Sudden onset of joint pain

[jtstud]

On August 17th 2001, i was a robust 36 YOA male, in fantastic shape, with basically no medical problems except high blood pressure and high cholesterol.    On August 18th, every joint in my hands felt like they were sore to the touch, almost like i had completed a hard work out the day before.  By the evening, it had spread to my feet and knees, lower back, wrists, elbows, almost every joint.  I was in so much pain the sheets on the bed hurt.  I went to my doctor the next day and he prescribed a pregnisone pack which took away the pain and swelling, but once it ran out, everything came back with a vengance.  I was sent to a Rheumatologist and they ran tests for lyme, HIV, RA, sed rate, etc. everything came back negative?  I was basically diagnosed as having somekind of sudden onset of arthritis, probably RA, given vioxx and pregnisone and sent on my way.  I finally got on enbrel in 2002 and it worked real well but about a year ago its effectiveness wore off.  I forgot to leave out that not to soon after this all happened i developed atrial fibrilation and was put on beta blockers.  The AF got so bad that i had an ablation in 2005 and have been pretty much been cured since then.  For about the past 6-8 months my doctor has had me on cymbalta 30 mgs, which seems to work real well with the pain.  But the joint stiffness and crepidess is still there and i get break through pain even though i still take 600-1000 mgs of ibuprofen a day.  I was given percocets and vicodin to take for the break thru pain, but they are poison, addicting and i was developing a very high tolerance to the drugs, which scared me straight into not taking them anymore.  My question is this, i have never been really diagnosed with anything other than, "we really don't know".  I was told that there are more specific tests for lyme disease and other tests that i am sure i never had that might possibly shed some light on my condition.  My doctor wanted me to go up to 60 mgs of cymbalta but i felt to tired at that dose, so i came back down to 30 mgs.  Any suggestions?

[Cindee56]

Hi, I think you should keep searching for a doctor who can at least give you a diagnosis.  It's ridiculous that you're in so much pain at a young age and no doctor is really trying to find out what's going on.  Get copies of all your test results and medical records, and switch doctors.  I would start with another rheumatologist.  I don't know where you live, but a lot of the teaching hospitals or large medical centers usually have very good experienced doctors who know the latest stuff.

The one other thing I can think of since you mentioned you have high cholesterol is are you on statins?  The statin drugs, like lipitor, zocor, crestor can all have side effects of muscle and joint pain.  I had to go off of them for that reason, then I tried Niacin and that was terrible also.  I am 52 and the doctors harp on me about my cholesterol (I also have high BP).  I suppose I will have to try another one soon.  Even your blood pressure drugs might be a problem.  Ask the pharmacist about side effects.

Good luck, and I would like to know how it turns out.  I have osteoarthritis and fibromyalgia, so I know that kind of pain and I understand how hard it is.

[txsilver]

Cindee is right (again), if you are not getting a definitive dx after all this time, it is time to see another rheumatologist.  Your best bet is to be your own advocate and form a partnership with a doctor who is really interested in your case.
About Cymbalta, I went up to 120mg per day and did not get relief, but that is me.  I can relate to how tired they make you feel.  It does get better as you adjust to the increased dose, but that takes time and it can be miserable waiting for that to happen.
I think your best bet is to get a dx and a new treatment plan.  If the Enbrel worked, have you tried Humira?  There are lots of options out there.
I am on methotrexate and plaquenil.  I may have enbrel or humira added in the near future but am hoping to avoid it.  Before we got to a plan that provided some relief, the pain meds covered up the symptoms.  I now take Darvocet and flexeril or zanaflex if I need it instead of every 8 hours religiously.
Let us know how you are doing, what you find out and if you need any help know that we are here.