Q. I have severe low back pain with fatigue and leg pain. Are the symptoms related to arthritis?

Answered by
Dr. Peter Grutas
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 29, 2020

Hello doctor,

I have been dealing with severe lower back pain, hip pain, butt and leg pain, fatigue, insomnia, hot and sweaty, pain in wrist and fingers, foot pain (left foot my toes are curved down and one is curved to the left). I do not know if this has anything to do with arthritis but there are occasional lesions in my nose and occasional neck pain. I am currently taking Cymbalta. I have had Arnold Chiari malformation and underwent decompression surgery.

Dr. Peter Grutas

General Medicine Internal Medicine


Welcome to icliniq.com.

I am sorry you are having these symptoms. Have you had any laboratory workups done before? How about imaging studies?

There are many causes of your current symptoms and this makes it more complicated since you have Arnold-Chiari malformation. This includes autoimmune condition, degenerative condition and metabolic conditions. I would recommend that you do further testing to understand your condition. I would recommend that you check your CBC (complete blood count), RF (rheumatoid factor), SGPT (serum glutamic pyruvic transaminase) and SGOT (serum glutamic oxaloacetic transaminase), BUN (blood urea nitrogen), creatinine, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), thyroid function test and FBS (fasting blood sugar) as initial tests.

In the meantime, I recommend that you undergo a physical therapy program to include ultrasound, TENS (transcutaneous electric nerve stimulation), William's flexion exercise, Myofascial release, joint conservation techniques, range of motion exercises within pain-free range, endurance exercise as tolerated. I would also recommend you take Naproxen three times a day for pain and Ibuprofen twice a day for breakthrough pain. Once you have the results of the tests, please do follow up.

I hope this helps.

Regarding follow up:

Follow up with lab results.

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