Download this guideline as a pdf, or offline using the QuickChart EMR app for Android

Case Definition

Clinical assessment

  • Vague, generalized, non-disabling discomfort in joints and muscle, minimal physical findingsA,C, E
  • “Olivia’s syndrome”: headache, shoulder, chest, arm, neck and back painR
  • Headache, cough, abdominal pain, back pain, rash, due to multifactorial causes (stress, sleeping on ground, smoke exposure, heavy lifting, soccer collision, body mechanics, stooping over)E, G, S , leaning over pila to wash clothesN
  • Dull localized leg pain due to dehydration, walking long distances, malnutrition, osteoarthritisI, N : increase liquids, vitamin supplements, calcium supplementsN

Red Flags

  • Signs of infection, recent fall or accident, if SOB, muscle weaknes, inability to moveC
  • Headache: If severe pain, recent head trauma, fever, stiff neck, nasal congestion, cough, visual changesC
  • Back pain: Recent injury, MVA, fall, symptoms of acute nerve dysfunction, loss of bowel or bladder control C


General recommendations

  • ACE wraps (for knee supports) F,, stretching activities and analgesic creams, consider physio referralG, T
  • Massage neck daily, improve postural mechanics, roll towel and put in the small of the back when sittingF,R
  • Headache: consider dental caries, vision problemE
  • Oral rehydration salts, reading glassesG.
  • Alcohol withdrawal: hydration 1-2L/dayH

Pharmacologic management

  • NSAIDs or acetaminophenA,C,E, M
  • Back pain: Fever, dysuria and pyuria: UTI treatment with cipro 500mg bid 3 days or Bactrim DS BID 7 daysC