Q. I get joint and muscle pain with positive ANA test and normal ESR and CRP. What is my problem?

Answered by
Dr. Naval Mendiratta
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 16, 2020

Hello doctor,

I get frequently sick with joint and muscle pain and burning legs sometimes feel difficulty walking and climbing stairs. I consulted a physical, he tested ANA and it came back positive but since ESR and CRP are normal he said no need to test further and I am perfectly healthy. But my pain never subsided, I cannot go to the office due to AC and joint pain. It is affecting my work and quality of life due to frequent sickness and unable to do normal activities. After consulting a rheumatologist he further tested ANA profile and anti ds DNA. That also came perfectly alright. I am confused with my body why my joints are paining so much without any disease?



Welcome to

I would like to ask you a few more queries. Is your sleep pattern normal? Do you have morning fatigue? How long did the viral last? Any hair fall, oral ulcers, dry eyes, or dry mouth? Any recent irritability or forgetfulness?

It more appears to be chronic fatigue syndrome which usually has a previous viral illness. But let me know these queries and would guide you further.

Thank you doctor,

When I am stressed I do not get sleep. After this sickness, I could not sleep due to pain and stiffness. I did not have a viral fever. Hair fall is there but no dry mouth. And yes, I often get irritated and forget the points, I cannot even work in the office. Kindly check my attached lab reports.



Welcome back to

I have gone through the reports as well (attachment removed to protect patient identity). Alone ANA I could not find but the rest of the subset seems fine. Also, since you mentioned your ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) are normal. We can conclude that the ANA is not causing so much impact on your body. So we can just observe for any evolution of symptoms as the other symptoms which I asked are also negative.

As for the current symptoms, it seems like fibromyalgia, chronic fatigue syndrome which is going on. I would suggest you start on tablet Pregabalin M 75 mg at night and see how it works. Side effects are giddiness and sleep but it gets normal in a couple of days. You can read about it once and see if your symptoms match through it.

And definitely try to combat the stress. I know it is easier said than done but it adds up to your pains.

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