I was diagnosed with ostioartheritas in Jan. I have put of surgery. Since then I have started hurting all over my body, different places at different times. pain, twinges, sharp stabbing pains, dull aches, . Would this be due to damaged nerves in my back or something else, ??
Person's Gender: Female
Person's Age: 66
nothing, just aleve
are you there
no you are fine so where is your pain?
all over, different places at diferent times
back, neck, legs, feet, chest, ribs, head,
well you can have a variety of diffuse pain with diffuse osteoarthritis. have you had your vit D level checked?
no, don't know what that is
perimenopausal woman lose bone and the degenerative changes can cause pain
well the diffuse osteoarthritis is caused by a condition called osteoporosis
lack of estrogen causes bone thinning, tendon pain , etc
vitamin D, sorry,
yes they check your vit d level and give you activated vit d pills
not always in the bone
there are also new meds like boniva that helps
right so where exactly?
they wanted me to get on pain managment, but I was affraid that that would just mask other pains,
I just sent a list of where
well it is a quality of life issue really how well can you handle the pain?
you sent a list?
the other thing is the FDA just approved Cymbalta as a treatment for diffuse osteoarthritic pain
but again just masking the pain, not fixing it
let me get you a webpage on that drug so you can review it and decide if you are interested. It blocks the ascending pain fibers in the spinal cord by stimulating inhibitory tracts. and it is used in a variety of conditions like fibromyalgia and depression, but now also osteoarthritis. It is masking pain though
sorry about the list, guess it got lost.
right, so some things are hard to "fix" without making it worse Osteoarthritis is kind of like that
so surgery won't fix it
for example, you really cannot remove all the remodeled bone if you have osteoarthritis in your back. People try it all the time but just cause more pain
well you might get some relief for a few months, but where are you in 2 years?
you really have to try and stop the process from starting.
that is why the Vit D and calcium and boniva
and that doesn't always work either don't get me wrong, but the fracture percentage in the treated group is better
so what surgery did they want to do?
do you think the pain all over is caused by the back problem? or can it be something else too?
I don't think they put a name on it, other than reeming out the spurs on the bone.
usually for it to be your back it has to be within certain places on your body. for example if the nerves are pinched at L5/S1 disc space, you will have pain down the back of your thighs to your mid calfs, and maybe numbness on your foot
right, osteophytes, but that is a exercise in futility they just come back
my legs get tired and hurt when I walk unless I lean on a grocery cart.
stretching exercise, bone health, some people still believe in estrogen replacement
right so that could be osteo in your hips, your sacroiliac joints, your lumbar spine it is diffuse
I do epidural steroid injections in the lumbar spine for symptom relief, but it doesn't cure it
have you tried those?
so you don't think the neck pain, is from the back
wouldn't that fall into pain managment?
the neck pain is from the neck with is probably like the lower back
arthritis of the cervical spine. do you have pain into your arms?
sure this is all pain management, steroid epidural injections into the cervical spine
some, just aches.
well, I don't think you are telling me anything new.
here is a webpage on this type of treatment
no there is nothing new here. pretty standard stuff. you can also try physical therapy, swim therapy etc
you can use medicines like celebrex or voltaren. If you have a bad stomach, Mobic or Arthrotec
I am worried that all this new pain is from something else, like cancer
well it is hard for me to tell you that without an exam. are you losing weight? that is the first sign
cancer bone pain is somewhat different. It is more aching, and nauseating do you have that?
actually I've gained 20 pounds because I quit smoking in Jan too
well that is good congratulations!!!!
I do feel nauseated for no reason at times
do you have GERD? gastric reflux, did you try tums?
no not that
well if you have diffuse pain, and nausea, you should get it checked out. there are many tests available
you could start out with some common blood work, a CEA level, a mammogram, etc have you done all of that?
had all that done in Jan and mamo just a few weeks ago
since you were a smoker, did you get a chest xray in the last few years?
yes not too long ago, maybe 4 years ago
all heart tests
so you are good to go
why are you so worried
well , back and all the other little pains all over my body.
maybe I'm being a hypocondriac
are you depressed?
by the way I had bacterial meningitis in 2002
wow how did you get that
don't know, almost died tho
that is different, very uncommon unless you are immunocompromized
don't understand, was told I just caught it
so you do not have rheumatoid arthritis correct?
no not that I've been told, no
did they check a sedimentation rate on you? with your blood work?
don't know what that is
I am type 2 diabetic
just a blood test, for inflammatory muscle diseases oh maybe that is why you have some pain
do you have diabetic neuropathy? burning pain in your distal extremities. numbness?
there was a test for inflamation, that may be it
no, to neuropathy and numbness
If you came into my office with this grouping of complaints, I would probably give you some samples of Cymbalta 30 mg caps to try for 2 weeks as a trial
just to see how you did, if it helped as a diagnostic tool
do you have any other questions that I could answer ?
what would the cymbalta tell us
well if you had arthritic pain, it would hopefully improve, I would also watch your mood, there are conditions like small fiber neuropathy related to diabetes that can give you diffuse pain and that might also improve
this might be a magical little capsule for you, once a day, at night empty stomach
early side effects are nausea, but it passes
thank you for your help
you are welcome. I hope I could give you some direction
please come back anytime. please rate my service if you can
Dr Frank T
General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
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