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Diffuse pain syndromes in the elderly
1Asheville Arthritis and Osteoporosis Center, North Carolina, USA. drkrisg@aol.com
Rheumatic Diseases Clinics of North America
|September 16, 2000
Summary
Diffuse pain syndromes like fibromyalgia and polymyalgia rheumatica (PMR) are common in older adults. Differentiating these conditions requires careful evaluation, including medical history, physical exams, lab tests, and steroid response.
Area of Science:
- Geriatrics
- Rheumatology
- Pain Medicine
Background:
- Diffuse pain syndromes are prevalent in the elderly population.
- Fibromyalgia and polymyalgia rheumatica (PMR) are the most frequent causes.
- Other conditions, including inflammatory, endocrine, and neoplastic diseases, can also manifest as diffuse pain.
Purpose of the Study:
- To outline diagnostic approaches for differentiating common diffuse pain syndromes in older individuals.
- To highlight the potential for fibromyalgia to be a secondary condition.
- To emphasize the importance of considering alternative diagnoses when treatment response is suboptimal.
Main Methods:
- Comprehensive patient history and physical examination.
- Screening laboratory tests.
- Observational assessment of response to a low-dose corticosteroid trial.
Main Results:
- A systematic approach combining history, physical exam, labs, and steroid trial aids in differential diagnosis.
- Fibromyalgia can occur secondary to other diffuse pain conditions.
- Inadequate treatment response may indicate an underlying or alternative diagnosis.
Conclusions:
- Accurate differentiation of diffuse pain syndromes in the elderly is crucial for effective management.
- Clinicians should consider secondary fibromyalgia and reassess diagnoses if initial treatments fail.
- A multi-faceted diagnostic strategy improves patient outcomes.