Hello

are you there

no you are fine so where is your pain?

well you can have a variety of diffuse pain with diffuse osteoarthritis. have you had your vit D level checked?

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

yes they check your vit d level and give you activated vit d pills

and calcium

there are also new meds like boniva that helps

right so where exactly?

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

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

right, so some things are hard to "fix" without making it worse Osteoarthritis is kind of like that

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?

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

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?

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

http://emedicine.medscape.com/article/325733-overview

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

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?

well that is good congratulations!!!!

do you have GERD? gastric reflux, did you try tums?

ok

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?

since you were a smoker, did you get a chest xray in the last few years?

colonoscopy?

so you are good to go

why are you so worried

are you depressed?

wow how did you get that

community acquired?

that is different, very uncommon unless you are immunocompromized

so you do not have rheumatoid arthritis correct?

or fibromyalgia?

did they check a sedimentation rate on you? with your blood work?

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?

yes

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 ?

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

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