Myalgia in myositis and myopathies

Publication date: Available online 4 October 2019Source: Best Practice &Research Clinical RheumatologyAuthor(s): Stefanie Glaubitz, Karsten Schmidt, Jana Zschüntzsch, Jens SchmidtAbstractMyalgia is a common symptom of various neuromuscular disorders: myalgia occurs in metabolic muscle diseases, inflammatory muscle diseases, dystrophic myopathies and myotonic muscle disorders. Myalgia leads to a significantly reduced quality of life. Other muscular symptoms that are present along with myalgia often provide the clue towards a diagnosis and include weakness, cramps and myotonia as well as the type of pain. In addition, extramuscular symptoms like an erythema in dermatomyositis can lead to the correct diagnosis. Basic diagnostic workup includes a detailed medical history, full neurologic assessment, laboratory tests, EMG and nerve conduction studies. Muscle imaging, genetic testing and muscle biopsy may be required to make a diagnosis. Whenever possible, treatment should aim to improve or correct the underlying cause for myalgia such as inflammation or hypothyroidism. Symptomatic therapy includes different avenues: Myotonia can be treated with mexiletine. Carbamazepine or phenytoin can be used in myotonic syndromes, particularly with muscle cramps. Pregabalin, gabapentin, or amitriptyline can be tried in conditions with myalgic pain. This review summarizes the symptoms, diagnostic strategies, and therapeutic approach in neuromuscular disorders that present with myalgia.
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research

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CONCLUSION: Patients take most pain medication during the first postoperative week after adolescent ACLR, although patient and surgical variables had no notable influence on pill consumption. LEVEL OF EVIDENCE: Level IV, case series. PMID: 32213778 [PubMed - in process]
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Conclusions: Clinical symptoms and spinal fusion efficiency were not significantly different between CBT and PS except for postoperative improvement in low back pain. The treatment effect on postoperative low back pain was smaller for CBT than for PS. PMID: 32213798 [PubMed - as supplied by publisher]
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Authors: Ogon I, Takashima H, Morita T, Oshigiri T, Terashima Y, Yoshimoto M, Fukushi R, Fujimoto S, Emori M, Teramoto A, Takebayashi T, Yamashita T Abstract Study Design: Cross-sectional study. Purpose: The purpose of this study was to elucidate the relevance among Schmorl's node (SN), chronic low back pain (CLBP), and intervertebral disc degeneration (IVDD) with the use of magnetic resonance imaging T2 mapping. Overview of Literature: SN may be combined with CLBP and/or IVDD; however, their relationship has not been determined to date. Methods: A total of 105 subjects were included (48 men and 57 wome...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Authors: Rudy HL, Cho W, Oster BA, Tarpada SP, Moran-Atkin E Abstract Study Design: Retrospective cohort study. Purpose: To determine the effects of massive weight loss on perioperative complications after lumbar fusion surgery (LFS). Overview of Literature: Patients who are obese are more likely to experience low back pain, which would require LFS. Nonetheless, they have a higher risk of perioperative complication development compared with individuals who are not obese. Methods: Patients who underwent LFS at hospitals that participated in the National Surgical Quality Improvement Program database withi...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Conclusions: This study demonstrated that the use of CDR continued to increase. The most common complication was mechanical and/or bone-related, and cost analysis demonstrated no significant difference between inpatient and outpatient CDR. PMID: 32213792 [PubMed - as supplied by publisher]
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
I'm sure we all have them. The high HEART score patient with chronic chest pain who comes back every 2-3 days. I'm curious how you handle them as I got into a fight with one of my PAs who was angry I wouldn't admit the HEART score 5 chronic chest painer with 3 admissions already this month. I usually document "Patient has chronic chest pain, and this is unchanged from baseline. Workup shows no evidence of acute ischemia". Some of my colleagues admit these every single time and don't... HEART score in chronic chest pain
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Emergency Medicine Source Type: forums
Spine Intervention Society - COVID-19 Resources for Members Guidance on Interventional Pain Procedures During the COVID-19 Global Emergency When planning for interventional pain procedures during the COVID-19 emergency, consider the Centers for Disease Control and Prevention (CDC) statement regarding goals for the U.S. healthcare system in response to COVID-19: Reduce morbidity and mortality Minimize disease transmission Protect healthcare personnel... SIS Guidance on Spinal Procedures During COVID-19 Pandemic
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Publication date: Available online 27 March 2020Source: Brain, Behavior, and ImmunityAuthor(s): Mpumelelo Ntogwa, Satoshi Imai, Ren Hiraiwa, Madoka Koyanagi, Mayuna Matsumoto, Takashi Ogihara, Shunsaku Nakagawa, Tomohiro Omura, Atsushi Yonezawa, Takayuki Nakagawa, Kazuo Matsubara
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Publication date: Available online 27 March 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): A. Roquilly, B. Vigué, M. Boutonnet, P. Bouzat, K. Buffenoir, E. Cesareo, A. Chauvin, C. Court, F. Cook, A.C. de Crouy, P. Denys, J. Duranteau, S. Fuentes, T. Gauss, T. Geeraerts, C. Laplace, V. Martinez, J.F. Payen, B. Perrouin-Verbe, A. Rodrigues
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 27 March 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Marc-Olivier Fischer, Anne-Lise Fiant, Stéphane Debroczi, Mariam Boutros, Léa Pasqualini, Marguerite Demonchy, Frédéric Flais, Arnaud Alves, Jean-Louis Gérard, Clément Buléon, Jean-Luc Hanouz, for the PANEX3 study group
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
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