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All About FibromyalgiaA Guide for Patients and their Families$
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Daniel J. Wallace and Janice Brock Wallace

Print publication date: 2002

Print ISBN-13: 9780195147537

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195147537.001.0001

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“I’m Stiff and Achy”— Musculoskeletal Complaints

“I’m Stiff and Achy”— Musculoskeletal Complaints

9 “I’m Stiff and Achy”— Musculoskeletal Complaints
All About Fibromyalgia

Daniel J. Wallace

Janice Brock Wallace

Oxford University Press

Patients with each of the 150 distinct rheumatic disorders frequently have overlapping muscle and joint complaints. Weakness, myalgias, arthralgias, spasm, lack of endurance, and stiffness are prominent features of fibromyalgia that may be difficult to differentiate from other conditions. The prominence of complaints in this area is what frequently brings patients to a musculoskeletal specialist such as a rheumatologist, as opposed to an infectious disease expert, general internist, or endocrinologist. Abigail was devastated after the unexpected death of her younger brother at age 30. Her physical and mental health had seemed tenuous, but she managed to pull herself together for the funeral and the visits of relatives from the Midwest. When it was over, Abigail’s coping skills began to fray. First, she began experiencing left-sided upper back pain and thought it was from lifting Aunt Minnie’s suitcase when taking her to the airport. Abigail saw the chiropractor she had consulted three or four times over a five-year period for similar backaches. However, this time the pain did not go away and spread to the right side. Dr. Johnson’s manipulations usually “snapped things back into place,” but this time they made her worse. Abigail became very concerned when her fiancée tried to take her to Myrtle Beach for a relaxing weekend and found that she was in agony whenever he hugged her. Although she had been an aerobics instructor, Abigail found it very difficult to do her morning exercise routine and after several weeks gave up. Trying to exercise was extremely painful. Innocent movements such as washing her back in the shower caused her muscles to tighten up and go into spasm. Dr. Johnson referred her to a rheumatologist, who diagnosed fibromyalgia and instituted a medication, education, and rehabilitation program. Over 80 percent of fibromyalgia patients have muscular symptoms or signs. Aching in the muscles, or myalgias, is common in the upper or lower back and neck area. Myalgias are usually present on both the right and left sides and present as a dull, throbbing discomfort. Spasm, defined as an involuntary muscular contraction, is less common than the sense of tightness in muscles that seems like spasm.

Keywords:   anemia, colchicine, deconditioning, infections, joint complaints, multiple sclerosis, neck osteoarthritis, osteoarthritis, polymyositis, soft tissue complaints

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