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Vakul Aren
Vakul Aren, Doctor
Category: Health
Satisfied Customers: 3518
Experience:  MBBS,DTM&H( Univ of Liverpool),34yrs experience in practice
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I have a history of fibromyaglia as well as facet arthropy.

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I have a history of fibromyaglia as well as facet arthropy. Since late in the year in 2007 I have been having very sharp pains in my upper left abdomen just below the diaphram. This pain, until tonight, has always happened when sitting in the car driving, but not on a regular basis, it has always been sporadic. Tonight, however, I have been having a sharp pain off and on. There is a hard knot you can feel under the skin that is quite painful when pressed on. I am accustomed to muscle and joint pain due to the fibro, but it has much worse than normal tonight. My regular pain medications are having very little, if any, effect on my pain. Does this sound like something that is an imediate concern or can it wait a couple weeks until I have the money to go to the actual doctors office?
Submitted: 7 years ago.
Category: Health
Expert:  Vakul Aren replied 7 years ago.
Hello.You are on good analgesics .The pain as described by you would probably be a part of your Fibromyalgia syndrome.I would suggest the addition of a Tricyclic antidepressant like Nortryptelene,or a SNRI/SSRI like Duoloxetene which will gradually help control the pain and fatigue.Gabapentin and Pregabalinmay also yield good results.The addition of a simple analgesic,antiinflammatory like Naproxen will suffice to handle this pain.You may discuss the addition of antidepressants and gabapentin to your basic drug regime to reduce your chronic pain,and maybe reduce the reliance on narcotic analgesics.Local heat and hot baths will also help.SW Diathermy,other physiotherapy modalities may be reduced for the muscular pains.
Customer: replied 7 years ago.
So you feel the pain in my left upper abdomen is simply the fibromyaglia? And there is nothing to be concern about with the painful knot? I just want to make sure I am understanding you.
Expert:  Vakul Aren replied 7 years ago.
Muscular pains are the hallmark of Fibromyalgia.The pain should be investigated to rule out any other cause,like Abdominal cause by a Ultrasound Scan ESpecially the left kidney and spleen as the pain is in the left upper diaphragmatic area,but if a knot is forming under the skin,it is suggestive of muscle spasm/skeleto-muscular origin of the pain.Further,since the pain is related to a particular position,the likelihood of musculoskeletal pain would be more pronounced.Other pains would also cause other symptoms.Another possibility is of gastritis/Acid ity related pain.A PPI and Sucralfate would take care of that but the nature of that pain would be burning in nature.Intestinal/Renal pathology would be more spasmodic in nature,the other possibility of Ischaemic Colitis/Mesentric Insufficiency would be extremely severe ,unrelenting pain.By this reasoning the likelihood of musculoskeletal pain is the most.
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