HomeAnswersRheumatologyjoint painI have had joint pain along with other symptoms. Kindly help.

Why do I have joint pain, back pain, depression, gastric irritation, and headache since a long time?

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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

iCliniq medical review team

Published At April 19, 2022
Reviewed AtOctober 10, 2023

Patient's Query

Hello doctor,

Since childhood, I have experienced joint pains. I had food aversion and was taken to the ER once for fainting with a high fever. I developed food allergies, severe joint aches, chest pains, depression, and anxiety as an adult. Now that I am 54 years old, my depression is somewhat managed, and I have seen specialists. I lost my job eight years ago due to hypothyroidism. Now I feel like I cannot remember much and cannot reason well as I once did. I also have GI and periodontitis that keep me home (embarrassing gas and halitosis). I am menopausal and have fibroids and hirsutism. Some symptoms improve with time and then come back, like back pain, headaches, and joint pain. My current medications include:

  • Liothyronine 5 mcg.
  • Levothyroxine 112 mcg.
  • Omeprazole 40 mg.
  • Duloxetine 30 mg.
  • Cetirizine half a tablet for allergy and dryness.
  • Hydroxyzine for insomnia.
  • Iron supplements.
  • Montelukast 30 mg.
  • Vitamin D 50,000 IU weekly.
  • Multivitamins.
  • Tylenol one tablet daily.
  • Statins for high cholesterol and triglycerides.
  • Repatha.
  • Prozac.
  • Wellbutrin.
  • Mobic.

My protein electrophoresis test results show an elevation in alpha-2 globulin, ESR, and CRP values. An oncologist ruled out multiple myeloma. However, my hemoglobin is low sometimes, and so are my CO2 and chloride. In addition, I have numerous allergies, anemia, asthma, tremors, central hypothyroidism, sleep apnea, pre-diabetes, periodontitis, chronic fatigue, depression, joint pain, IBS, weakness, and memory problems. What do you think is going on with me?

Hello,

Welcome to icliniq.com.

I went through your reports and investigations (attachments removed to protect the patient's identity). It seems like you have polymyalgia rheumatica. I would suggest a single intramuscular dose of Depo-Medrol (Methylprednisolone Acetate) 40 mg. If the response in symptoms is more than 50 %, that will confirm the diagnosis and ease further management.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Is polymyalgia rheumatica called just arthralgia for people under 50 years of age? I have had body pain since elementary school.

Thank you.

Hello,

Welcome back to icliniq.com.

If you have had the problem for decades, I believe it cannot be a serious illness because no serious illness will stay silent for decades. Polymyalgia causes pain and elevation in the ESR (erythrocyte sedimentation rate). If ESR were normal, fibromyalgia would have been a better diagnosis. PMR (polymyalgia rheumatica) is generally a disease that occurs after 50 years, as you said. I am sure there is nothing wrong with one injection of Depo-Medrol, or you can start Duloxetine 20 mg and increase the dose after two weeks for FMS (fibromyalgia syndrome).

Regards.

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

Dr. Ashaq Hussain Parrey
Dr. Ashaq Hussain Parrey

Rheumatology

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