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What causes bilateral shoulder pain when diagnosed with fibromyalgia?

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Posted on Tue, 19 Jul 2016
Question: I had a sudden onset of acute pain, bilateral shoulders, in February following a trip to Aruba. I wound up in the hospital for 4 days with elevated liver enzymes, TSH ( I had a thyroidectomy in 2013 - taking Levothyroxin 150mcg alternating 125mcg), elevated T4. No one has been able to diagnosis what happened. I am an RN of 35 yrs, currently working. I have been to Mayo Clinic for the thyroid treatment, which is now stabilized.
I saw a rheumatologist who has done a series of blood work - ESR, CRP and Rheumatoid factor are negative. Vit D is still pending. She is prescribing Gabapentin for diagnosis of Fibromylasia. The only other med I take (besides the levothyroxin) is Requip for my restless leg syndrom.
I have always been active - was a marathon walker, swimmer, golfer. I am so limited now by overall pain, fatigue. What could have triggered this sudden change ? Are there other tests that would be helpful? Other treatment?
Thank you!
doctor
Answered by Dr. Neeraj Kumar (17 minutes later)
Brief Answer:
Get investigated as advised and take treatment

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.

Bilateral shoulder pain may be due to some viral infection related joint involvement.
Is there any restriction in movement at shoulder joint or difficulty in lifting upper limbs?
Any diabetes?
Any neck pain?
Any pain in hips or lower limbs?

Fibromyalgia involves back of neck, lower back region mostly. Bilateral shoulder joint ache without other symptoms seems unrelated. However I will recommend you continue treatment prescribed by your rheumatologist. You should continue Thyroid medication. Gabapentin can be used for shoulder pain.
Other drugs are pregabalin, amitryptiline or duloxetine.

In addition physiotherapy will be helpful.
Vitamin D 3 should be tested too. CPK-MM for muscle involvement can be tested. Wait for vitamin d test and discuss about CPK MM test with your doctor.

Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Neeraj Kumar (59 minutes later)
Thank you, Dr. XXXXXXX
No diabetes, or other diseases other than heridtary erythrocytosis for which I have therapeutic phlebotomies every 4-6 weeks based on CBC.
I have tried physical therapy which seems to aggravate my symptoms.
Congecture is that I got some kind of bug bite in Aruba, then an infection , just no known origin.
Yes, I will continue to follow with theumatologist and take Rx as prescribed.
Thank you!
doctor
Answered by Dr. Neeraj Kumar (31 hours later)
Brief Answer:
Get treatment as advised

Detailed Answer:
Hello,
Physiotherapy will be helpful along with other medications as discussed.
Any thinning of shoulder or weakness in limbs needs investigation with nerve conduction study especially brachial plexus study.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Sonia Raina
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Dr. Neeraj Kumar

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Practicing since :2006

Answered : 2263 Questions

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What causes bilateral shoulder pain when diagnosed with fibromyalgia?

Brief Answer: Get investigated as advised and take treatment Detailed Answer: Hello, I have gone through your question and understand your concerns. Bilateral shoulder pain may be due to some viral infection related joint involvement. Is there any restriction in movement at shoulder joint or difficulty in lifting upper limbs? Any diabetes? Any neck pain? Any pain in hips or lower limbs? Fibromyalgia involves back of neck, lower back region mostly. Bilateral shoulder joint ache without other symptoms seems unrelated. However I will recommend you continue treatment prescribed by your rheumatologist. You should continue Thyroid medication. Gabapentin can be used for shoulder pain. Other drugs are pregabalin, amitryptiline or duloxetine. In addition physiotherapy will be helpful. Vitamin D 3 should be tested too. CPK-MM for muscle involvement can be tested. Wait for vitamin d test and discuss about CPK MM test with your doctor. Hope you found the answer helpful. Do get back to me for further queries. Regards Dr N Kumar Neurologist