Statins in the Musculoskeletal Landscape

This is a one-hour heavily evidence-based inquiry designed for musculoskeletal clinicians on statin intolerance and SAMS or statin-associated muscle symptoms. Statin intolerance may affect certain individuals who are on statins with muscle pain and spasm. I was not aware of this issue until I had a patient four years ago with the strangest bilateral lower extremity muscle pain that eventually resolved when she went off the statin. I started researching the topic and was fascinated by the information and felt I needed to share it. Hence the development of this course.

Statin intolerance may affect up to 9% of statin users. It is a very controversial subject. Some researchers and physicians say muscle symptoms are due to the nocebo effect and the beliefs of the patient that the drug is doing them harm and other researchers and physicians feel SAMS is a valid issue and the prevalence of SAMS is upwards of 20% of statin users. Even the Mayo Clinic has a statin intolerance clinic.

This evidence-based inquiry course comprehensively explores statin muscle pain and intolerance for musculoskeletal healthcare professionals. It covers a wide range of topics, including symptoms, risk factors, types of statins, potential mechanisms, research findings, diagnostic tools, and effective management strategies. Additionally, the course delves into the controversies surrounding statin therapy, as well as the potential benefits and risks associated with the use of these medications.

This course is not designed to tell your patients to stop taking statins It is designed to give you information to screen your patients and refer them to their physician or cardiologist for further investigation.

This course is designed for medical professionals and not the general public.

Course Outline:

I. Introduction to Statin Muscle Pain and Intolerance

     a. Definition and prevalence of statin muscle pain and intolerance

     b. FDA information for clinicians and patients

     c. Importance of statins

d. Benefits and risks of statin therapy

2. Statin Overview of the symptoms and risk factors of statin muscle pain and intolerance

     a. Symptoms and possible side effects

     b. Risk factors

3. Types of Statins

     a. Lipophilic

     b. Hydrophilic

c. Dosage discussion

4. Diagnosis of Statin Muscle Pain and Intolerance

     a. Creatine Kinase

     b. Diagnostic tools

     c. Statin-associated muscle symptom clinic index

     d. Mayo Clinic Statin Intolerance Service

5. Nocebo Effect

     a. Discussion of the nocebo effect

     b. Ways to prevent the nocebo effect

6. Position paper international lipid expert panel

     a. Paper findings and outcomes

7. Research

     a. SAMS and low incidence reasons in research

     b. STOMP Study (2013)

     c. Lancet Report (2022)

     d. Meta-analysis Davis et al (2021)

     e. Meta-analysis prevalence of statin intolerance Bytuci I et al (2022)

8. Mechanism behind SAMS

9. Levels of Muscle Involvement

     a. Rhabdomyolysis

     b. Myalgia and Mild HyperCKemia

     c. Self-Limited Toxic Statin Myopathy

     d. Statin Associated Autoimmune Necrotizing Myopathy

10. Differential Diagnosis of Muscle Pain

     a. Immune-mediated myopathies

     b. Other possible diagnoses

11. Statins and Tendinopathy

12. Drug and Food Interaction

13. Statins in Rehabilitation

14. Case study of a patient with statin muscle pain and intolerance

15. Summary and Conclusions

     a. Summary of key concepts covered in the course

     b. Quiz

     c. References

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Frequently Asked Questions

How long do I have access to the course materials?

You can view and review the lecture materials indefinitely, like an on-demand channel.

Can I take my courses with me wherever I go?

Definitely! If you have an internet connection, courses on Udemy are available on any device at any time. If you don’t have an internet connection, some instructors also let their students download course lectures. That’s up to the instructor though, so make sure you get on their good side!