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Non-Articular Rheumatism (Fibromyalgia (Treatment (non-pharmacological…

- - - - does not require a tender point examination.
        
        preliminary criteria: symptoms present at a similar level for at least three months, and no other disorder.
        
        combine a widespread pain index (WPI) {measure of the number of painful body regions from a defined list of 19 areas.} and a symptom severity (SS) scale
      - symptom severity (SS) scale
        
        For the each of the 3 symptoms below, indicate the level of severity over the past week using the following scale:
        -Fatigue (0-3)
        -Waking unrefreshed (0-3)
        -Cognitive symptoms (0-3)
        0 = no problem
        1 = slight or mild problems, generally mild or intermittent
        2 = moderate, considerable problems, often present and/or at a moderate level
        3 = severe, pervasive, continuous, life- disturbing problems
        
        somatic symptoms in general, indicate whether the patient has:
        -No symptoms (0)
        -Few symptoms (1)
        -A moderate number of symptoms (2)
        -A great deal of symptoms (3)
        muscle pain, irritable bowel syndrome, fatigue/tiredness, thinking problem, muscle weakness, headache, pain/cramps in the abdomen, numbness/tingling, dizziness, insomnia, depression, constipation, pain in the upper abdomen, nausea, nervousness, chest pain, blurred vision, fever, diarrhea, dry mouth, itching, wheezing, Raynaud's phenomenon, hives/welts, ringing in ears, vomiting, heartburn, oral ulcers, loss of/change in taste, seizures, dry eyes, shortness of breath, loss of appetite, rash, sun sensitivity, hearing difficulties, easy bruising, hair loss, frequent urination, painful urination, and bladder spasms.
      - A patient satisfies diagnostic criteria for fibromyalgia if the following 3 conditions are met:
        1) Widespread pain index (WPI) ≥7 and symptom severity (SS) scale score ≥5 or WPI 3-6 and SS scale score ≥9.
        2) Symptoms have been present at a similar level for at least 3 months.
        3) The patient does not have a disorder that would otherwise explain the pain.
- - - - Morning stiffness duration >45 min - 2 points
        
        Hip pain or limited ROM - 1 point
        
        Absence of other joint involvement- 2 points
        
        At least one shoulder with subdeltoid and/or biceps tenosynovitis and/or N/A 1 glenohumeral synovitis (either posterior or axillary) and at least one hip with synovitis and/or trochanteric bursitis
        
        Both shoulders with subdeltoid bursitis, biceps tenosynovitis, or gleno-humeral synovitis