Do I really have arthritis?

[Netto]

I'm hoping you can shed some light on what I might be dealing with.  I am a healthy 29 year old female.  Don't smoke, don't drink and workout at a gym 3-5 times a week.  In 1996, the tendons in my wrists became very sore.  It hurt to bend my wrists.  No swelling, no redness.  Just pain.  This went on for about 3 weeks before I went to the doctor.  X-rays were normal; blood showed some inflammation.  I was told to take Advil and sent on my way.  The pain eventually went away but returned in about 6 months.  Ever since, I have had these flare ups which last about 3 weeks and occur about every six months.  I have gotten used to this.  In September 2001, my left arm, from the shoulder down to the fingers (outside of arm only) would ache during the night.  After a few days my arm became weak.  It would also tingle like it was asleep.  I had to prop my arm up to drive and at my desk at work.   Also, the tops of my hands would ache.  Not every day but about 2-3x a week.  I was sent to a rheumatologist.  Blood work was normal. He didn't think I had RA.  He gave me Voltaren.  That didn't work.  After about 2 months the symptoms went away.  But...they came back in January 2002.  This time it lasted about one month.  Then went away.  The end of February I started having stiff/numb ankles.  Eventually my ankles started to tingle/burn when I drove or sat at my desk.  Walking relieved the burning but my tendons were so sore it hurt to walk.  Referred to neurologist.  Nerve conduction studies were normal.  He also tested my balance and reflexes.  No MS.  After about 2 months my ankles felt normal again.  On August 21, 2002, I began a new flare and after two months, it hasn't gone away.  This time it is even worse.  My ankles and lower legs burn/tingle when I sit for more than 20 minutes.  The tendons in the front of my ankle ache.  The front of my knees throb with pain and my knees become stiff when I sit.  My hips ache 3-4 days a week.  My lower back is stiff/aches.  My neck and upper back ache when I sit.  My shoulders, the inside of my elbows and fingers ache.  My fingers are frequently stiff.  And every once in a while my jaw hurts.  With all of my joints (except my jaw), the pain and stiffness are on both sides. One side is usually worse than the other.  When I walk up stairs my legs feel exhausted.  When I walk down stairs, my quads sometimes tremble like they're weak.  With every new day, different joints will get worse or improve.  I've been back to the rheumatologist.  He took more blood.  With the exception of low lymphocytes, everything is normal.  He says I am "a puzzle".  He doesn't think I have fibromyalgia, lupus or RA.  He thinks I have some sort of arthritis that isn't showing up in the blood work yet.  I am currently on Vioxx - 25mg.  This has helped but I am still in a lot of pain.  I do seem to feel a little better when I walk and at night.  I also feel good when I sleep.  But I am miserable everyday from the time I get out of bed until late afternoon and the pain is driving me crazy.  FYI, I have no visual swelling, no redness, no fever, no rashes, no weight loss, no loss of appetite, no headaches, no fatigue (except legs), no family history of diseases/arthritis and I still have full ROM.  

Do you agree with my rheumatologist?   Would your average arthritis be this painful?  Is Vioxx/Celebrex/Bextra the best my doc can do for pain relief w/o serious side effects?  Because I "look normal" family, friends and co-workers think I am exaggerating my pain and think I am fine.   I am desperate for any advice/suggestions and/or ideas about a diagnosis, you can offer.

Thank you for your time.

[Amber Moon]

I have all of the symptoms that you are describing and I have been diagnosed with Fibromyalgia and osteoarthritis - There is another disease that is very similiar called chronic Myofascial pain.  Your symptoms sound very much like one or the other.  You didn't say why your doctor doesn't think you have Fibromyalgia but I would ask my primary doctor to be referred to another specialist if there are any in your area.   I know how tough a situation this is for you and how frustating it can be - it took almost 4 years before I received a diagnosis of Fibromyalgia.  It took a nurse practitioner to notice all of my symptoms and put them together and she is the one to refer me to the specialist who diagnosed me right away.  I do have inflammation is some areas, none in others, I also have acid reflux, irritable bowel syndrome, endrometriosis(which also took years for a diagnosis) insomnia and am currently waiting for testing for sleep apnea and osteoporosis.  The pain you feel is real and if your doctor wants to dismiss this pain and treats you like you are just imagining the pain I would definitely see another doctor.  And I would tell him that the frustation you are having to deal because they can't give you a diagnosis does not help the pain any.  I would also ask for a referral for physical therapy, which helps tremendously and ask about a tens unit to help with the pain (works great for relieving pain without all the medication.  Read all you can about these diseases on the internet and educate yourself so you will be better equipped on what to tell your doctor. Aerobic exercise is the most important thing you can do for Fibromyalgia and it helps greatly.  I hope this is of some help to you and I sympathize with your problems.
There is a lot of great information on the internet and I wish you the best on getting a diagnosis - just knowing what is wrong and how to deal with it is the biggest battle.  Once you know a lot of worry and stress will go away and that will also help alleviate some of your symptoms.  Good luck and I will say a prayer for you.

[karrie2020]

I had sciatica for several years. I did some nutritional research, and found that taking a balanced  Vitamin B complex, IN ADDITION  to a good complete multivitamin, cured my problem. Maybe it's worth a try for you. PS This didn't work over night, it took aprox. two weeks to get results. I know how painful that condition can be.  Good luck.

[ErinF]

I realize this is going to be anectodal and that I can't really help your condition, but I just wanted you to know you are not alone.  I'm 25 and have been suffering from sciatica for over 6 months now.  Some days it is so bad I need a cane.  AT 25!!!  Still, since the doctors can't find anything they're guessing herniated disc and put me on Celebrex which I cannot take because it give me severe diarrhea.  Now they are calling me "noncompliant" because I can't take the medicine and as such they're saying it's in my head!!  AAAAHHHHH!!!

[Forum-M.D.-DT]

Thank you for visiting the family practice forum.
I have a couple of thoughts here. Firstly, I would agree that it appears as if you have some type of inflammatory condition such as Rheumatoid arthritis or Osteoarthritis. I don't think it sounds like a Neurologic problem. It really sounds like you have some type of muscle/joint inflammation. I would tend to think that this is a Rheumatologic problem.
Now, what I would suggest is that you speak to your Rheumatologist about the following options.
1. Increasing the dose of Vioxx to 50 mg/day
2. Consider a stronger pain medication such as "Darvocet" True, it has the potential for addiction, however, in my experience I have seen VERY FEW patients become addicted to this medication and have seen it prove to be very helpful with arthritic conditions.
3. Why not consider a medication such as "Amitryptaline" or "Neurontin" for treatment of your chronic pain.
You give a very thorough history here, I suspect your symptoms are most certainly real and just have not been fully treated. While Vioxx 25mg/day may be helpful ... I think you need more.

I hope this helps!