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Ask Anthony Bray, MD Your Own Question

Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6938
Experience:  14 years as clinician in the field of Family Practice
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I was diagnosed with Lupus a couple of years ago. I have shooting,

Resolved Question:

I was diagnosed with Lupus a couple of years ago. I have shooting, stabbing pains in random areas throughout my body. They are sharp, and pulsating. It will be in one hip and then be in my upper arm at another time. These are painful enough that I can't get comfortable at night. Do you think this is lupus related or is it something else? Should I see a doctor or just chalk it up to an other weird lupus symptom?
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD :

Hello!

Anthony Bray MD :

Yes, I think that these pains MAY be lupus realted....

Anthony Bray MD :

I think that this would help to have your rheumatologist check on your C-reactive protein adn sed rate to help guage how ACTIVE your lupus is currently...

Anthony Bray MD :

Also physical exam may give helpful clues as to the source of these pains....

Anthony Bray MD :

What are you currently taking for your lupus? // inflammation// painm??

Customer:

Plaquenil for tx and Ibuprofen in the daytime and Hydrocodone at night.

Customer:

Oh and also 5mg prednisone daily as well

Anthony Bray MD :

I see >> well I do think that follow up with your rheumatologist may be of help. There may be possible benefit of considering trying Lyrica or Cymbalta which are helpful for neuogenic pain and/or fibromyalgia via complimentary mechanism to the hydrocodone...

Anthony Bray MD :

Checking the inflammatory markers would help to determine how likely it may be that this new symptom is realted to your lupus....

Customer:

I will follow up with doctor but I'm already on Lexapro for depression so can't take cymbalta. Tried Lyrica and it made my pain worse (actually doubled the pain) and I also had a negative psychological reaction to it.

Anthony Bray MD :

I see...

Customer:

Probably a good idea. I was just in to see him about a week ago and had blood work done about 3 weeks ago. Nothing showed at that time despite the fact that I'm in pain.

Anthony Bray MD :

Ultram may be an option that you caould add during the day to help the pain control of the hydrocodone at night...

Anthony Bray MD :

Do the pains seem to be muscular in nature??

Anthony Bray MD :

Joints??

Customer:

Both muscular and joint pains, but the muscular pain is what I was talking about today. I also have joint pain but that is not pulsating more chronic in nature.

Anthony Bray MD :

I see and the pain >> poor sleep quality and this may >> more muscualr pain >> this may be a vicious cycle...

Customer:

Could be...

Anthony Bray MD :

You might have some fibromyalgia or simuilar although the quality of the pains is not sounding typical to me... Ambien at bedtime may sometimes help with fibromyalgia patients...

Customer:

He checked me for fibro and he also didn't think it was fibro. I could try ambien. I have it, but it typically doesn't last through he night. I end up waking up.

Anthony Bray MD :

A trial of a direct switch from Lexapro to Cymbalta might be considered... the Cymbalta works on serotonin like Lexapro but ALSO works on norepinephrine (both are neurotransmitters)

Anthony Bray MD :

Right Ambien usually helps more getting to sleep but it is short acting ... about 4 hours...

Customer:


That's a thought. I may try that. He mentioned that as a possibility awhile back.

Customer:

Yes Ambien doesn't really do it.

Anthony Bray MD :

Elavil at bedtime would be another possible help>>

Customer:

Hadn't tried Elavil. Will mention that too.

Anthony Bray MD :

It is antidepressant used in low dose at bedtime to help with insomnia nd also chronic pain...

Anthony Bray MD :

OK to use this in combination with either Cymbalta or Lexapro at the low dose of 25mg/bedtime...

Customer:

hmmm...that sounds like it might help. I get nervous about all the medications but I guess that is my life at this point. It seems to be the only way I can keep functioning.

Anthony Bray MD :

Yes I understand... it is typical that we gradually need more support with meds as we (hate to say it..) age... ME TOO!!

Customer:

Yes, I know...just wish there was some other way, but there doesn't seem to be. I've tried diet, exercise, counseling, meditation, acupuncture and numerous other things, but they just don't work as well.

Anthony Bray MD :

Well there is definitely a role for healthy habits (I'm not sure about the acupuncture but you know I am ingrained with Western medicine!!) Medications have their role to play as well however...

Customer:

for me Definitely. Like I said, I don't think I'd be functional at this point without them.

Anthony Bray MD :

We are fortunate to have the benefit of the years of research and progress before us but there are certainly some trade offs... like the high costs and side effects..

Customer:

Yes I agree but there are always trade offs for everything. Thanks so much for your help. I'll definitely follow up with my doctor about what you suggested. Thanks again.

Anthony Bray MD :

You are very welcome!

Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6938
Experience: 14 years as clinician in the field of Family Practice
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