For years people with fibromyalgia who are unable to continue working at a full-time job have struggled and worried about whether they would qualify for Social Security Disability. Finally, last week the Social Security Administration issued a ruling providing guidance on how they develop evidence to establish that a person has a medically determinable impairment (MDI) of fibromyalgia, and how they evaluate fibromyalgia in disability claims and continuing disability reviews under titles II and XVI of the Social Security Act. This ruling went into effect on July 25, 2012.
For a complete copy of the ruling, including footnotes, references and a tender point diagram, see Social Security Ruling, SSR 12-2p; Titles II and XVI: Evaluation of Fibromyalgia in the Federal Register. Following is a copy of the core elements of the ruling that I think would be of most interest to people with fibromyalgia.
Fibromyalgia is a complex medical condition characterized p...
My shoulder hurts...is it osteoarthritis?
Osteoarthritis is a very common problem. Most people know someone who is dealing with arthritis of at least one joint. Spine, hips, knees, and hands are the most common places for osteoarthritis to cause symptoms. However, any joint can be affected and a common question I hear when a patient presents with shoulder pain is: Do I have arthritis?
First, a bit of anatomy -- the shoulder is composed of two separate joints:
(1) the acromioclavicular joint where the collarbone meets the shoulder bone (2) the glenohumeral joint where the ball of the humerus articulates with the shoulder blade (scapula). Both joints can be affected by osteoarthritis. It is relatively uncommon for osteoarthritis to develop in the glenohumeral joint without a history of trauma or previous injury. We'll discuss that in a minute. First, let's review the acromioclavicular joint.
Causes of Shoulder Pain Besides Arthritis The glenohumeral joint is the most mobile j...
Diagnosis There is no obvious, objective method (such as laboratory or imaging tests) for diagnosing fibromyalgia. The criteria used to study fibromyalgia are very helpful, particularly if the patient does not have another disorder, such as depression or arthritis, which could complicate the diagnosis. Failure to meet the criteria, however, does not rule out fibromyalgia. Fibromyalgia should be suspected in any person who has muscle and joint pain with no identifiable cause. Because many patients do not meet the current fibromyalgia criteria, the American College of Rheumatology (ACR) has proposed a new set of diagnostic criteria that take into consideration symptoms such as fatigue, sleep disturbance, and cognitive problems, in addition to pain. Criteria for Classifying Fibromyalgia In 1990, the ACR set the following criteria for classifying fibromyalgia: A. Widespread pain must be present for at least 3 months. This pain must appear in all of the following locations: Both sides of the bod...
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