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Q. All my test reports are normal, but I have severe joint pain for 17 years. Why?

Answered by
Dr. Nupoor Acharya
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Sep 07, 2021

Hi doctor,

I am 32-year-old, of weight 93 kg and height 181 cm. For almost 17 years, I have serious pain in all my joints. As I grow, these pains grow with me. I have a complete analysis done lately, but I do not think I had the best medication as I still live in pain on a daily basis. I have small white dots on both legs, redness in my eyes, and tension if this will help you.

However, when the pain started, it was only the knees. Now it is moving all over the body. Mostly after work. At night time and when I wake up early morning, there is pain. It fades away with activities throughout the day. But not all the time. And sometimes, I get the pain without reason or when I am stressed. I often take Brufen to manage. Mostly is the knees and bottom of the feet and fingers. No back or hip pain so far. The pain is indeed associated with stiffness and swollen joint. I also added an X-ray of the hip and hands (it was normal). I also have dry eyes (mostly) and a mouth.

The doctor thought about SLE (systemic lupus erythematosus) and advised me to take Hydroxychloroquine 200 twice daily. What do you think? Kindly give your opinion.

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Hello,

Welcome back to icliniq.com.

I saw your reports (attachments removed to protect the patient's identity). I was, unfortunately, unable to understand your X-ray reports, but you told me that it is normal. So I will take that as normal. Your blood reports do not suggest any inflammation as your ESR (erythrocyte sedimentation rate), and CRP (C-reactive protein) are normal, and autoantibodies are also negative. The cause of your pain might be mechanical. If you have laxity of joints, that can also lead to recurrent aches and pains. You might benefit from physical therapy and lifestyle modification. You may take NSAIDs (nonsteroidal anti-inflammatory drugs) only when needed. If you have trouble sleeping, anxiety, or low mood, you may start tablet Duloxetine 30 mg once a day. It might also help with muscular pains. I hope this was helpful.


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