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Forum Name: Rheumatology Topics

Question: rheumatology appropriate?


 pollyby - Wed Sep 14, 2005 2:54 pm

Hello,

I'll try to keep this as short as possible
I’m a 35 year female and I’ve had various aches and pains since I was about 16 but pretty much constantly over the last 9 years. Although most of the time the pain is tolerable and doesn’t limit my movement in any way it has been getting slowly but progressively worse over time.

In 1992 I started to notice a “clunk” in my hip if I moved it in a particular way. I did not have any hip pain at this point however.

In 1996 II started to get constant shoulder (around the shoulder blade). Felt like something just a bit “out”.. had to constantly move and crunch it. I returned to college this year to complete my MA. GP said it was wear and tear. It would get worse during my lifetime, wouldn’t refer me to physio and just told me to take ibuprofen. On completing my MA severe left shoulder pain, shooting right down to my hand, arm numb at times (due, I presume, to many hours spent at the computer). Various alternative therapies helped.
A Chiropractor who actually was more concerned with my hip. This surprised me as I had no hip pain at this point.She also said my shoulder blade pain was “ribs sticking out”, pushed and shoved until I felt something move. I had about 3 days pain free and the shoulder felt loose. Soon I was back to “normal” pain.
Over the next few years my left Hip/ lower back pain started, as did my left wrist and ankle.

2000 I Fell down some stairs landed on my bum and felt pain shoot right up my back into my neck. I was x rayed which showed nothing. Saw a different GP, again suggested ibuprofen and massage….

2001
I was pregnant with my first baby and (like all pregnant women I guess) I had a lot of low back pain. This eased a lot after the baby was born. However when she was about 3 months old I got trigger thumb on my right hand. It was x rayed which showed nothing Iin all this time the “baseline” shoulder, neck, hip pain continued. My left wrist and ankle continued to be,… not really sore, but just felt “out”… needing to click and crunch them all the time.

In 2002 I tried physio. Again he was more concerned with my hip and lower back. Exercises and traction eased the pain. He seemed unable to see the problem was with my neck and shoulder. in fact thought my right shoulder seemed worse. Despite some neck work the pain continued.

In 2004 while pregnant with my 2nd baby I suffered v bad low back/ hip pain to the extent that I couldn’t walk for more than 5 mins. After the baby was born it eased gradually although remains worse than pre pregnancy.

This year I’ve found that all my pains are increased. From April to June I suffered from constant and severe headaches. I had blood tests including ESR, CRP etc which were all normal. GP concluded that it was from my neck and prescribed cataflam when needed and exercises and book (Robin Mc Kenzie).

The headaches have gone now although I still occasionally have shooting head pain when I turn my head in a particular way. Neck and shoulder pain increased however and my neck is really annoying me at the minute. When it’s really bad I take the cataflam which takes the edge off but doesn’t get rid of it. I also have some pain down my left arm.. right to my middle finger. some days my left hip( or lower back.. not sure which ) really bothers me. Pain half way down my buttock and sometime on the inside of my thigh... occasionally shooting pain if I turn quickly.

So 9 years of daily (though mostly tolerable) pain and I don’t really know what is causing it. Is it some kind of arthritic thing or unavoidable wear and tear like that first GP told me. Do you think these symptoms warrant a rheumatology assessment. I have never had any joint swelling. When I stand up after sitting for a while or getting out of bed in the morning I am stiff and it takes more than a few seconds to straighten up but that is all. My father has had similar symptoms since his twenties and has seen various specialists but never a clear diagnosis. We both wondered about fibromyalgia but concluded that we’re not actually sore enough!
Would the ESR a couple of months ago have been elevated if it was some arthritic condition?
Alcohol (not that I often have any!) makes all my pains much worse... that's been the case since I was 17. I have also had restless legs at night for years.

Apologies for the epic. Thanks for bearing with me! Any advice welcome.

Pauline
 nurodude - Fri Sep 30, 2005 6:54 pm

I don't necessarily disagree with Nurse2, but don't totally agree either. A rheumatoid factor would certainly be in order, but an ANA, even if positive won't explain your symptoms. Another ESR and CRP would be helpful to determine the degree and length of your inflammation if that is your problem. Fibromyalgia is somewhat elusive to determine even though the ACR came out with diagnostic requirements about 10 yrs ago. Your shoulder could be thoracic outlet syndrome or even a brachial plexus problem. Have your doctor give you a medrol dose pack and see how much relief, if any, you get from it. If you get a lot, then your problem is inflammatory in origin. You should also have plain films done of your spine, etc. to see if you have any osteoarthritis.

Dr. C
 Jackie E. Pool, LPN - Sat Oct 01, 2005 9:35 am

User avatar Have you had ANA and RA Factor done? i would make an appointment with a Rheumatologist that is knowlegable in Fibromyalgia and go from there. The main thing is getting to the bottom of your pain and treatment for it.
 pollyby - Mon Oct 03, 2005 8:04 am

Thank you both,

i've done nothing about my aches and pains since I last posted (so I can't be that bad eh?) but I will follow your advice soon. Hubby is due some time off work soon so I'll be able to go to my GP, x ray etc without dragging 2 small noisy people with me! Thank you.

P

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