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Having muscle, joint pain, anxiety and fatigue. Has three bulging disc in back. Guide

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Internal Medicine Specialist
Practicing since : 1998
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Over the last 4 years of have had increasing muscle and joint pain along with fatigue and anxiety. I have had an arthroscope done on my left shoulder 2 years ago ( with severe arthritis,bursitis and a hangnail size symptoms and has has 1 injection of cortisone last september. My hips have both had injections for buristis at least once, but remain very painful. My back has 3 buldging disc, with arthritis causing an the nerve to be pinched to my legs and will be going for a second epidural on the 23rd of this month. MRIs and ct scans show arthritis and inflamation in these joints, but these are not the only joints hurting. This is becoming almost debilitating as it is getting hard to do anything, and the pain and stiffness is worse in the am but continues through out the day. I am currently taking levothyroxine, lyrica, mirapex, fenofibrate,prilosec, zantac, klonopin, propanonol, XXXXXXX dose of ibuprohen or aleve a day, then if necessary followed up with percocet 10/325. I am being treated for this through my primary DR. and respect and love his patience, but my last appointment I asked him what is wrong with me, I can't stand this. He never answered my question? I am wondering with the symptoms and the chronic issues with pain, This is daily. Some days better some worse. but never pain free. I want to ask him to refer me to a rhuematologist, but I dont want to make him feel like I am disrespecting him. I just want to know, or have a name for whatever in the world is going on. Is it appropriate, have I been more then patient.
Posted Mon, 3 Jun 2013 in Bones, Muscles and Joints
Answered by Dr. Pankaj Malhan 2 hours later

Thanks for asking.

I think it is quite appropriate for you to look for a diagnosis, four years of continued pain in the multiple joints of the body definitely demands investigations.

There are few possibilities, rheumatoid arthritis is one of them, along with other connective tissue disorders .

Rheumatoid arthritis (RA) is an autoimmune disease that results in a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks flexible (synovial) joints. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility if not adequately treated.

To get to the diagnosis of rheumatoid arthritis, you need to undergo some special investigations like RA factor, ESR, C reactive proteins, and now a days more specific blood marker which test for the presence of the anti-citrullinated protein antibodies (ACPAs) or anti-CCP has been used.

I think the time has come to consult a Rheumatologist. Just keeping on taking pain killers is not going to stop the progression of the disease, if it is rheumatoid arthritis.

I hope I have answered your query, I am available for follow up questions if needed.

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