Maximizing patient benefit through a reversed pathway from specialist to generalist: the case of chronic pain

Authors

  • Ioannis Karageorgiou University of Crete, Medical School
  • Stamatios Kokkinakis School of Medicine, University of Crete, Heraklion, Greece
  • Neofytos Maliotis School of Medicine, University of Crete, Heraklion, Greece
  • Christos Lionis Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
  • Emmanouil K Symvoulakis Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece

DOI:

https://doi.org/10.15386/mpr-1873

Keywords:

primary health care, polymyalgia rheumatica, fibromyalgia, herpes Zoster

Abstract

Polymyalgia Rheumatica (PMR) is a syndrome characterized by chronic pain and/or stiffness in the neck, shoulders or upper arms and hips. It affects adult patients usually over 50 years old and is treated with low-dose oral corticosteroids. In this case, a 68-year-old female with a history of PMR, diagnosed by a specialist sporadically seen in the past, presented to a primary care physician due to herpes zoster (HZ) infection. Thorough history taking, along with a careful review of previous laboratory results, raised serious doubts concerning her diagnosis (PMR). Because the patient described diffuse pain throughout her body, sleep disturbances and a depressed emotional state, fibromyalgia was suspected instead and appropriate treatment was given. The patient remained free of symptoms and corticosteroids for almost a year. Information from this case may help to point out that PMR is a disorder that can be easily confused with other chronic pain conditions with similar manifestations, especially when the initial diagnosis is sped up in terms of consultation depth and care continuity. Under certain circumstances, primary care can lead to improved clinical outcomes.

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Published

2021-10-30

How to Cite

1.
Karageorgiou I, Kokkinakis S, Maliotis N, Lionis C, Symvoulakis EK. Maximizing patient benefit through a reversed pathway from specialist to generalist: the case of chronic pain. Med Pharm Rep [Internet]. 2021 Oct. 30 [cited 2025 Jul. 14];94(4):512-5. Available from: https://medpharmareports.com/index.php/mpr/article/view/1873

Issue

Section

Case Report