Musculoskeletal pain?

[allen's mrs.]

I am a 40 year old female. My job requires I spend time on the computer. The last couple of years I have had a lot of muscular (?) aches that I have assumed were sprains. (though I had not overexerted myself-mysterious) The last year or so it has gotten worse. It is present in my trapezoid area (front and back) my arms, and my neck. I wake up stiff in these areas occasionally. I have no fever, just lethargy along with these pains. (but I have always needed naps in the afternoon, lol)

My family doctor gave me Flexeril for it last year, but it hasn't helped now. Aspirin doesn't help either. I am currently under chiropractic care, which has helped lessen the neckaches. (I want to stay away from drugs if at all possible) I just want to know what is going on; all the doctors I've seen want to do is to call it muscular strain/sprains and send me to physical therapy. I tried PT with no help. I haven't even had any lab work ordered. I know you cannot see me, but do you have any earthly idea what could be wrong? I try to jog daily, and I do stretching exercises, but I feel like it is only like throwing a bucket of water against an inferno.

If you could give me any help, I sure would appreciate it. (Also, spinal x-rays in my chiropractor's office did not show any arthritis in my spine--so that's not it.)

[doll face]

You and Caramich have just listed EVERY symptom that I was going to ask about.

I have just finished 72 weeks of Hepatitis medication (shots and pills) and now have all these horrible aches and pains,sleep disorders, I have been advised to go to my family MD and be tested for Fibromyalgia .

[allen's mrs.]

I've had all of those things except for the accident/fall recently. It's been something that's been building up in the past 2 years.

Part of the problem I think is that a lot of MDs must think that if you come in complaining about back or neck pain and your x-rays (I've only had cervical and thoracic plain xrays) are negative, then it's just a strain and tell you to take NSAIDs and get more exercise. (or physical therapy) When you follow up and tell them this is not working, they seem to have this assumption that you're a drug (narcotic) seeker. As I stated earlier, I do not want to be on pills. My job and my role as a mother require mental alertness. What I was so upset about with one orthopedic doctor was that he REFUSED to run ANY tests on me, just because he looked at my 1+ year old PLAIN x-rays which were negative. (except for some slight scoliosis) I happened to have been having a really bad day that day, and already was on the verge of tests. Then he insinuated that maybe that my mental state was causing the pain. I was incredulous. (Never mind the fact I was not normally sad like that)

At least my chiropractor cares about my symptoms and really takes the time to listen to my symptoms and seems to really care about whether I am getting any relief. Not patronizing in the least. I guess this is one of the reasons I have been turned off of traditional medicine.

But my pain has increased to the point that the Flexeril I was prescribed didn't work, and I had to take Hydrocodone (that was almost 2 years old--I got it prescribed when I had a dental extraction). It worked, but it made me feel drunk.

What happened to you, if you don't mind my asking? Thanks for your concern too, btw. :)

[caramich]

One more note........if you have headaches or neck pain DO NOT DO NOT DO NOT DO NOT see a chiropractor till you've had an MRI of your head and neck.  

Just trust me on that one.

[caramich]

Definitely find a GOOD rheumatologist or FM doctor and get evaluated.  They should run the tests above, also Lupus, Lyme and THYROID if those weren't mentioned.

How is your sleep? Headaches? TMJ? Irritable bowel?

Are you a 'type a' person?  Any recent trauma like car accident or fall? History of mono?  All these things can trigger or contribute to Fibromyalgia/Chronic fatigue if everything else is ruled out.  

Don't just sit on this in any case.  Don't let doctors put you off either.  As women we too often get the short end of the stick with healthcare.  Find a doctor who listens and who doesn't make you feel stupid and who runs a LOT of tests starting with a few gallons of bloodwork.  It can only go downhill in any case so please don't wait.  There is help out there for any of these conditions so jump and get it. These days we need to be responsible for our own healthcare, no one will do it for us!  

Make a list of symptoms head to toe before heading to the next specialist. Even if symptoms seem unrelated or 'silly', write them down. Flip paper over and write down any tests you've had done in the last couple years and the results.  That all helps with clarity & diagnosis.  Really!

Good luck and my prayers are with you!  (ps. there is a site online called co-cure that has a patient derived list of the best Fibro docs in the country.  Any of them should be able to rule OUT all the other conditions mentioned above before ruling IN something like Fibromyalgia. A good rheumatologist should be able to do the same but they can be tough to find) And don't let them call it Fibro till they've run all the tests!

[Kevin Pho, MD]

I would consider some rheumatological diseases, such as polymyalgia rheumatica, which can present with shoulder and neck pain.  A blood test looking for inflammation (i.e. a sedimentation rate - ESR) would be a resonable test to consider for this disease.  Other possibilities such as lupus and rheumatoid arthiris can also be considered.  Tests such as a blood count, thyroid test, ANA level, and rheumatoid factor should all be considered.

If negative, you may want to be evaluated for fibromyalgia, which can present with similar symptoms.

In any case, these options can be discussed with your personal physician, as well as a rheumatology referral.  

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.
Medical Weblog:
kevinmd_b