This Article  • References  • Full text PDF  • Correction  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Steven R. Garfin, MD

JAMA. 1995;274(24):1949-1954.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Dr Delbanco:

Miss W is a 50-year-old woman who has a long history of low back pain. Divorced, she lives in an apartment by herself and works as a medical technician in a community-based doctor's office. She is insured through a large not-for-profit managed care organization.

At 4 years of age, Miss W fell off a horse, but she did not have subsequent problems until 18 years of age when she experienced low back pain. Since then, she has had intermittent pain and multiple therapeutic recommendations from chiropractors, orthopedists, and a neurosurgeon in addition to her primary care doctor. At times, she has been on prolonged periods of bed rest and has had to miss work. Approximately 8 years ago, Miss W developed symptoms of fibromyalgia with generalized pain focused on her knees, bunions, elbows, wrists, shoulders, and pelvic region. She has been treated with multiple nonsteroidal anti-inflammatory agents (NSAIDs), . . . [Full Text PDF of this Article]

Footnotes
Dr Garfin is Professor of Orthopedic Surgery, University of California, San Diego.

This conference took place at the Orthopedic Grand Rounds of the Beth Israel Hospital, Boston, Mass, on July 26, 1995.

Reprint requests to Division of General Medicine and Primary Care, Beth Israel Hospital, 330 Brookline Ave, LY339, Boston, MA 02215 (Ms Walzer).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?