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Multiple Sclerosis Community
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1207048 tn?1282177904

Lots of questions. I'm not sure what my next step should be. Advice?

My regular doctor called this morning and my blood work was normal (as I expected it would be). He really wants me to start Celebrex for the joint pain. I'm very resistant to that. Mostly, because I really think it is more of a muscle issue than it is a joint issue. I think I'm out of alignment LOL I don't want to take Celebrex when I don't think it will address the real issue and I'm nervous about the potential side effects.

I've been looking online the last few days to try to figure out what might be going on with me. The sharp stabbing pain I had in my right foot *might* be tendinitis. It makes sense because the pain started after a day of lots of walking, a good amount of that walking was uphill. It is also my right leg that has had the pain in the muscle behind my knee for months, so I'm pretty sure my gait is effected by that. If I'm walking weird it stands to reason I'm going to make things worse. Once I stayed off my feet for a couple days the stabbing pain went away.

My other issue right now is my left hip/thigh. My lower back has been hurting since Saturday. I have degenerative disk disease, and I have had sciatic nerve issues in the past due to that. The sciatic nerve problems have *always* been on my right side, down my butt to the back of my thigh. It has always only been that spot. From what I can tell, the sciatic nerve branches off from the lower back and runs down both sides of the butt and down the back of the legs to the feet.

The problem I'm having right now involves the lower back, but instead of the pain going down my butt and leg, the pain is the outside and front of my hip down to my thigh (outer front thigh mostly). Everything seems very sore and tight in that area. On Wednesday when I went for x-rays (of my ankles/ feet/ elbow) one of the x-rays she had me lay my leg straight out on the machine (I was sitting in a chair up close) and to flex my toes towards the ceiling. You would have thought she asked me to do a split, that is how uncomfortable that stretch was!

I am planning to go see the nurse in the infusion center at my neuros on Tuesday so she can see me do the shot and see the reaction I have been having (so she can see if it is an allergic reaction & possibly recommend new sites to use). Should I try to see my neuro also at the same time?

I just know something is going on with my muscles. They are sore and tight in areas. My arm muscles will get tired from just regular activities (brushing my hair, putting dishes away, etc) and I need to rest them for a few minutes half way through :-(

Physical therapy is an option I'm very willing to try. But, who should I ask to refer me? My regular doctor or my neuro?

Sorry this is so long! I'm just not sure what I should do. And, I feel bad about possibly having to tell my regular doctor that I don't want to try the Celebrex. I don't want him to think I don't trust his judgement :-(
~Jess
2 Responses
667078 tn?1316004535
Jess,
  I have many of the same issues and I find that exercise is important. Days I do not do yoga stretches and exercise I learned in PT I have had it. My PT guy taught me to keep going even when my back and shoulder lock up. You do need to have a good PT who teaches the right exercises for situation. I also watch what I eat food can add to inflammation.

I look up medications and turn them down if I feel they do not work for me. It makes my PCP mad but oh well.

Alex
1045086 tn?1332130022
Lots of times I think it's hard to tell what's going on with our bodies.  There are just more unknowns than medical science wants to admit to us or themselves.  There is nothing wrong with letting any doctor know that you would like to try something other than drugs as your first option.  (Ironic isn't it, after you had to fight so hard to get started on the DMD?)

I remember you telling us about some similar aches and pains in the past.  Since they are taking center stage again as autumn comes upon us, I'm wondering if what's going on now might be related to temperature, humidity and barometric pressure changes.  I know some people don't believe things in nature can influence our bodies.  But I know that the (way far away) moon causes the mighty ocean's tides to rise and fall.  Our bodies are a collection of tissues with an extremely high percentage of water in a closed container.  Why wouldn't we be at least as vulnerable?

After many years of experiencing it, I am still surprised by my own increase in pain and stiffness every spring and fall (especially when temperatures are rising and I assume Mother Nature's heating pad will feel good).  It usually hits hard for a few weeks before both joints and muscles readjust.  I notice lots of other people in the pool and at work are complaining at about the same time.

Like you, I've searched for an answer to the pain and multiple movement difficulties I've had over the years.  The pain was sometimes bad enough to stop me in my tracks.  Other times it was what I call a 'wearing' pain - not overly intense but so constant as to wear down my energy and motivation.  It was one of those invisible disabilities we so often talk of here.  At one point, I was diagnosed and treated for fibromyalgia.  I suspect the fatigue and pain I had then were early symptoms of the MS.  

It's clear I have osteoarthritis.  This 'old people's' arthritis became visible in my hands in my early 30's.  It's in lots of places now that I really am getting old.  It's in both knees.  One needed replaced but the other rarely hurts.  The surgeon said it looked worse inside than the films indicated.  It's in my back but didn't show up clearly on MRI until years after the pain came to stay.

There isn't a lab test for osteo (or degenerative) arthritis.  Studies haven't shown much relation between severity of disease in x-ray findings and severity of pain reported.  Sometimes there's lots of arthritis and little pain.  Sometimes lots of pain for little arthritis.  Makes one think there are other factors.

Celebrex does help me but I only realize how much when I have to stop taking it prior to tests.  It's another one of those expensive drugs that I stick with because I don't have another good option.  My doc didn't think there was much cardiac danger with the 200mg daily dose I take, especially when it offers the best non-narcotic pain relief for me.

From time to time I've also been treated for bursitis, tendonitis or some other inflammatory type processes.  I've had more than my share of hand and foot surgeries to move or correct things that somehow got out of place, enlarged, compressed or contracted.  The hand surgeon told me once that he suspects I have some type of connective tissue disorder that causes these disruptions.  He didn't know what.  I decided against starting a blind search or repeating tests that had been negative in the past.  I put my energy toward medical and surgical symptom relief to stay as well and functional as possible.  Any single process that may be creating my multiple symptoms has remained satisfied to disrupt my life without becoming a full blown (detectable) disease.

MS however, did finally show itself clearly enough for diagnosis.  And although it doesn't explain all my medical ills, it has certainly contributed.  I now recognize that a good deal of the stiffness and pain I experienced in the past originated in muscles rather than joints.  MS may not effect the joints or muscles directly.  It's effect on nerve conduction sure does change how they both function.

Intermittent spasticity from MS explains some of the variations in findings on physical evaluation by different clinician's.  I had tension in my muscles for so long I forgot it hadn't always been there.  Or I assumed the muscles were tense because of pain.  Now that MS has added a cramp type of spasm to my experiences, it is easy to see that pain is the result rather than the cause.

I had an excellent PT evaluation recently that confirmed muscle spasticity.  I learned how to keep many muscle groups stretched in just three sessions.  My co-pay for therapy is high so I let the therapist know early on that my goal was to do things on my own at home.  She made sure I was doing stretches right, gave me several stretch bands to work with (you change color and increase resistance as you improve) and printed out a books worth of illustrated examples.

Alex is absolutely right that activity is key.  But so is proper rest.  Like MS fatigue, joint and muscle pain require us to constantly monitor ourselves for the optimum activity level on any given day.

Sorry for going on and on here.  I can't know what's going on with your body.  I guess it all struck a nerve and sent me on a journey over the years.  There were times I felt I was losing my life to symptoms and searching (not to mention the dollars and dignity lost).  Guess I'm in grieving my loss mode today.  I enjoy your tales of active family life and am hoping you can find enough relief to let go of the details of figuring out symptoms while there is life to enjoy.

Mary
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