HomeAnswersInternal Medicinechronic fatigue syndromeI suffer from chronic muscular pain, fatigue and neck stiffness. Why?

What could be the reason for chronic musclar pain with stiffness and fatigue?

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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

Dr. Hemalatha

Published At December 30, 2019
Reviewed AtDecember 30, 2019

Patient's Query

Hello doctor,

I am a 31-year-old male. I am suffering from muscle pain for more than four years. It has just become worse and I could not get a diagnosis until now. It started as an ankle and calf pain four years ago and slowly progressed upward.

At present I experience severe bilateral pain in the calf muscles and ankle, a bit lesser pain in the posterior thighs, fluctuating back pain, dull aching pain in posterior shoulder muscles. I need a pain killer all the time, as I cannot take the pain for an hour with out pain killers. Currently, I am on Tramadol. For peptic ulcer issues I take NSAIDs.

My other symptoms include frequent neck stiffness (especially during mornings), frequents headaches, pulsatile tinnitus, and jaw pain usually accompanies headache. I sleep for 14 hours and still feel tired. I have frequent papitation (like panic attacks), fatigue, concentration issues, lots of floaters, tinnitus, GERD.

All my blood workups are normal except Vitamin D3 which is low and my Tg was way high hence my doctor thought I am having diabetes even though my FBS, RBS were normal. He also thought it as diabetic neuropathy. But my HbA1c is normal and it does not explain the symptoms other than the leg pain. All x-rays were normal. MRI of the lower back was normal, bone scan is normal, EMG MCV are normal, Doppler of extremities and heart are normal.

My life has become devastating. It has hugely impacted my daily life. I cannot work, take care of my family or be a normal person for one day. I have seen many doctors but all tests, blood workups are normal. What could be wrong with me? How can I get myself diagnosed?

Hello,

Welcome to icliniq.com.

I have gone through the complaints with chronic muscular pain, fatigue to be your main symptoms. Do you have any urinary problems like pain during passing urine, frequency, urgency? Do you have any history of weakness in the muscles in the form of difficulty in walking, climbing stairs, and performing daily activity? History of recurring fevers? Presence of lymph nodes, memory problems?

Unrefreshing sleep, unexplained muscle pain, and extreme exhaustion associated with all normal investigations go with a functional syndrome by name chronic fatigue syndrome or fibromyalgia.

Patient's Query

Thank you doctor,

I do not have any problems with urine. I have not noticed any muscle weakness that interferes with activities. No recurring fevers.

I have a history of lymphadenopathy. I think I have problems concentrating and putting things in mind. Because of my memory of events before my sickness got worse are very clear. But in recent years, I have to think very hard to remember. I feel exhausted when I try to recall sometime. But it is there in my mind. It is mostly the pain and fatigue that makes it difficult to start any activity. If it is chronic fatigue syndrome or fibromyalgia, how can it be diagnosed or confirmed?

Hello,

Welcome back to icliniq.com.

They both are diagnosis of exclusion that is that are confirmed only after other medical conditions are excluded. They are functional and do not have a structural or organic cause. This recovery can be assured only following complete understanding as well as trust in the treating physician. They require a physical examination and a detailed inspection and history taking to confirm the diagnosis.

They include fatigue questionaire, inspection of tender points. Following confirmation, treatment includes medical therapy under surveillance, physiotherapy, graded exercise, water-based exercises like swimming (in a graded or incremental way), and cognitive therapy. You need to go to a neurologist.

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

Dr. Geetha Priyadarsini Kamminana
Dr. Geetha Priyadarsini Kamminana

Internal Medicine

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