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Feeling cold, sweats, pain in wrists, ankles, hips, lower back and have red face. Any permanent cure?

Nov 2013
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Practicing since : 1994
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Temp 95 cold sweats profuse pain wrists, ankles, hips, low back, redness of face, exertion exacerbates symptoms

During early years rheumatologist performed many diagnostic tests, x rays, mri's, blood tests and nothing was found to be abnormal.

Acupuncture threw me into horrific pain and needles were quickly removed.

If I am stuck in a place where I cannot lie down ( such as airport) for more than few hours the pain becomes so severe ( like I am loaded down with wet sandbags) that I have to just lie on the floor until the pain subsides. I can't imagine what my body would do without the medications. In first few years I was completely bedridden until this combination of drugs I now take was found.

The buprenorphine was given because I was on massive doses of morphine, fentanyl and when my pain doctor left town no one would take my case. I was fortunate to know Psychiatrist Dr. XXXXXXX McClure who is licensed to prescribe suboxone and have found the buprenorphine to be far more effective in treating this pain than the other narcotics ever were plus my mind is more clear.

Still I feel there must be some diagnostic test we haven't yet tried. My GP knows of nothing. Please help me if you can.
Posted Wed, 28 Nov 2012 in Brain and Spine
Answered by Dr. Sudhir Kumar 59 minutes later

Thank you for posting your query. And I must appreciate the details you have provided.

I agree with you that it can be frustrating if the condition has not been diagnosed or confirmed for such a long time.

Chronic pain (lasting more than six months) is always neuropathic, either partly or in full.

Central nervous system (CNS) is involved in pain perception in chronic pain, the most important structure being thalamus. Other area of CNS involved in pain perception is spinal cord. For assessing these two areas of CNS, MRI scan of brain and spinal cord would be useful (if they have not already been done).

The assessment of peripheral nervous system (PNS) is also important. This can be done with nerve conduction studies of motor and sensory nerves. The dysfunction of sensory nerves gives rise to chronic pain.

Common markers of inflammation may have already been performed by the rheumatologist. If not, they may be done, which include ESR, C reactive protein, rheumatoid factor, XXXXXXX etc.

Additionally, venous system of legs should also be tested, as incompetence of veins in the legs can also cause severe pain in the legs on standing, which subsides on lying down.

I hope it helps. I would be pleased to answer any more queries, if you have.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Consultant Neurologist
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