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Coachrobmd, Internal Medicine MD
Category: Medical
Satisfied Customers: 1785
Experience:  •Fmr. Dir. Hep. C Clinic. •Fmr. Dir. Head Trauma Rehab Ctr.
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From last few months i am having sever pain in my back and

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from last few months i am having sever pain in my back and around shoulders when i awake up in th morning and first few minutes are very heavy and then pain goes away as the day progresses.
Submitted: 5 years ago.
Category: Medical
Expert:  Coachrobmd replied 5 years ago.
Hi, I'm Doctor Robert, a Medical Internist (MD) who specializes in diseases of all major organ systems. All my education has been completed in the US.

Because I can NOT see, touch, speak with or examine you, nor do I have access to your complete medical history, labs, scans or medications, I will NOT be able to give you an exact diagnosis. If that's what you are expecting from me here, STOP READING NOW. Otherwise you may possibly give me a negative I BAD/POOR SERVICE rating, which is not helpful. There are limits to what can be done across the internet. PLEASE keep this in mind as you read my responses.

Pain upon waking that gets better as the day progresses if often due to:
1. sleeping in an awkward position, causing muscle stiffness. Light stretching in the morning will correct this.
2. Rheumatoid arhtiritis (RA) can do th is, as the muscles "gel" over the morning and it imrproves. but that is rare without joint pains in the hands or wrists. the test for this is a rheumatoid factor.
3. polymyalgia rheumatica (PMR) is a disease characterized by systemic inflammation. It is diagnosed by an erythrocyte sedimentation rate (ESR) blood test.
4. dermatomyositis is similar to PMR and is also diagnosed by ESR.

I cannot differentiate between these without testing and an exam, but your primary care physician (PCP) can certainly do that for you.

This is the very best information I can provide for you with the background limited details you provided. Please keep in mind the significant hurdles I face: I cannot see you, examine you, see your labs, review your studies, get your complete medical/surgical or family history, or most important or all, SPEAK with you like your regular doctor can. If you expected a definitive diagnosis or treatment, I'm sorry if this disappoints you. There are simply too many limitations for that to happen over the internet. If that WAS what you were expecting, please do NOT give this a NEGATIVE rating by selecting BAD or POOR SERVICE (or clicking on ONE or TWO STARS). Kindly don't rate it and do ask me to find another expert to assist you. I'll refer you to someone else who may wish to go out on a limb with a very specific diagnosis/treatment. I cannot do that and maintain my integrity. Thank you!

Please remember to only rate my answer when you are 100% satisfied. If you feel the urge to leave a NEGATIVE rating of "BAD" or "POOR" service (or one or two STARS, depending upon your screen), please stop and reply to me via the CONTINUE CONVERSATION button.

I will be happy to do everything I can to provide you with the service you seek. Selecting from the RIGHTMOST 2 faces/stars (EXCELLENT SERVICE is always best) is how I receive compensation for all the years of training that went into assisting you today. It would be most appreciated. Bonuses are also welcome.

I'll be in and out most of today so I'll be checking on and off. If you write back, it may take a couple of hours to hear back from me, so please be patient. I have clients I'm seeing and that means I can't always be on the board.
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