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I have been having pain some pain when I swallow or yawn…

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I have been having pain...
I have been having pain some pain when I swallow or yawn only. I have been have all over pain in the last 3 months. If I do to much I feel worse with simple house work. I do have RA but it's not pain from that. I seen my RA doctor but he really didn't see anything in my blood test to be concerned.
Submitted: 3 years ago.Category: Medical
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Answered in 18 minutes by:
6/10/2015
Doctor: Dr. D. Love, Doctor replied 3 years ago
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,827
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hello from JustAnswer.
Where is the pain with swallowing or yawning located?
Is the pain when you swallow or yawn in the jaw, the face, the throat, or the neck?
Is the all over pain in the muscles or the joints?
What are your regular medicines?
Do you know whether the blood tests included a sed rate or a CPK?
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Customer reply replied 3 years ago
Right side throat..muscles aches. My medications are naproxen 500mg 1 tab twice a day, hydroxychloroquine sulfate 200mg. 2 tabs a day, methotrexate sodium 2.5 mg. 10 tabs a week, folic acid1 mg. 1 tab a day. Omega 3 1000mg 3 times a day. Tylenol for pain as needed.
Blood work. Anti CCP
CBC ANA screen
ESR
CRP
BMP
Hepatic function panel
RF rheumatoid factor
Doctor: Dr. D. Love, Doctor replied 3 years ago
Thank you for the additional information.

There are several issues to consider in this situation.

If there is pain with swallowing or yawning in the throat of someone taking an anti-inflammatory medicine, it is common for this to be related to acid reflux irritation of the throat. Even without heartburn, acid reflux can present with pain in the throat as a sole symptom.

The other major issue to consider is that there is a muscle condition causing the diffuse muscle pain, and since there is muscle in the throat, the diffuse muscle pain could also be the cause of the throat pain. I ask about the lab work because it is possible to have an inflammatory condition that affects the muscles, called myositis, although there are several different types of myositis. There would usually be an elevation in the sed rate (or ESR) and CPK. If the ESR is normal, then it would be much less likely that a myositis is present, but a normal CPK would be a more complete evaluation.

There also are certain muscle conditions that can cause diffuse muscle pain and tenderness without any evidence of inflammation or abnormal lab tests. The most common of these is fibromyalgia. This is the most common cause of chronic muscle pain with a normal evaluation.

At this point, it would be reasonable to try a medicine to suppress stomach acid, such as Prilosec, Prevacid, or Nexium, to see if it helps the throat pain. If the evaluation of the diffuse muscle pain is normal, then treatment is usually by a variety of medicines to ease symptoms. If the Tylenol is not adequate for control of pain, then there are several medicines that can help, including certain anticonvulsants (gabapentin or pregabalin), and certain antidepressants (amitriptyline or duloxetine).

If I can provide any further information, please let me know.
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Customer reply replied 3 years ago
The SED RATE on my test result show value 47.0 and reference range says 0.0- 20.0.
I am not sure what this all means.
Doctor: Dr. D. Love, Doctor replied 3 years ago
The sed rate is a non-specific measure of inflammation, so can be increased from a wide variety of conditions. It certainly can be elevated because of the RA, but since it is not normal, it also cannot be said to make a myositis less likely. Therefore, it is more important to get a CPK to assess for a myositis.
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