Undiagnosed symptoms

[TLM16]

I am a 25 year old female and for the past 7 months I have been dealing with increasing pain and swelling in both my hands and my feet. It started with my right foot when I started having pain in the balls of my feet when I walk. It then spread to my left foot and eventually both of my hands. The pain is also associated with swelling on the dorsal aspects of my feet and in my fingers. The pain is worse when waking, but only improves slightly throughout the day. The pain feels like a tightness, and hurts most with movement (I have virtually no pain if I do not move).

I have been seen by my PCP, rheumatology, plastics, dermatology, and ortho, and I do not have a diagnosis. All blood work came back negative including the ANA, RF, and basic labs. Plain films of my hands and feet showed nothing except a small piece of glass in my finger that they believe is unrelated. However, my TSH was elevated and I was started on Synthroid 4 months ago. I have had repeat lab work that now shows a normal TSH but I have increasingly worse symptoms. I am getting to the point where I want to sit all the time because of how much pain I am having. Up until this point I was completely healthy and have never had any surgery.

I take NSAIDs everyday with very little relief. I am very fearful that this is a chronic problem that I should be being treated for.

Any advice or ideas would be appreciated. Thank You

[Kevin Pho, MD]

You have had evaluations by multiple physicians and basic rheumatological tests including an ANA level and rheumatoid factor.  This would evaluate for major rheumatologic disease including lupus and rheumatoid factor.

For the pains in the foot, you can consider various causes of peripheral neuropathy.  A blood test to evaluate the vitamin B12 level can be considered, as well as a referral to a neurologist and/or podiatrist.  

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[missmellie]

do you have pain in the back at all, could it possibly be stemming from there.  one test that you need to consider is the HLA27B, people witht the gene are presiposed to develop ankylosing spondylitis. heel pain is a symptom, this might not be it at all but the disease can affect people differently, effecting ligaments and joints throughout the body, can casue tingling numbness etc..  good luck