#532: Updates in Fibromyalgia Management featuring Dr. Dan Clauw
Summary
Dr. Daniel Clauw joins the Curbsiders to update clinicians on fibromyalgia, emphasizing nociplastic pain and central sensitization over outdated tender point exams. He discusses diagnostic strategies, including body maps and assessing sensory sensitivities, while highlighting non-pharmacologic treatments like graded activity and sleep hygiene as first-line therapies. The episode also explores the bidirectional relationship between chronic pain and mood disorders, offering practical guidance for primary care management.
Topics discussed
Intro and puns
Guest introduction and mentoring
Fibromyalgia diagnosis and nociplastic pain
Sponsors: Quince and Breeze
Etiology and central sensitization
Patient communication and workup
Diagnostic criteria and physical exam
Non-pharmacologic therapies and exercise
Medications: SNRIs, TCAs, and gabapentinoids
Opioids and low-dose naltrexone
Cannabinoids and endocannabinoid system
Conclusion and resources
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