Print This Page     Close Window Consult Request Guidelines for Muscle Pain (Generalized )     Muscle Pain (Generalized ) Suggested Pre-Referral Evaluation and Management Guidelines If associated with headache or tenderness of temporal head region, consider polymyalgia rheumatica if geriatric age group Rule out temporal arteritis. Careful examination for evidence of temporal artery pain, tenderness, and for visual symptoms If present, refer to rheumatology, start prednisone (high dose), obtain MRA of the head or refer to neuropathy for temporal artery biopsy for temporal arteritis which is can be associated with sudden irreversible blindness. If proximal and symmetric consider myopathy. Review medications for steroid and/or statins. Consider discontinuing steroid or statins If diabetic and painful, consider diabetic amyotrophy Consider fibromyalgia Consider NSAIDS or acetaminophen for pain. Chronic pain consider tricyclic antidepressants (TCAs), begin conditioning exercise program Suggested Additional Test/Management Prior to Specialty Visit Consider WESR, CBC with differential, CPK, TSH, T 4, rheumatologic laboratory work up Consider EMG to evaluate for myopathy, diabetic amyotrophy Patient Education/Information (includes preps)   Appointment Timeframe   How to Get Results to Consultant UMHS Patients: See CareWeb External Patients: hand carry medical records and clinic notes to visit Clinic Contact Information Physician: 800-962-3555 Patient: 734-936-7175 Clinic Location Sites MedRehab, Briarwood Building 04 UM Consulting Physician Neuromuscular Rehabilitation Faculty Revised on: 10/07/2009