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What causes severe pain tendons and ligaments? - Online Doctor Chats

Date : 11-Apr-2014
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2009
Answered : 983 Questions
User:i am a 58-year old female wondering if some disease process is cause of chronic and worsening pain; started, oddly, in tendons or ligaments at point of joining to bone or muscle (not joint pain per se, but the ligaments and tendons themselves); this has been years and now muscles and even my "fat" hurts (or the skin around it when slightly pinched). i just live with it but, having enjoyed especially good musculo-skeletal health most of my life (and having been a competitive runner for for about 20 years), i feel there is something more than "old age" at work. this started in my late 30s and has progressed so incrementally that i just "let it go"; it doesn't stack up with other women i know my age; exacerbated by menopause, perhaps. Seriously, even my "fat" hurts? It's as though I've been bruise all over ...with no bruises.
Let me read your query for few minutes to be able to have a good discussion here.
Doctor:May I know since how long have you been in pain?
Doctor:Does it hurt throughout the day or only at times?
Doctor:Are you there?
Doctor:You there?
User:for 20 years, progressing, as noted, from what appears to be connective tissue areas. I now have pain always -- though it is worse at times, as though more inflamation -- but it is not just joints, or not just muscles. It is in all sorts of tissue.
Doctor:Which areas of the body are affected - upper limbs or the lower?
User:throughout the day i must focus on things other than the pain and so resolved to live with it. but it, along with my lung function since my pneumonia 15 years ago, seem to be just worsening. i have never smoked but feel phlegm-y all the time and am wondering if the two symptoms are related. upper and lower extremities involved. it basically feels as though i have been through a strenuous work-out, with soreness in all muscles when i have actually done nothing.
Doctor:Alright. Besides this pain and breathing issues do you have any other symptoms?
Doctor:Do you feel weak and tired most often?
Doctor:How is your sleep?
Doctor:And your appetite?
User:appetite has increased substantially but i attribute this to hormonal changes - menopause. Obvioiusly the menopause also affects my sleep - i wake up anywhere from 5 - 20 times a night. But the pain began well before menopause -- it's jsut worse now. I am often overly tired but my schedule is such that, with the lack of sleep, that seems like a normal result. i do get to points where i am so tired i can't funtion -- i just must lay down -- even on my office floor. i am a "do-er" and tend to go go go go then HAVE TO STOP and be utterly without any energy and then very aware of the pain
Doctor:I appreciate your courage and efforts. I would need some more time to discuss about your concern; I shall add another 15 minutes to your account.
User:it is almost like i have a poison in me (not to be dramatic). it's jsut that it's so spreadout -- diffuse -- and constant. And Odd.
Doctor:Since you mentioned you were diagnosed with rheumatic fever, do you have nodular lesions on the body.
Doctor:And have you been evaluated by a doctor / started treatment for it?
Doctor:* treated for pain?
User:I'm not quite sure to what you are referring: do you mean swollen nodes? like on my neck? I think of "lesions" as sores...I am not currently treated for RF; i have take prophylactic antibiotics when having dental work done (and i have had much dental work done -- several root canals and crowns). otherwise, no "current" treatment for RF and, in fact, they did not diagnose it at the time i was 4; fever was bad enough that they did spinal tap and never did, according to my mother, come up with definitive diagnosis at that time. i believe that the doctor who diagnosed the mononucleosis when i was in high school, said he heard a murmur and this was somehow consistent also with getting mono...i don't know how he arrived at this after-the-fact diagnosis.
User:oh, sorry, i didn't see the next question. No, i XXXXXXX not been treated for this pain. They did much to try to help me because of the residual pain from the ruptured disc, which i let go to far - thus the drop foot. i have had PT and they offered Lyrica and other like drugs -- not my thing so i did not take. i am more concerned with the overall pain and "why" than ingetting drugs to mask. i take ibuprophen when i just can't take it anymore and / or need to sleep ...600miligrams every several hours for a few days and then try not to take for as long as possible. i'm too young to wreck my stomach :)
Doctor:I am sorry for confusion you. Before I proceed to address your concern I wanted to know what measures were taken by your doctor to treat this pain.
Doctor:Nevertheless, let me give you my opinion now.
Doctor:Yes, you seem to be suffering with a chronic painful condition. It may or may not be from an inflammatory condition. However in the background of rheumatic fever
Doctor:I would not like to over look inflammatory condition per se.
Doctor:Joint pains, painless nodules especially on the upper limbs, palms are characteristic of rheumatic fever.
Doctor:You there? some prompt that confused me ...
Doctor:Since you also have breathing issues along with painful tissues in the back ground of rheumatic fever, I would strongly recommend that you be investigated for autoimmune conditions.
Doctor:The next possibility that I would be considered are neuralgic pains related to hormonal, vitamin and mineral disturbances.
Doctor:If all these are negative, I would relate these issues to fibromyalia where the body tissues are overly sensitive to normal stimulus.
Doctor:All these 3 conditions that I mentioned can very well explain your symptoms.
Doctor:Therefore before we put you on medicines to treat this pain, you need to be thoroughly investigated.
Doctor:A rheumatologist will be the first doctor I would approach in such situations.
Doctor:Since you have been enduring the pain for pretty long time, I would suggest that you call rheumatology specialist at the earliest and start your treatment.
Doctor:Did you follow what I said? Can you summarize our discussion?
User:the only autoimmune testing ever done (by my internist) was maybe 10-12 years ago: rheumatoid arthritis only. i do not know the exact test (it was on the labs though). this, however, wouldn't have explained the muscle pain anyway. A rheumatologist sounds like a reasonable answer to me -- it seems autoimmune.
Doctor:I would not label the diagnosis of autoimmune condition right away
Doctor:but based on your symptoms and your back ground history I would like your doctor rules this out first.
User:no...i understand; but since it pre-dated my menopaus and even my peri-menopause, i don't believe it is the cause - only exacerbates what already was
User:thank you very much.
Doctor:I wasn't talking about menstrual hormones
Doctor:I hope I have answered your questions.
Doctor:Thanks for consulting me.
Doctor:Bye for now.
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