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Suggest Treatment For Postmenopausal Syndromic Pains

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Posted on Tue, 5 May 2015
Question: I have moderate to severe body aches and pains that seem to attack my joints in my knees, hips, spine, shoulders hands, fingers, neck sciatic pain in right buttocks, I also have memory problems I have vision changes that I got glasses for this past month, I have no energy, I don.t sleep well at night due to pain especially in my leg muscles and knees. I have had a rotator cuff surgery in may and a Left knee replacement in Feb and a right knee replacement scheduled for May. I am sure some of my issue is depression since I have not been out of my house more than 5 times in the past 8 months because I cannot walk far. When I work around my house it is slow and difficult due to pain then for the next several days I cannot move from a chair because of the pain. What should I look for or do to feel better. I am 55 but feel 85.
doctor
Answered by Dr. Sabiha Banu (55 minutes later)
Brief Answer:
postmenopausal syndromic pains

Detailed Answer:
Hi

Thanks for using HCM.

Can understand your condition & feel concerned.

Most of the pains what you are having are postmenopausal syndromic pains.
I suggest you to check out with your calcium, vitamin-d3, vitamin b12 & thyroid levels, then add up with calcium & vitamin d3 supplements daily.

With all the above surgeries,crp levels & the due surgery it appears that you have chronic health problem, especially with the joints.

Please try to relax yourself by slow physiotherapic exercises,warming up after prolonged position or getting up from bed & slow walking.

I would suggest you to consult a pain specialist to start you on initial non opioid treatment with pregablin in combination of methylcobalamine, along with the course of immunomodulators like diacerin + glucosamine.

Proper hydration, electrolyte balance,with multivitamin supplements will help you to great extent.

Try to change your lifestyle,to avoid medical depression by involving yourself in other activities, interaction,or get yourself counselled by a psychiatrist.

Always hoping for your good health with speedy recovery.
Best wishes for your next surgery.

Please be free to discuss any doubt related to your problem.

All the best, Take care.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sabiha Banu (1 hour later)
I am on premarin, diclofenec vitamins and minerals including omega3 and lutein. Extra calcium and vit d and I take an extra B complex I do take Norvasc for BP. I try to exercise everyday which includes yoga and light weight lifting. I always feel like I am getting the flu with body aches and I have great fatigue all day everyday. I have sun sensitivity with rash and stinging so I am never in the sun without coverup and sun screen I don't drink pop or use sugar, I try to healthy but I have lost 20 # over the last 8 months. I do not smoke or drink. I am just wondering if my issues could be lupus, RA, MS. I do know that I had a severe sciatic pain and was given a predinisone pak, That was the best week I have had in 4 years.
I am on premarin, diclofenec vitamins and minerals including omega3 and lutein. Extra calcium and vit d and I take an extra B complex I do take Norvasc for BP. I try to exercise everyday which includes yoga and light weight lifting. I always feel like I am getting the flu with body aches and I have great fatigue all day everyday. I have sun sensitivity with rash and stinging so I am never in the sun without coverup and sun screen I don't drink pop or use sugar, I try to healthy but I have lost 20 # over the last 8 months. I do not smoke or drink. I am just wondering if my issues could be lupus, RA, MS. I do know that I had a severe sciatic pain and was given a predinisone pak, That was the best week I have had in 4 years. FYI my vit D and B12 levels were normal,
doctor
Answered by Dr. Sabiha Banu (1 hour later)
Brief Answer:
rheumatologist consultation.

Detailed Answer:
Hi

Thank you once again for following up with HCM.

From all the symptoms what you have described, your condition more so drifts into lupus, although RA factor being seroneagative, this cannot be totally ruled out.

I really suggest you to consult a rheumatologist, the most better person to differentiate & diagnose your condition.

In my opinion it would be more better for you to stop premarin (as it can increase osteoporosis & drug induced lupus in many) & diclofenac too which can alter your kidney functions.

kindly evaluate for your serum ANA (antinuclear antibodies), ESR, serum ferritin levels,urine for lupus antibodies,kidney & skin biopsy,ACPA(anti-citrullated protein antibodies-specific for RA) with the assistance of your treating doctor, co-relating clinically.

In your condition the best outcome of treatment would be with steroids, or immuno-suppressants,DMARD-(disease modifying anti rheumatic drugs),controlled diet,positive acceptance of the clinical condition,change of life style, destressing yourself-not to develop progressive clinical depression.

Hoping for your positive recovery & good health once again.

All the best, take care


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sabiha Banu (5 hours later)
My ANA and RA were negative last year when they were checked. could I still have something like Lupus even with neg tests? I saw a rheumatologist last year and he did no other testing than what my primary doctor had done and said I just had osteoarthritis and tried Celebrex, Relafen, Naprosen, feldane? and diclofenac. The Diclofenac did seem to help my fingers, hands , wrists and shoulder at least so it was tolerable but not the other areas like spine, hips and knees.

doctor
Answered by Dr. Sabiha Banu (3 hours later)
Brief Answer:
conservative treatment

Detailed Answer:
Hi
Thanks again for using hcm.

Really feel helpless on your condition & suffering.

You do not have to repeat the test again,as your tests and history seems to favour osteoarthritis,which is confirmed by your treating doctor.

It is the most common degenerative disorder, added with collagen impairment.

The best treatment for your problem is
Application of topical painkillers,
Simple drugs like paracetomol,aspirin,diclofenac(with regular check on your kidney and renal parameters).
Opiod analgesics
Weight reduction & change in life style.
Local deposition of steroids,hyalouridinase.
Antioxidants like vitamin a,e,c.
Bone immuno modulators like glucosamine.
Ultimate treatment lies with joint replacement surgeries with involvement of major joints (as in your case).

Hoping that I could have helped you to some extent.
May the Almighty sustainer provide you progressive relief and betterment.
All the best.
Take care.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Sabiha Banu

Pain Medicine & Palliative Care Specialist

Practicing since :2000

Answered : 749 Questions

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Suggest Treatment For Postmenopausal Syndromic Pains

Brief Answer: postmenopausal syndromic pains Detailed Answer: Hi Thanks for using HCM. Can understand your condition & feel concerned. Most of the pains what you are having are postmenopausal syndromic pains. I suggest you to check out with your calcium, vitamin-d3, vitamin b12 & thyroid levels, then add up with calcium & vitamin d3 supplements daily. With all the above surgeries,crp levels & the due surgery it appears that you have chronic health problem, especially with the joints. Please try to relax yourself by slow physiotherapic exercises,warming up after prolonged position or getting up from bed & slow walking. I would suggest you to consult a pain specialist to start you on initial non opioid treatment with pregablin in combination of methylcobalamine, along with the course of immunomodulators like diacerin + glucosamine. Proper hydration, electrolyte balance,with multivitamin supplements will help you to great extent. Try to change your lifestyle,to avoid medical depression by involving yourself in other activities, interaction,or get yourself counselled by a psychiatrist. Always hoping for your good health with speedy recovery. Best wishes for your next surgery. Please be free to discuss any doubt related to your problem. All the best, Take care.