stretching for most cases of chronic low back pain before choosing treatment with over-the-counter or prescription drugs, according to new guidelines from the American College of Physicians (ACP). If the pain began recently, the guidelines recommend superficial heat, massage, acupuncture or spinal manipulation. If patients…