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Pain in joints and hurting. Taking physical therapy. Suggest a solution?

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Orthopaedic Surgeon
Practicing since : 1994
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I’m a 22 year old in the USA with a problem no doctor seems able to diagnose. I have been healthy all my life, eat a standard diet and have no family medical history. In high school I was very active and played on several sports teams but over the past five years I have had an increasing number of pain problems with my “joints”. It began with my knees when I stood for hours behind an ice cream counter in high school, and now includes my ankles, jaw, elbows, and wrists. This has made me unable to perform nearly all exercises including low impact swimming and even walking. After minimal exercise, such as a two hour hike, my ankles will have a low level constant ache for days. They hurt every day. I have been to a total of six doctors including a rheumatologist, orthopedic surgeon, and an orthopedic sports medicine doctor, and two physical therapists. In physical therapy, the furthest they were able to get me was resistance bands. All the obvious things have been tested for and come up negative, from Lyme disease to arthritis to any sort of infection or inflammation. No doctor has any suggestion now of what I might do to resolve this and the last group stopped without any diagnosis they could name or suggestion of whom I might go to see. Last thing I did with them was a three phase bone/joint scan with radioactive tracer. The doctors found anomalies where I had complained of pain. They said my scan looked similar to that of a marathon runner or someone who currently engaged in intense physical activities, but I have only sat a lot for the last few years. There were no signs of an inflammatory joint disease such as rheumatoid arthritis. I was told the findings are “more suggestive of stress reactive changes on the bones where tendons and ligaments attach”. As the official report said, “There was no evidence of an inflammatory arthropathy to joints. There are stress reactive changes to elbows and wrists and stress related periosteal reactions in mid right foot and in the bilateral tibial tuberosites.” Unfortunately they offered no solutions to my problem besides pain management medication, and every doctor has said they have never seen a similar condition. This issue has really taken a toll on my life, as I have seen myself go from a physically fit individual to being inactive and overweight. I was hoping for some guidance or suggestions as to what the problem is and how I can go about making myself better. Is there a nutrition related component I should pursue? If I go to another orthopedic (?) doctor what should they be looking for? What sort of specialty should I pursue? I’m not into the new age alternative medicines approaches of kinesthetic, energy healing, deep massage, etc.
Posted Tue, 1 Oct 2013 in Arthritis
Answered by Dr. Praveen Tayal 1 hour later
Brief Answer:
You can consult an orthopedician.

Detailed Answer:
Thanks for posting your query.
The bone scan is suggestive of stress related changes in the joints causing the pain. These changes are difficult to reverse but further progression can be retarded with pain medications and physical therapy.
A few simple dietary changes, like reducing refined carbohydrates and sugar, can make a dramatic difference in your joints. Eating more fruits and vegetables, which contain natural anti-inflammatories, and adding a high-quality multivitamin to fill any nutritional gaps will also help.
A high-quality omega-3 fatty acid supplement is also recommended.
You can consult an orthopedician for proper supplements and pain management.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
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