Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Heavy Arms, Stiff Knees And Soreness On Shoulders
Question: I have heavy arms, legs, stiff knee, sore shoulder that spread to the other, flu-like feeling up and down legs once in awhile, trouble getting out of bed in the morning and exhausted at the end of the day.It seems to be most sore in the muscles, not so much the joints. I am an otherwise very healthy, active and strong, in-shape 48 yr old mother of four, who had been going to the gym regularly, eating very healthy, no drinking or smoking. This came on 6 weeks ago, started with a sore shoulder, and has not let up. In fact, it's gotten worse. I have tested negative twice for the Western Blot for Lymes disease by Quest Labs. Only one band on the test came up "reative" as I had Lymes back in '08, found a rash, treated immediately with Doxy and was completely fine for the past 7 years, no symptoms. Before knowing I was negative for Lyme and while waiting for test to come back, I was prescribed Doxy 2x a day (by primarry) and took for 18 days, with no change in symptoms whatsoever. My CBC is normal, my SED rate is normal, Parvo virus tested negative twice, I have no rash or tick bite but have guessed Lymes from the beginning. A rheumatologist tried to get fluid out of my knee, but couldn't get much fluid, that little bit tested negative.I feel sick, tired, achey like an old person and very scared. My mother had Polymyalgia 10 years ago and says I present the same, but my SED rate is completely normal, where hers was very elevated. I am behond frustrated. I don't know what else to do, seeing the Rheumatologist again, but want ideas on what to ask for besides more Motrin! Thank you so much. XXXX
Brief Answer:
Migratory Poly arthritis. Require further tests.
Detailed Answer:
Hello, Madam.
I understand your concern.
Many of your symptoms largely point to a connective tissue disorder
Lyme's disease is extremely unlikely in the presence of negative symptoms and lab profile.
Polymyalgia is also unlikely in the presence of normal CBC and SED.
I advise you to get a complete autoimmune screen antibody test.
Rheumatic arthritis is typically poly migratory in nature involving large joints.
Hence, serum ASO titers along with 2 D echo of the heart are also indicated.
Further management is based on the test results.
Post your further queries if any.
Thank you
Migratory Poly arthritis. Require further tests.
Detailed Answer:
Hello, Madam.
I understand your concern.
Many of your symptoms largely point to a connective tissue disorder
Lyme's disease is extremely unlikely in the presence of negative symptoms and lab profile.
Polymyalgia is also unlikely in the presence of normal CBC and SED.
I advise you to get a complete autoimmune screen antibody test.
Rheumatic arthritis is typically poly migratory in nature involving large joints.
Hence, serum ASO titers along with 2 D echo of the heart are also indicated.
Further management is based on the test results.
Post your further queries if any.
Thank you
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your attention and answer to my case. I have researched Migratory Poly arthritis, and find that I have none of the typical reasons for it's cause (gonorrhea,etc.)....and see that the best way to cure it is with Advil, analgesics, etc. All of which I have been taking. If that is indeed what I have, why wouldn't 800mg of Ibuprophen be helping now? What is the typical treatment and how long would it possibly take? I am assuming this is a temporary condition? I will ask my Dr on Monday about this and also for an Autoimmune panel. Why such a sudden onset and how long do people typically suffer from this? Thank you so much. XXXX
Brief Answer:
Disease course is largely predicted based on test results.
Detailed Answer:
Hello, Madam,
I understand your concern.
Migratory polyarthritis is not always caused by Gonorrhea.
Joint involvement one after the one like shoulder followed by knee followed by hip etc.Sequence may differ, but multiple joint involvements over a time period are common.
I also mentioned Rheumatic arthritis can be a leading diagnosis in view of the symptoms.
Please note Rheumatic is different from Rheumatoid arthritis.Later is purely an autoimmune disorder. But both can present clinically one and same.Hence, an autoimmune panel is asked for to differentiate the two.
Rheumatic arthritis is a sequel to childhood streptococcal sore throat infection which after a lapse of 20-30 years affects the joints and heart(RHD-rheumatic heart disease).This may look like such a sudden onset.This is a very prevalent disorder.Hence, I advised ASO(anti-streptococcal O titers) and 2D echocardiography of the heart.
Yes, Ibuprofen 800 mg is an excellent option against this form of joint involvement. This condition can be temporary if coupled with excellent medical measures.
Based on the test results(ASO and echo) if turned out positive for Rheumatic arthritis, then penicillin prophylaxis is indicated on a long-term basis to bring the disease under control.
In case if an autoimmune screen is positive then Rheumatoid arthritis should be primarily concerned.In all such cases, long-term steroids will be the treatment of choice.
In both cases, early diagnosis and treatment will bring the disease under long-term remission.
Post your further queries if any,
Thank you.
Disease course is largely predicted based on test results.
Detailed Answer:
Hello, Madam,
I understand your concern.
Migratory polyarthritis is not always caused by Gonorrhea.
Joint involvement one after the one like shoulder followed by knee followed by hip etc.Sequence may differ, but multiple joint involvements over a time period are common.
I also mentioned Rheumatic arthritis can be a leading diagnosis in view of the symptoms.
