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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I have fibromyalgia, rhuematoid arthritis and degenerative

Customer Question

I have fibromyalgia, rhuematoid arthritis and degenerative disc/bone disease. Recently Ive been in severe pain. Moderate to severe in bones and joints all over and more severe in left knee and hip and leg bones. My energy level has decreased and pain meds even when doubled are not stopping pain. Is there something else possibly going on.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. If you have fibromyalgia, rheumatoid arthritis and osteoarthritis (degenerative bone and disc disease) then you have plenty of reasons for moderate to severe pain, so I am not sure why you would think something else is going on? Fibromyalgia has a clear association with CFS, chronic fatigue syndrome, so that might explain your energy level. Have they checked epstein barr antibodies? Are you thinking lyme disease or Lupus on top of those 3? How can I help from here? Please get back to me with questions. I can review your laboratory testing if you need them explained to you. What medications are you taking and at what dose? Dr Frank

Customer: replied 1 year ago.
Norco 10mg 3 x daily, Topamax 300mg daily (migraine)maint., Wellbutrin XL 300mg daily, Amlodipine 10mg daily and anti inflammatory meds. I guess I was just concerned that there could be something else wrong. I hurt really bad when I try to sleep. My legs and muscles all over my body seem to spasm. I'm restless. The only way I can explain the pain is it goes all the wsy to the bone. Don't know if that's just my problems getting worse
Expert:  Dr. Frank replied 1 year ago.

You can have variants of Rheumatoid Arthritis effecting your muscles more diffusely, Polymyalgia Rheumatica, or polymyositis/dermatomyositis are inflammatory myopathies that will raise your CK levels and sed rate and C Reactive protein levels, and cause more diffuse pain than your fibromyalgia, which should be discreet tender points. You are on a strong grouping of medications, I don't think I have any great suggestions over what you take, although you didn't mention any specific migraine abortive meds like imitrex/sumatriptan. You are on a high dose of Topiramate, but I assume that is for a reason. So I would ask your rheumatologist if you could have something like I mentioned above, do you need immunomodulators for your inflammatory autoimmune disease? That is about it for me, unless you have a question I could answer. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

Rene. Get back to me to discuss this if I can help. If satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work. thanks Dr frank