#6 Become a Fibromyalgia and Chronic Pain Master, Part 1

May 4, 2016 | By Matthew Watto, MD

This episode, part 1 of 2, is a must listen if you’ve ever felt helpless in the face of fibromyalgia and chronic pain. Listen as we “curbside” expert clinician and prominent researcher Dr. Daniel Clauw, from the University of Michigan’s Chronic Pain and Fatigue Research Center. The show is chock full of clinical pearls for the mastery of chronic pain syndromes. 

Take Home Points:

1. Recognize the symptom pattern of multifocal pain with fatigue, memory problems and sleep disturbances as fibromyalgia.
2. Intervene early and you can prevent disability, development of narcotic addiction and a vicious cycle of comorbidity.
3. Fibromyalgia can be present in addition to a chronic nociceptive conditions e.g. rheumatoid arthritis, lupus, sickle cell disease
4. There are lots of evidence based nonpharmacologic and pharmacologic therapies for fibromyalgia and chronic pain. Read Dr. Clauw’s JAMA review and use them!

Clinical Pearls

• Dr. Clauw’s YouTube video and Fibroguide.com website work better than meds
• Give Cyclobenzaprine 5-15 mg about three hours before bed to minimize next day grogginess
• Give two thirds of sedating meds like gabapentin, pregabalin in the evening and one third in the morning
• Drop the tender point exam. Instead use the new 2011 ACR Criteria to diagnose fibromyalgia

Recommended Reading:

Claus, DJ. Fibromyalgia: a clinical review. JAMA. 2014 Apr 16;311(15):1547-55. doi: 10.1001/jama.2014.3266.
Clauw, Daniel J. Fibromyalgia and Related Conditions. Mayo Clin Proc. 2015; 90(5):680-692.

Resources for patients

Chronic Pain – Is it All in Their Head? – Daniel J. Clauw M.D.

FIBROGUIDE.com