How to manage a stiff shoulder, lower back, and hip and knee joint pain?

Hi,

Welcome to icliniq.com.

I understand your concern. All the reports are blurred in the picture (attachments are hidden to protect the patient's identity). But since you have muscle stiffness and straightening of the LS (lumbosacral) spine, I suggest you the following precautions:

1. Avoid lifting heavy weights.

2. Avoid arching your back. Instead, bend your knees to pick up something from the floor.

3. Avoid sitting for long hours.

4. Avoid two-wheeler rides.

5. Improve your posture while sitting.

6. Try to get up from your chair every 20 minutes and take a quick walk around and then continue working. Always sit on a chair with back support.

7. Do not get up suddenly from a sleeping position. Rather, turn to the side and then get up.

8. Take bed rest if severe pain.

9. Do hot fomentations locally over the affected area at least twice daily.

10. Apply Oxalgin gel (Diclofenac, menthol, and methyl salicylate) for local application twice daily.

11. Take tablet Pregabalin 75 mg once at night for 15 days before food at 7 PM every day.

12. Take the tablet Myoril (Thiocolchicoside) 4 mg once at night for ten days after food. Continue tablet Naproxyn.

A probable diagnosis of your condition is RA (rheumatoid arthritis) with low back pain. Follow up with me after ten days and also upload clear pictures of the reports and X-rays. This is a professional suggestion subjected to the actual examination of reports, images, and inputs provided to me. It can be correlated with clinical findings for accurate diagnosis. Hope this has addressed your concern.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

You have avascular necrosis of the femoral head. The probable diagnosis is AVN (avascular necrosis) left hip stage 3 RA (rheumatoid arthritis) positive. I see a lot of cases of avascular necrosis of the hip. Most surgeons will ask you to get operated on for a total hip replacement for this, but studies have shown that medicines have a high possibility to avoid surgeries. I suggest you follow these:

• Continue rheumatoid arthritis medications.
• Take a tablet of Osteofos (Alendronic acid) 70 mg once a week for a year on an empty stomach early morning with two glasses of water and do not lie down or eat for 30 minutes after taking the tablets.
• Tablet Bio-D3 strong (Eicosapentaenoic acid, Ccalctriol, and folic acid) once in the morning for a year.
• Tablet Uprise-D3 60K (Vitamin D3) once daily for ten days, then once a month for a year.
• Tablet Celedol 200 mg once a day for 15 days after food and in case of pain.
• Tablet Rabeprazole 20 mg once in the morning for 15 days after food.
• Injection of Zoledronic acid 5 mg IV (intravenous) over 45 minutes, once a year for three years. Take two tablets of Crocin (Paracetamol) five minutes before or after the injection, as you might get a mild fever with this injection.
• You should use a walking stick on the right side.
• You can walk but do not exercise or do physiotherapy.

It will be a lot better if an in-person examination is done to give more accurate and elaborate suggestions.

Follow up in case of more queries.

Regards.

Hi,

Welcome back to icliniq.com.

I understand your concern.

I am very happy that you followed the complete course of treatment and that you have less pain in the hip. For the ankle, you need to stop Celedol (Celecoxib), and I suggest you start the tablet Piroxicam 20 mg once at night for ten days after food. Continue all other tablets. Wear an ankle brace all day and at night too. Keep ankle and foot elevated as far as possible.

Follow up with new hip X-rays and upload the new ankle X-rays.

Regards.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Pins and needle sensation of the ankle need another tablet temporarily. I cannot give you medicines for RA as I am not a rheumatologist, and I am an orthopedic doctor. You also need to consult a cardiologist and a physician due to deranged cholesterol levels. Hip X-rays are good, and sclerosis is a good sign with my treatment, so the progress is good. The ankle X-ray is fine, so the pain is just due to soft tissue, which is a rheumatological issue. But for ankle tingling and numbness, I suggest you take tablet Gabapentin 300 mg once at night for five days before dinner at 8 PM, then stop the medicine after five days. Continue with the ankle binder. Meet a rheumatologist and a cardiologist also for the problems mentioned above (deranged reports). Continue my treatment as before.

Follow up with me online after six months with a fresh X-ray of the hips.

Regards.

Hi,

Welcome back to icliniq.com.

I understand your concern.

By this time, if you do not improve, then a clinical examination is required in the OPD (outpatient department), and tablets need to be continued depending on the clinical examination. It is very difficult to correlate by just seeing the X-rays. So, continue the same tablets till you follow up in the OPD for a clinical examination. Get all your reports and X-rays when you come in person.

Hope this helps.

Regards.