Please note Rheumatic is different from Rheumatoid arthritis.Later is purely an autoimmune disorder. But both can present clinically one and same.Hence, an autoimmune panel is asked for to differentiate the two.
Rheumatic arthritis is a sequel to childhood streptococcal sore throat infection which after a lapse of 20-30 years affects the joints and heart(RHD-rheumatic heart disease).This may look like such a sudden onset.This is a very prevalent disorder.Hence, I advised ASO(anti-streptococcal O titers) and 2D echocardiography of the heart.
Yes, Ibuprofen 800 mg is an excellent option against this form of joint involvement. This condition can be temporary if coupled with excellent medical measures.
Based on the test results(ASO and echo) if turned out positive for Rheumatic arthritis, then penicillin prophylaxis is indicated on a long-term basis to bring the disease under control.
In case if an autoimmune screen is positive then Rheumatoid arthritis should be primarily concerned.In all such cases, long-term steroids will be the treatment of choice.
In both cases, early diagnosis and treatment will bring the disease under long-term remission.
Post your further queries if any,
Thank you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi Dr,
thank you for your answer. I have seen the Rheumatologist today. I learned that she had already tested for the ASO titer, it had been negative. Anything Rheumatoidal had come back negative. She did one more test, "CP---" can't remember the next letter, but it is a more specific test to get my SED rate and indicate more definitively anything showing an inflamatory situation. She also ordered xrays of the neck and back to look for any spinal stenosis or pinching of nerves, etc. to indicate some kind of strange spinal relationship to nerves, muscles, etc. She said they have been surprised by this before. I asked for any kind of treatment to alleviate some of my pain, discomfort like a steroid, etc. She said absolutely not at this point, opening me up for further complications. I was very frustrated but understood her point. Right now, it is very hard not to think this is one stubborn weird virus. But it has not let up and stays very steady. She definitely sees it is more muscular than in the joints. She told me to continue on the 800 Advil, but with food. She also said she would refer me to a neurologist if needed after tests come back.
I am asking you 1) what esle can I do at this point? to alleviate pain 2) I know the Dr's dont think Lyme, but don't my symptoms still seem to mimic Lyme symptoms? Hard to get that out of my head! With people we know having had false negatives....although I DID test negative for Babeesia. Thank you so much for your time and for helping not to go insane! I have been suffering for two months! XXXX
.....correction, it is the CRP test she ordered, another way of getting an accurate SED rate, thank you
thank you for your answer. I have seen the Rheumatologist today. I learned that she had already tested for the ASO titer, it had been negative. Anything Rheumatoidal had come back negative. She did one more test, "CP---" can't remember the next letter, but it is a more specific test to get my SED rate and indicate more definitively anything showing an inflamatory situation. She also ordered xrays of the neck and back to look for any spinal stenosis or pinching of nerves, etc. to indicate some kind of strange spinal relationship to nerves, muscles, etc. She said they have been surprised by this before. I asked for any kind of treatment to alleviate some of my pain, discomfort like a steroid, etc. She said absolutely not at this point, opening me up for further complications. I was very frustrated but understood her point. Right now, it is very hard not to think this is one stubborn weird virus. But it has not let up and stays very steady. She definitely sees it is more muscular than in the joints. She told me to continue on the 800 Advil, but with food. She also said she would refer me to a neurologist if needed after tests come back.
I am asking you 1) what esle can I do at this point? to alleviate pain 2) I know the Dr's dont think Lyme, but don't my symptoms still seem to mimic Lyme symptoms? Hard to get that out of my head! With people we know having had false negatives....although I DID test negative for Babeesia. Thank you so much for your time and for helping not to go insane! I have been suffering for two months! XXXX
.....correction, it is the CRP test she ordered, another way of getting an accurate SED rate, thank you
Brief Answer:
Please get remaining tests.
Detailed Answer:
Hello, Madam.
I understand your concern.
1.In case you are tested negative for ASO, I advise you to shift your focus on the autoimmune screen and a 2D echo of the heart.
2.Likewise anti ccp antibodies for Rheumantoid arthritis is more specific and sensitive than CRP and sed.Hence this test is highly recommended to you.
3.Lyme disease is unlikely.
4.Babesia is also unlikely.
5.Further evaluation through complete autoimmune screen,2D echo oh heart,Anti CCP ab's can broaden therapeutic options.
6.Continue with Advil 800 mg as prescribed.
7.Steroids can be given only if autoimmune screen and anti CCP are positive.
Right now they are not indicated.
Post your further queries if any,
Thank you.
Please get remaining tests.
Detailed Answer:
Hello, Madam.
I understand your concern.
1.In case you are tested negative for ASO, I advise you to shift your focus on the autoimmune screen and a 2D echo of the heart.
2.Likewise anti ccp antibodies for Rheumantoid arthritis is more specific and sensitive than CRP and sed.Hence this test is highly recommended to you.
3.Lyme disease is unlikely.
4.Babesia is also unlikely.
5.Further evaluation through complete autoimmune screen,2D echo oh heart,Anti CCP ab's can broaden therapeutic options.
6.Continue with Advil 800 mg as prescribed.
7.Steroids can be given only if autoimmune screen and anti CCP are positive.
Right now they are not indicated.
Post your further queries if any,
Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
