Question

Ms. H is a 40 year old Hispanic female with a 2 year history of chronic joint pain related to a diagnosis of Systemic Lupus. Recently, she was diagnosed with a secondary diagnosis of Fibromyalgia by her rheumatologist and referred to a pain medicine practice. Ms. H is having difficulty with widespread body pain, joint pain to her shoulders, knees, and hips, fatigue, nausea, dizziness, and brain fog. Her lab work and vital signs have been primarily normal for the past year. Ms. H is having difficulty working even part time as a teachers aid, and caring her her kids, which are ages 10 and 12. She also feels like her social life is lacking due to having to miss scheduled dates with friends and family. During her visit with the pain doctor, Ms. H rates her pain an 8/10 to her joints, and 6/10 for her widespread body pain.

Please answer these questions:

1. What about Ms. H's primary diagnosis of Lupus made her susceptible to developing Fibromyalgia?

2. Why does Ms. H state that it hurts when she lightly bumps herself against items or when she gets a hug from her kids? Why is her pain tolerance now so low?

3. What medications could be prescribed for the treatment of the joint pain related to Lupus and the Fibromyalgia pain? And how due each of these work to reduce pain?

4. What non-pharmacologic pain treatments are available to help with pain and possibly increase function? Why might each of these recommendations be helpful?