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HomeAnswersInternal MedicineanemiaHow to manage body pain and fatigue present for many years?

Kindly suggest me a therapy to overcome fatigue and body pain.

Kindly suggest me a therapy to overcome fatigue and body pain.

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At December 8, 2016
Reviewed AtJanuary 18, 2024

Patient's Query

Hello doctor,

The primary concern surrounding my inquiry is body pain and fatigue. I have lymphedema in my lower legs since eight years. Intermittently, the condition is mediated with compression stockings, massage therapy and occasional stationary exercise. The swelling persists with activity, just to a lesser degree as long as garments are applied. At this point, there is slight pitting. The tissues from the calves down to the feet are consistently engorged and tough. Extensive rest is required to adjust leg shape from the calves down from columnar to moderately curve. The condition has limited impact on my physical activity and energy. It manifests as pain and hence, there is related slowing down after cardiovascular sports.

Before six years, I began experiencing upper respiratory infections several times a year, coinciding with or without any flu or cold, requiring days of rest and OTC medication to recuperate. The timing coincided with a change of place and so, I presumed climate adjustment may have been the culprit. But, the symptoms have persisted ever since, with or without vaccinations. I had signs of anemia since my young age and got to know the diagnosis in after a year following the testing related to a women's wellness examination. A year later, lethargy and moderate pain of the lower extremities became a regular occurrence regardless of the physical activity. The symptoms would subside over time with rest. Migraine pain also emerged that year, seeming to coincide with sinus activity, due to the pain's concentration around the forehead and eyes, and required the use of OTC pain relievers. Migraines had not been a concern prior to that point.

Then, the lethargy and body ache became a more persistent fixture, occurring several days a week, weekly, subsiding on its own, regardless of the amount of rest. Last year, the lethargy overwhelmed the physical pain and is remaining at the same frequency, but coupled with a spike in symptoms of anxiety, such as difficulty in concentrating, aphasia, heightened fear around mundane circumstances and nausea. Additionally, during winter a brief exposure outdoors at night resulted in Raynaud's disease in the fingertips of both hands for about a month, until it started to warm outside.

Since the beginning of this year, the ongoing fatigue has occurred daily and the body ache occurs throughout the day, regardless of rest or activity. The pain is usually dull all over, but also presents with inflammation around the joints (knees, elbows, wrists and ankles) and muscle soreness primarily of the mid and lower back. Daily use of extra-strength OTC pain reliever is now necessary, though I try to refrain from every day use as much as possible. Dull headache pain, in the front region occurs several times a week, as do issues of concentration and mental fog. Additionally, twice this year I have experienced syncope. I am attaching the results of recent blood work, which was completed during my menses. Previously, I was taking Acetaminophen. Currently, I am taking Aspirin. Please help with my condition.


Welcome to icliniq.com. The laboratory reports (attachment removed to ensure privacy) indicate mild anemia and microscopic hematuria. The anemia seems to be a dual deficiency involving iron and B12. To confirm the cause, further tests including reticulocyte count, peripheral smear, serum iron, total iron binding capacity (TIBC), ferritin, erythrocyte sedimentation rate (ESR), thyroid profile, and serum vitamin B12 levels are necessary.

Although iron deficiency anemia is common in menstruating females, the red blood cell indices don't strongly support this diagnosis. Therefore, these additional tests are vital.

Hematuria can result from various factors, often including stones and urinary infections. In your case, as there's no apparent infection, it's important to rule out stones through ultrasound or repeat urine microscopy examination after five days. If hematuria persists, further tests might be needed.

Regarding your symptoms, have you experienced any tension or work-related stress? Has sinusitis been definitively confirmed, and did you receive treatment previously?

While you mentioned Raynaud's, your presentation doesn't seem typical for it. Classical Raynaud's involves skin color changes from white to blue to red over minutes, not days. Primary Raynaud's has a positive prognosis without complications. Secondary Raynaud's is linked to other connective tissue disorders, but your negative antinuclear antigen (ANA) result rules out such disorders. Raynaud's treatment involves avoiding cold and wearing protective clothing. Only severe cases necessitate calcium channel blockers like Nifedipine.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Naresh Kumar M.
Dr. Naresh Kumar M.

Internal Medicine

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