Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Joint And Muscle Pain And Swelling In Face And Limbs?
Question: I was suffering from whole body pain, itchy rash, swelling of face and limbs later thickening/hardening of skin & muscles, throat pain, mouth ulcer for more than 2 months. After tests, Hb% 10.5, huge Vitamin D deficiency, TSH 6.5 CPK 239, Eosonophil 24, ESR 48, Absolute Eosonophis Count 1600. All other factor normal. All Auto-immune tests negative, RA negative. Some routine anti allergic, anti inflammatory and Vitamin medicines did not do anything. Later doctors have suspected Scleroderma or Eosonophilic Faciities. Treatment done being admitted in a Hopital - Pulse Methyle Prednisolon 1G for 5 days then Oral Tablets of Wysolon(Pednisolon 40mg) and then after one month added Azoran(Azathioprine) 50mg tablet. Now I am taking Wysolon 30 mg OD, Azoran 50mg OD, CCM 1000(Cholecalcipherol & Vitamin D), Esomeprazole 40mg BD daily. All other symptoms have gone. I have now severe joint and muscle pain, bilateral shoulder joint pain/stiffness and restricted body movement. I had joints pain/back-pain earlier for more than 10 years. What to do now ?
Brief Answer:
Need more details
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well i have gone through your history. It seems you havent got much improvement from the high doses of steroids as you still continue to experience joint pains. What i am trying to figure out here is the exact diagnosis for which you have been treated as you are on high dose steroids and Azathioprine. Cause we normally dont use such high doses of steroids in Scleroderma.
If the joint pains was due to inflammation, it would have responded well to the treatment given. Your low vitamin D levels have been corrected as well. Kindly let me know a few queries i have here cause once we know what we are treating, it will make the treatment easier
1. Do you experience morning stiffness??
2. Does your sleep get disturbed in the night due to pain
3. Do you have difficulty in getting up from bathroom seat or climbing stairs or combing hair?/
4. Have you been irritable recently?
5. have you experienced forgetfulness in the recent past?
6.Do you notice any swelling of the joints as well or is it just pain?
7. Do you experience bluish discolouration of fingers in cold
Do let me know these queries and the exact diagnosis for which you being treated . Would be happy to help out.Will try to guide you to a solution
Take Care
Regards
Dr Naval
Need more details
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well i have gone through your history. It seems you havent got much improvement from the high doses of steroids as you still continue to experience joint pains. What i am trying to figure out here is the exact diagnosis for which you have been treated as you are on high dose steroids and Azathioprine. Cause we normally dont use such high doses of steroids in Scleroderma.
If the joint pains was due to inflammation, it would have responded well to the treatment given. Your low vitamin D levels have been corrected as well. Kindly let me know a few queries i have here cause once we know what we are treating, it will make the treatment easier
1. Do you experience morning stiffness??
2. Does your sleep get disturbed in the night due to pain
3. Do you have difficulty in getting up from bathroom seat or climbing stairs or combing hair?/
4. Have you been irritable recently?
5. have you experienced forgetfulness in the recent past?
6.Do you notice any swelling of the joints as well or is it just pain?
7. Do you experience bluish discolouration of fingers in cold
Do let me know these queries and the exact diagnosis for which you being treated . Would be happy to help out.Will try to guide you to a solution
Take Care
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Prasad
1. I do not have morning stiffness.
2. My sleep is disturbed but not due to pain. It may be for anxiety.
3. Now-a-days I face difficulty in combing hair due to shoulder stiffnes/pain while raising hands.
4. Yes, I had/have irritation but not much. In rare ocassions.
5. No, I have never experienced forgetfulness.
6. No swelling of joints only pain.
7. No. I have never experienced/ I do not have bluish discoloation of fingers in cold or anytime.
I have already given answers of your queries. I have not yet got your further/follow-up reply.
XXXX, 11-12-2014
2. My sleep is disturbed but not due to pain. It may be for anxiety.
3. Now-a-days I face difficulty in combing hair due to shoulder stiffnes/pain while raising hands.
4. Yes, I had/have irritation but not much. In rare ocassions.
5. No, I have never experienced forgetfulness.
6. No swelling of joints only pain.
7. No. I have never experienced/ I do not have bluish discoloation of fingers in cold or anytime.
I have already given answers of your queries. I have not yet got your further/follow-up reply.
XXXX, 11-12-2014
Brief Answer:
cause of joint pains
Detailed Answer:
Good evening XXXX
Sorry for the late reply
Was caught up in hospital duty. Well I have read the other query also. I believe you did have initial relief to high dose of steroids. As for the diagnosis I am still not sure what you being treated on as this high dose steroids are to be avoided in scleroderma.
As for the pain, the kind of pain you are describing looks like myalgia(/inflammation of muscles). Even though your cpk is normal, there is a possibility there is still some underlying inflammation going on as you did have a response to high dose of steroids. I would like to repeat your cpk, aldolase,ldh, shot and sgpt as cpk can be normal in 20 percent of the patients with muscle inflammation as well.
If all these are normal, and the inflammatory markers Are also normal, You should try some pain modulator s like amitryptilline.
But yes, if it is scleroderma then I won't want to continue steroids on long term as it can precipitate the kidney problem.
Hope the information has been useful. Feel free to ask me for your queries. If you want an opinion of another rheumatologist, that can be arranged as well
Take care
Regards
Dr naval
cause of joint pains
Detailed Answer:
Good evening XXXX
Sorry for the late reply
Was caught up in hospital duty. Well I have read the other query also. I believe you did have initial relief to high dose of steroids. As for the diagnosis I am still not sure what you being treated on as this high dose steroids are to be avoided in scleroderma.
As for the pain, the kind of pain you are describing looks like myalgia(/inflammation of muscles). Even though your cpk is normal, there is a possibility there is still some underlying inflammation going on as you did have a response to high dose of steroids. I would like to repeat your cpk, aldolase,ldh, shot and sgpt as cpk can be normal in 20 percent of the patients with muscle inflammation as well.
If all these are normal, and the inflammatory markers Are also normal, You should try some pain modulator s like amitryptilline.
But yes, if it is scleroderma then I won't want to continue steroids on long term as it can precipitate the kidney problem.
Hope the information has been useful. Feel free to ask me for your queries. If you want an opinion of another rheumatologist, that can be arranged as well
Take care
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. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
