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What Causes Pain In Back And Shoulders With Elevated ESR Levels?
Question: I am female of 40 years, 2 years back my weight was 68 kg, which by regular exercise and diet control is reduced to 51 kg. from last 2 months I am feeling pain in back and shoulders, so went for arthritis profile,
in which the erythrocyte sediment count(WGA) found to be 41, more then normal.
Kindly suggest what problem it can generate or it is the symptom of......., suggest further.
in which the erythrocyte sediment count(WGA) found to be 41, more then normal.
Kindly suggest what problem it can generate or it is the symptom of......., suggest further.
Brief Answer:
possibility of spondylitis, needs investigation
Detailed Answer:
Dear,
Welcome to HCM
As i can understand from your complaints, you are having back and shoulder pain and your ESR count is 41.
Elevated ESR is generally found in rheumatic conditions. The symptoms of back and shoulder pain is also common in rheumatic conditions.
Here it is important to consider the profile of symptoms, back and shoulder pain as in your case points towards an spondylitis condition. It is important to consider for presence of any associated symptoms of wrist, knee, and joint pain, Fever, Lower back pain, etc.
I would need like to know
1) if your back feels tired and fatigued easily even on moderate exertion.
2) feels chest tightness or any breathing problems.
3) pain in which part of spine, upper or lower?
4) are there associated joint pains, fever, joint swellings?
5) the pain is aggravated on stress and fasting, and subsides on rest?
6) any medication tried?
7) are your energy levels low? do you get tired easily?
Your weight of 51 kg for your age is very much normal.
Esr of 41 is on higher side.
It can be a stress induced backache, which is very much normal. However its essential to rule out other causes.
The blood test report provided does not reveal any abnormalities besides elevated ESR.
My advice to you would be to get an X Ray spine done.
An NSAIDS class of analgesic like tab voveron 75 mg can be taken for severe pain as an when required.
It can help us to detect if any spondylitic activity.
Vit B12 levels testing is very much suggestible.
A consulation to local Rheumatologist can be helpful.
You can revert back for discussion with the information with respect to the above asked questions by me and for further queries.
Regards,
Dr Pankaj Borade
possibility of spondylitis, needs investigation
Detailed Answer:
Dear,
Welcome to HCM
As i can understand from your complaints, you are having back and shoulder pain and your ESR count is 41.
Elevated ESR is generally found in rheumatic conditions. The symptoms of back and shoulder pain is also common in rheumatic conditions.
Here it is important to consider the profile of symptoms, back and shoulder pain as in your case points towards an spondylitis condition. It is important to consider for presence of any associated symptoms of wrist, knee, and joint pain, Fever, Lower back pain, etc.
I would need like to know
1) if your back feels tired and fatigued easily even on moderate exertion.
2) feels chest tightness or any breathing problems.
3) pain in which part of spine, upper or lower?
4) are there associated joint pains, fever, joint swellings?
5) the pain is aggravated on stress and fasting, and subsides on rest?
6) any medication tried?
7) are your energy levels low? do you get tired easily?
Your weight of 51 kg for your age is very much normal.
Esr of 41 is on higher side.
It can be a stress induced backache, which is very much normal. However its essential to rule out other causes.
The blood test report provided does not reveal any abnormalities besides elevated ESR.
My advice to you would be to get an X Ray spine done.
An NSAIDS class of analgesic like tab voveron 75 mg can be taken for severe pain as an when required.
It can help us to detect if any spondylitic activity.
Vit B12 levels testing is very much suggestible.
A consulation to local Rheumatologist can be helpful.
You can revert back for discussion with the information with respect to the above asked questions by me and for further queries.
Regards,
Dr Pankaj Borade
Above answer was peer-reviewed by :
Dr. Raju A.T
Answers to your queries
1. Yes feel tired after moderate exertion.
2. No Chest tightness and no breathing problem.
3. Pain in full back, spine and other areas.
4. Joint pain in fingers and wrist, No fever and no joint swelling.
5.pain continues on fasting, not aggravated.
6. No medication tried.
7.yes , energy level low.
Kindly suggest further.
1. Yes feel tired after moderate exertion.
2. No Chest tightness and no breathing problem.
3. Pain in full back, spine and other areas.
4. Joint pain in fingers and wrist, No fever and no joint swelling.
5.pain continues on fasting, not aggravated.
6. No medication tried.
7.yes , energy level low.
Kindly suggest further.
Brief Answer:
suggestive of rheumatic condition, needs to be investigated
Detailed Answer:
Thank you for the reply.
Your clinical picture is consistent with rheumatic conditions like Ankylosing spondylitis, rheumatoid arthritis, or an autoimmune condition involving musculoskeletal system.
Your lab finding of elevated ESR is supportive to it.
Rh factor is negative, however it can be negative in certain rheumatic condition.
It is very much suggestible to consult a local rheumatologist, as he can advice you for more sensitive investigation to undergo. A detailed systemic examination is essential to establish a diagnosis.
One needs to check for the signs and symptoms involving other systems like thyroid, cardiac problems, respiratory problems, etc as it being general condition multiple organ involvement is there.
Mean while for your symptoms of pain
Tab voveron 75 mg twice a day
should provide some relief.
Remember i Have just given you a suggestion. Confirmation of any diagnosis can only be made after a detailed work up and on investigations.
welcome for further suggestions.
stay Healthy.
Regards,
Dr Pankaj Borade
suggestive of rheumatic condition, needs to be investigated
Detailed Answer:
Thank you for the reply.
Your clinical picture is consistent with rheumatic conditions like Ankylosing spondylitis, rheumatoid arthritis, or an autoimmune condition involving musculoskeletal system.
Your lab finding of elevated ESR is supportive to it.
Rh factor is negative, however it can be negative in certain rheumatic condition.
It is very much suggestible to consult a local rheumatologist, as he can advice you for more sensitive investigation to undergo. A detailed systemic examination is essential to establish a diagnosis.
One needs to check for the signs and symptoms involving other systems like thyroid, cardiac problems, respiratory problems, etc as it being general condition multiple organ involvement is there.
Mean while for your symptoms of pain
Tab voveron 75 mg twice a day
should provide some relief.
Remember i Have just given you a suggestion. Confirmation of any diagnosis can only be made after a detailed work up and on investigations.
welcome for further suggestions.
stay Healthy.
Regards,
Dr Pankaj Borade
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Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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