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Severe pain in arm, soles of feet, hand and neck. Prescribed celebrex for pneumonia. X-ray done. Prognosis?

Dec 2012
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General & Family Physician
Practicing since : 2012
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My wife, age 63, is very pain tolerant; however, about 4 weeks ago she began complaining of extreme pain in the muscles of her right arm. It soon included the muscles of her left arm. Doctor diagnosed pneumonia and gave her a trial sample of Celebrex. It didn't help. Then the pads on the soles of her feet began hurting. Then the base joint of her pointing finger of her right hand swelled very large and became extremely painful. Then her entire left foot swelled like a balloon. Followed by painful neck. And now shoulders. None of them go away -- they just keep spreading. No nodules; no fever; no gastric or intestinal problems. Just pain. Cannot sleep; just cries from the pain. Current doctor is awaiting results of RA test and X-rays. She is afraid to take any of the powerful pain pills, so don't know if they would relieve the pain. Pain starts getting worse in late afternoon, and peaks during the night. Mellows some during the day, but she can still hardly move without pain.
Posted Sun, 5 May 2013 in Lung and Chest disorders
Answered by Dr. Nsah Bernard 8 hours later

Thanks for posting on XXXXXXX

I am pleased to be able to answer your health query,

First I will like to start by saying that your wife's initial doctor's impression does not correlate to her presenting symptoms of pain (i.e pneumonia) except of course she had cough (and/or other signs of pneumonia) and the medication given celebrex (celecoxib) is an analgesia medication used to relief rheumatic type pain. Your wife is most probably suffering from fibromylagia or a form of rheumatic diseases (not arthritis). Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event. Women are more likely to develop fibromyalgia than men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (surely wife does not present with such a problem) disorders, irritable bowel syndrome (of course your wife does not present with such GIT disorder), anxiety and depression.
While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help. My suggestion is that you should start taking medication starting from the lowest class of pain medicine (increase dosage to maximum daily dosage) before you can change to stronger classes. Lower classes such as acetaminophen alone or in combination with opiate derivatives could yield some good relief. My reason for this suggestion is that if your wife starts with stronger pain relievers now and develops intolerance to them, she will find herself having no drugs to calm her pain and will now be placed on psychotropic medications (just to manage her psychological state). The specialist of choice here will be a neurologist or an anesthesist physician.

Hope this helps and wish you the best.

Dr. Nsah
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