Brief Answer:
I would like you to answer a few few questions

Detailed Answer:
HI,

Thanks for writing to Health care magic.

I am Dr Muhammad XXXXXXX

I have read your question and will try to help you out in this problem... For me to help you in a better way I would like you to answer a few queries.

1)Any previous diseases.?

2)Any meds he is on for any thing...

3) Does he have uric acid issues.. Blood pressure or diabetes?

4) any anxiety issues?

5) what's the type of pain? Piercing burning or what?

6) any addictions like smoking etc?

7. His height and weight?

I am waiting for your input.

Regards.

Dr Muhammad XXXXXXX

Resident. M. D

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Brief Answer:
Here I suggest future steps for him.

Detailed Answer:
Hi,

Thanks for writing back in such details, I have read your description and i can see that you have reached out to every possible doctor I think when dermatologist and neurologist have cleared him out, you guys can consider some other options.

1) Consulting a Psychiatrist .

2) Consulting a Pain clinic.


WHY PSYCHIATRIST?

There are some patients who are anxiety prone and are under anxiety meds, there is a ossibility that they may suffer pain which their brain creates, Here is a detail of major disorders which i mentioned.


1)Psychogenic Pain:

Psychogenic pain, is physical pain that is caused, increased, or prolonged by mental, emotional, or behavioral factors.

Headache, back pain, or stomach pain are some of the most common types of psychogenic pain.


Psychosomatic disorders may appear to be purely physical but they originate in emotions that are unconscious or dissociated from consciousness.There are hundreds of illnesses and disorders that are purely psychosomatic or have a psychosomatic component,

yet it is quite astonishing that despite the prevalence of these disorders, the medical community remains in the dark about this. . . When physicians are confronted with a psychosomatic disorder they do not recognize it, or if they do, they tell the patient that it is all in the mind.

Loss and isolation can cut like a knife. Grief or anger can be stored in the muscles of the neck, head, back, or gastrointestinal tract, and can cause allergies to flare. The waiting rooms of primary care physicians are filled with people in very real physical distress for which no medical cause may be found. . . . Their pain may well originate in the mind or psychic pain might greatly exacerbate the pain of a physical disorder. But in any case, it is not all in the mind. It is in the mindbrainbody. It is psychosomatic (Farber 2013, pp. 166-7).


2)Pain Disorder:

More or less Pain disorder and psychosomatic pain are synonymous.

Medicine refers also to psychogenic pain or psychalgia as a form of chronic pain under the name of persistent somatoform pain disorder or functional pain syndrome. Causes may be linked to stress, unexpressed emotional conflicts, psychosocial problems, or various mental disorders.


Some specialists believe that psychogenic chronic pain exists as a protective distraction to keep dangerous repressed emotions such as anger or rage unconscious.


Pain disorder is chronic pain experienced by a patient in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may begin at any age.

Treatment options:

The prognosis is worse when there are more areas of pain reported. Treatment may include psychotherapy (with cognitive-behavioral therapy or operant conditioning), medication (often with antidepressants but also with pain medications, and sleep therapy. According to a study performed at the XXXXXXX M. Miller School of Medicine, antidepressants have an analgesic effect on patients suffering from pain disorder.

In a randomized, placebo-controlled antidepressant treatment study, researchers found that "antidepressants decreased pain intensity in patients with psychogenic pain or somatoform pain disorder significantly more than placebo"


WHY PAIN CLINIC?

In pains for which no reason can be found they actually use other methods like carpet bombing with pain killers and they use pain relieving exercises plus methods and drugs which decrease brain perception for pain.


I hope things will get better for him in future keep calm and consult a good psychiatrist, plus use some multi vitamins and get blood tests for vitamin B and folate whose deficincies can cause neuropathies, but still in my opinion she needs the above suggested professionals as a next step in pain management,that's what i suggest .


Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!


Regards.

Dr.Muhammad Ahmad.

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Brief Answer:
There are few things to know if its allergy

Detailed Answer:
Hi,

Thanks for writing back , i am pleased that my response made sense to you guys and you are willing to pursue this thing,


I can give you simple things to know yourself if this is an allergy or not,


will need some info regarding this,


1) Is there any particular thing which can irritate him in his office?

2) What do you think can be causing allergy during house construction , he is 60 he must have been exposed to many construction sites, till date, is there any thing special like pain ,sand or mist etc which irritated him?

3) Did those symptoms start with change of office or start of construction or a particular construction even at home? like start of paint or wook work etc?

4) Is the construction over now?

5) Is there any change in frequency of his pains?


Waiting for your input.

Regards Dr.Muhammad Ahmad.

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