A 46-year-old woman comes to the physician because of a 5-month history of severe muscle and joint pain. The pain varies in location and intensity. She also has joint stiffness in the morning and reports fatigue throughout the day that she attributes to not sleeping well. She reports a tingling sensation in the lower limbs. Her bowel habits are unchanged, but she often feels bloated. She has hypertension and occasional tension headaches. She does not smoke cigarettes or drink alcohol. Her medications are hydrochlorothiazide and naproxen. She appears healthy. Vital signs are within normal limits. Examination shows symmetric muscular tenderness at the base of the neck, over the shoulders, and in the lumbosacral area. Strength and deep tendon reflexes are normal. Laboratory studies show no abnormalities. Which of the following is the most likely diagnosis?

Question

Quizplus · Accepted Answer

Eductional Objective: Fibromyalgia occurs most commonly in women age 20-55 and presents with diffuse musculoskeletal pain, fatigue, and neuropsychiatric disturbances.  It is characterized by abnormal central processing of painful stimuli.  Although initially painful, aerobic exercise helps to improve pain and functioning in these patients.

A 46-Year-Old Woman Comes to the Physician Because of a 5-Month