Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Severe Pain After ACL Replacement Surgery
Question: Hi I am a lupus suffer I recently had an ACL replacement and have been dealing with moderate to severe chronic pain and not only the area that I had surgery on but also all over body pain but it's not being relieved by corticosteroids and plaquenil . When I have gone to the emergency room's here they just say to take prednisone and sent me home but my pain is become so I manageable that I am unable to focus on my daily function I live in a rural Area and also suffer from degenerative disc disease and neuropathy I have seen a rheumatologist in the past but I'm wondering if I would be better served by a neurologist and also by going to a larger hospital like the University of Iowa to deal with this pain it is interfering with my daily life both physically and psychologically any suggestions that you have would be helpful
Brief Answer:
Chronic pain syndrome
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history..It does seem like the pains you are suffering from looks unrelated to lupus or it is some muscle disease going along which is causing the difficulty.
With lupus it is always a tricky situation...Whether to increase steroids or not...Whether it is due to disease or something else
I would like to know a few more queries:
1. DO you have difficulty in getting up from bathroom seat or combing your hair?
2. Is there any dry eyes or dry mouth?
3. What is the dose of prednisolone are you taking?
4. Is there any history of irritability?Disturbed sleep or forgetfullness??
DO let me know these queries. WOuld guide you further from here
Regards
Dr Naval
Chronic pain syndrome
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history..It does seem like the pains you are suffering from looks unrelated to lupus or it is some muscle disease going along which is causing the difficulty.
With lupus it is always a tricky situation...Whether to increase steroids or not...Whether it is due to disease or something else
I would like to know a few more queries:
1. DO you have difficulty in getting up from bathroom seat or combing your hair?
2. Is there any dry eyes or dry mouth?
3. What is the dose of prednisolone are you taking?
4. Is there any history of irritability?Disturbed sleep or forgetfullness??
DO let me know these queries. WOuld guide you further from here
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Sonia Raina
Brief Answer:
Chronic pain syndrome
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history..It does seem like the pains you are suffering from looks unrelated to lupus or it is some muscle disease going along which is causing the difficulty.
With lupus it is always a tricky situation...Whether to increase steroids or not...Whether it is due to disease or something else
I would like to know a few more queries:
1. DO you have difficulty in getting up from bathroom seat or combing your hair? Yes very much so
2. Is there any dry eyes or dry mouth? Constantly
3. What is the dose of prednisolone are you taking? 5mg 2x day
4. Is there any history of irritability? Very much so Disturbed sleep I never get a full nights or forgetfullness?? Yes- heavy brain fog
Also lots of falling, numbness/tingling in my hands and feet
DO let me know these queries. WOuld guide you further from here
Chronic pain syndrome
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history..It does seem like the pains you are suffering from looks unrelated to lupus or it is some muscle disease going along which is causing the difficulty.
With lupus it is always a tricky situation...Whether to increase steroids or not...Whether it is due to disease or something else
I would like to know a few more queries:
1. DO you have difficulty in getting up from bathroom seat or combing your hair? Yes very much so
2. Is there any dry eyes or dry mouth? Constantly
3. What is the dose of prednisolone are you taking? 5mg 2x day
4. Is there any history of irritability? Very much so Disturbed sleep I never get a full nights or forgetfullness?? Yes- heavy brain fog
Also lots of falling, numbness/tingling in my hands and feet
DO let me know these queries. WOuld guide you further from here
Also trouble with urination constipation and maliase
Brief Answer:
Delayed Reply
Detailed Answer:
Good evening
Sorry for the late reply..Had a long duty
Thanks for your answers... I would suggest you a couple of things here:
1. WE need to rule out lupus activity : Kindly do CPK, LDH, ESR and CBC levels...IF they are normal at least we know lupus is not active...Your symptoms do fit with muscle involvement as well and we may need to increase the steroid dose after confirmation. Your GP can examine you for any muscle weakness as well, which will definitely give us and objective clue.
2. The symptoms of irritability, malaise, brain fog...are Very much specific for Fibromyalgia...It is common disease especially in the long standing illness like SLE . Eventually pain becomes so much worse,, that the symptoms of SLE gets masked...You can read up on the net and see if your symptoms match: www.rheumatology.org--> Patient information--> Fibromyalgia
It is always a tough challenge even for rheumatologist to distinguish between SLE activity and Fibromyalgia. The treatment differs and one needs to be sure about what we are dealing. There is a high chance of Fibromyalgia since the steroid is not making any difference. But the myopathy( Muscle involvement) needs to be ruled out as a person needs higher steroid dose.
Kindly get the tests done and read up on the net about Fibromyalgia.
Hope the information was useful
DO let me know with these results
REgards
Dr Naval
Delayed Reply
Detailed Answer:
Good evening
Sorry for the late reply..Had a long duty
Thanks for your answers... I would suggest you a couple of things here:
1. WE need to rule out lupus activity : Kindly do CPK, LDH, ESR and CBC levels...IF they are normal at least we know lupus is not active...Your symptoms do fit with muscle involvement as well and we may need to increase the steroid dose after confirmation. Your GP can examine you for any muscle weakness as well, which will definitely give us and objective clue.
2. The symptoms of irritability, malaise, brain fog...are Very much specific for Fibromyalgia...It is common disease especially in the long standing illness like SLE . Eventually pain becomes so much worse,, that the symptoms of SLE gets masked...You can read up on the net and see if your symptoms match: www.rheumatology.org--> Patient information--> Fibromyalgia
It is always a tough challenge even for rheumatologist to distinguish between SLE activity and Fibromyalgia. The treatment differs and one needs to be sure about what we are dealing. There is a high chance of Fibromyalgia since the steroid is not making any difference. But the myopathy( Muscle involvement) needs to be ruled out as a person needs higher steroid dose.
Kindly get the tests done and read up on the net about Fibromyalgia.
Hope the information was useful
DO let me know with these results
REgards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
