An 86 year-old female presents to the clinic for a routine visit. She has chronic low back pain due to severe degenerative osteoarthritis and fibromyalgia. She ambulates with a walker and is severely crippled with the arthritis. She reports her pain is only moderately controlled by taking Tylenol twice daily and the maximum dose of tramadol. Vital Signs: 128/84, P-64, RR-16, T-98.2, O2 sat 98. What is the main reason for the patient's chronic low back pain?
1) Severe degenerative osteoarthritis
2) Fibromyalgia
3) Ambulation with a walker
4) Moderate control of pain with medication