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What Causes Pain In The Legs, Arms And Neck While Having Raynaud's Disease?

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Posted on Mon, 5 Dec 2016
Question: 24 yr old female , anxiety and raynaulds having pain in legs arms and neck at both sides like throbbing pain i am scared i have something wrong with arteries like they are all clogged or vasculitis or something wrong with cartoid artery ive had ecg echo stress test chest xray blood tests including ESR and ANA which were negative and CPR -1 also had d dimer and alkaline phophatass which were negative what do you think? Im terrified my neck is throbbing
doctor
Answered by Dr. Ilir Sharka (22 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that your symptoms could be related to a thyroid dysfunction or anxiety.

All your performed tests have excluded a cardiac issue and also an inflammatory disorder.

Coming to this point, I would recommend performing further tests :

- a Doppler ultrasound of the cervical arteries to study the blood flow in them
- thyroid hormone levels to exclude a possible thyroid dysfunction.

Anxiety could also mimic this clinical scenario.

Considering your performed tests, I would explain that the main concerning disorders have been excluded.

Hope to have been helpful!

Feel free to ask me again whenever you need!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (38 minutes later)
Hi dr lliri , glad i got u again my health anxiety is really bad at the moment , do you think any my arteries in my neck could be clogged ? Its my leg and arm pain im scared my arteries are clogged everywhere ? My doctors dont want to perform any more tests and ive spent a fortune im scared something serious is underlying , how can i be certain my arteries are ok? What tests have ruled this out ? Also like pain under arms and feet and everything i keep getting throbbing pains thats why im thinking problem with my arteries everywhere
doctor
Answered by Dr. Ilir Sharka (13 minutes later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

I am glad too, to hear from you again on HCM!

In fact, considering your age and your performed tests, I don't think that there is any clogged arteries in your neck or anywhere.

I would recommend making a trial: raise your hands up and stay in this position for at least one minute. Does the pain worsen during this position? Do bluish nails occur in this position?

This little trial, would help investigate for thoracic outlet syndrome, which can mimic this clinical scenario.

Anyway, to examine your cervical arteries and the arteries supplying the blood to your arms (subclavian arteries), a Doppler ultrasound would be enough to exclude narrowing or low blood flow in these arteries.

I would also recommend performing thyroid hormone levels, as a thyroid dysfunction can cause pulsating arteries in the neck and a higher heart rate.

Hope you will find this answer helpful!

I remain at your disposal if you have any other uncertainties!

Greetings,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (13 minutes later)
Hi again , so i tried it had a little bit pain and nails are discoloured but im unsure cause i have pain anyway? I also have pain in my thighs and legs do you honestly think there is no clogging? Can there be problems with arterys everywhere at once ? Also have lower back pain i dont know if my symptoms are stress related as ive had health anxiety so bad its ridiculous , see the ultrasound on neck if i dont get it would something bad happen ? Im scared incase something happens to me and everyone thinks its anxiety and i have a wee girl as well so this makes my fear worse , you have been the only health professional to make me feel a bit more at ease , im like scared there is a problem with all my arteries so leg pain arm pain also have like a warm flush going up my back and neck and the pain is like throbbing pain at my shins etc and throbbing pain at both sides my neck , i think its definetly primary raynaulds i have as autommune have been excluded , ive had my thyroid checked its fine aswell , would stress test show like pad or cad ? And what about my cartoid arterys ? Could they be blocked or disection ? Im so scared please help
doctor
Answered by Dr. Ilir Sharka (25 minutes later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again dear!

I don't think that it will make any difference performing or not the cervical Doppler ultrasound. But it will just help you calm down and reassure that there are no narrowing or clogged arteries in your cervical arteries.

As your symptoms are more generalizes, I would exclude the outlet thoracic syndrome.

Finally, considering all your symptoms and performed tests which have resulted normal, I would recommend consider fibromyalgia as a possible cause of all your symptoms.

It is not just anxiety. It is something more.

I think that Duloxetine would be the best treatment choice in your case, because it is effective in both fibromyalgia and also anxiety.

You should discuss with your doctor about that.

Regarding your heart, I would explain that there is no need to perform any additional tests as it seems to be perfectly normal (based on your performed cardiac tests).

So, relax and don't worry about it!

Nothing bad is going to happen! I can assure you about that!

Hope to have clarified your uncertainties!

If you have any other questions, do not hesitate to ask me again!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (15 hours later)
Hi there again just a couple more things i was on amitriptline but i was feeling worse with side effects so ive stopped them but i read they can cause all sorts like abnormal heart rythm heart attacks strokes blood vessel problems is this true should i be worried ? Because im anxious aswell my heart was beating faster and im scared of heart attack ? Also i couldnt sleep last night for fear of something happening to me is this what health anxiety can do to you? Over the past few months ive been convinced i have loads of serious illness and problems its taking over my life like a vicious cycle , also could anything be wrong with my cartoid artery im scared of a stroke from it or disection ? Thanks hope you can help will the stress and anxiety cause anything to happen ? Thanks so much also do you have a post adress to send a thank you card .. Im scared incase im dying and no one knows
doctor
Answered by Dr. Ilir Sharka (5 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again dear!

You shouldn't be afraid of sudden death, because nothing bad is going to happen.

This is just an irrational fear, but there is no reason to come into this conclusion.

All your performed tests have shown a normal heart function and structure. Inflammation and autoimmune disorders have been excluded too.

So, there is nothing to be afraid of.

Anxiety can mimic a lot of symptoms that may raise suspicions of many disorders. But when all the tests come back normal, there is nothing to be afraid of, as all there suspicions are not based.

Regarding amitriptiline, you should know that it can cause some conductance disorders when used for a prolonged time (years) and in high doses. But this is not your case. Your cardiac tests have excluded this possibility. So relax and don't think about it.

If you really are so scarried about a carotid artery dissection, you can perform the Doppler ultrasound just to be sure that you are OK! But, I am sure that it will result normal, as you have no symptoms related to any arterial dissection.

The only advice I would give, is to focus on your anxiety. As amitriptiline has a lot of adverse effects, I would recommend trying sertraline or mirtazapine.

Duloxetine is another treatment option.

You should consult with a specialist of the field (psychiatrist, psychotherapist, psychologist) to help you manage your anxiety and your irrational fears. The truth is that all your performed tests are normal, which indicates a normal body function (including blood work, heart tests, etc.). This can be also confirmed by the fact that you are able to perform all your daily tasks (you are not lying at bed with motor deficits or shortness of breath).

Hope you will find this answer helpful!

Let me know about anything!

Greetings,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9313 Questions

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What Causes Pain In The Legs, Arms And Neck While Having Raynaud's Disease?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I carefully passed through your question and would explain that your symptoms could be related to a thyroid dysfunction or anxiety. All your performed tests have excluded a cardiac issue and also an inflammatory disorder. Coming to this point, I would recommend performing further tests : - a Doppler ultrasound of the cervical arteries to study the blood flow in them - thyroid hormone levels to exclude a possible thyroid dysfunction. Anxiety could also mimic this clinical scenario. Considering your performed tests, I would explain that the main concerning disorders have been excluded. Hope to have been helpful! Feel free to ask me again whenever you need! Kind regards, Dr. Iliri