Headache, back ache, and fibromyalgia.

[101N]

So the prevalence of these three common clinical conditions is about: 30% cLBP, 20% for HA/Migraine, and 5% for FMS.
If they are valid, unique, diagnoses then their co-occurance should be the product of their prevalence: .3 x .2 x .05 = .3%
A pretty rare situation to see all three in the same person.

So why isn't this born out clinically? Why do they co-occur with such an astonishing frequency,
if you go to the trouble of screening patients for all three?

1. Migraine in FMS pts 58%: http ://www.ncbi.nlm.nih.gov/pubmed/25994041
2. FMS in cLBP patients 42%: http://www.ncbi.nlm.nih.gov/pubmed/24022710
3. FMS in HA patients 36%: http://www.ncbi.nlm.nih.gov/pubmed/19170692
4. Backache and HA in FMS pt's 35%: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829161/table/T2/


Could it be that a LARGE share of the HA, cLBP, and FMS in working-aged adults is merely
somatic symptom disorder with predominant pain? Isn't time for rheumatologists, neurologists,
and pain management folks to stop pretending that these are 'nociceptive' syndromes.

"Overwhelming evidence reveals that what is often labeled as a single chronic regional pain syndrome is, upon closer evaluation,
a chronic illness beginning much earlier in life, where the pain merely occurs at different points
of the body at different points of time and is given different labels by the subspecialists focusing on "their region of the body".

Dan Clauw

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[ampaphb]

Could be, but given that there is significant overlap between fms and CLBP diagnostic criteria, acting surprised that there is crossover is disingenuous

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[lobelsteve]

CLBP is not a diagnosis. It is a location of a symptom present for more than 3 months.

 

[101N]

I agree. I don't think any of the three syndromes are a diagnosis.

 

[ampaphb]

The AMA, in the form of ICD9 & 10 codes, disagree

 

[101N]

Two codes to bind them all: F45.42 & G89.4.

 

[ampaphb]

M79.7, M54.5

 

[SSdoc33]

So the prevalence of these three common clinical conditions is about: 30% cLBP, 20% for HA/Migraine, and 5% for FMS.
If they are valid, unique, diagnoses then their co-occurance should be the product of their prevalence: .3 x .2 x .05 = .3%
A pretty rare situation to see all three in the same person.

So why isn't this born out clinically? Why do they co-occur with such an astonishing frequency,
if you go to the trouble of screening patients for all three?

1. Migraine in FMS pts 58%: http ://www.ncbi.nlm.nih.gov/pubmed/25994041
2. FMS in cLBP patients 42%: http://www.ncbi.nlm.nih.gov/pubmed/24022710
3. FMS in HA patients 36%: http://www.ncbi.nlm.nih.gov/pubmed/19170692
4. Backache and HA in FMS pt's 35%: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829161/table/T2/

Could it be that a LARGE share of the HA, cLBP, and FMS in working-aged adults is merely
somatic symptom disorder with predominant pain? Isn't time for rheumatologists, neurologists,
and pain management folks to stop pretending that these are 'nociceptive' syndromes.

"Overwhelming evidence reveals that what is often labeled as a single chronic regional pain syndrome is, upon closer evaluation,
a chronic illness beginning much earlier in life, where the pain merely occurs at different points
of the body at different points of time and is given different labels by the subspecialists focusing on "their region of the body".

Dan Clauw

if your medical career putters out, you might want to consider philosophy.

nobody thinks that there is zero central component. most of us believe it is a combination of the 2.