Suggest Treatment For Chronic Knee Pain, Tingling Feeling In Feet And Increasing Fatigue

Posted on Fri, 4 Sep 2015

Question: I have had about 3 years of odd symptoms but my health has really taken a hit during the past 6 months. My ana tested at 1:160. My esr was 25. My cardiac protein tested at 8.0. I have graves but my levels are in order on Tapazole. I have been treated for paranoia/depression with 5 mg of celexa for the past 3 years. I was fine before that. I have IBS. I had an MRI of my brain and it came back normal. I have had a normal stress test. I had a colonoscopy and endoscopy which were normal. My symptoms are very random. For months I had terrible knee pain. I could not walk up and down steps. Since my graves disease is being treated my knees are feeling better. Now my hips and lower back and legs are aching but sometimes it is much worse than others. Sometimes i have sharp pains that shoot through my hips. I also have tingling in my feet especially when I awake in the morning. I have had vocal chord damage so that i can no longer hit high pitches but no idea how that happened. I have episodes of sharp pain that shoots through my jaw and up into my head and then just aches until i take low dose prednisone to get rid of it. I am a tennis player and until 6 months ago I could play 2 hours of singles at a high level. I am lucky now to play doubles one day a week. Any help or ideas would be appreciated. I am 47 and I was very active. I have also gained about 20 pounds in the past 3 years with no change in my diet.

Answered by Dr. Naval Mendiratta (3 hours later)

Brief Answer:
Auoimmune condition

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your history and would Briefly summarize here before proceeding further:

1. Knee pain aggravated on climbing stairs

2. Bodyache affecting the hips, lower back and legs

3. Tingling over the feet and sharp pain over the jaw

4. Increasing fatigue over the past 6 months

5. vocal cord damage( ? Cause)

Considering your ANA positive( which can be due to Graves also) and symptoms affecting almost every part of your body, it would be worthwhile getting you investigated further. There is a possibility all these symptoms are due to ANA positivity which is not evolving. I would like to ask you a few questions before proceeding further:

1. Any history of dry eyes and dry mouth?

2. ANy history of oral ulcers/hair fall/rashes over the body/Photosenstivity?

3. How do you feel in the mornings when you wake up..Is your sleep quality good or you wake up fatigued?

4. Did they do testing further than ANA also like ENA profile

5. The pain in the jaw, does it get aggravated on cold exposure or on eating??

6. Any history of forgetfullness and irritability which has increased in the past 6 months?.

DO let me know these queries. These complaints can fit in with an autoimmune problem as well, like Sjogrens syndrome. But I would like to have a few answers before guiding you further

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (23 minutes later)

I do not have dry eyes or mouth. I rarely get any mouth ulcers. I have no significant rashes and I teach tennis in the sun. My eyes have always been sun sensitive but my skin is not sensitive to sun. I wear sunblock when i am out. I am not having hair loss. I do wake up fatigued. I have not been sleeping as well as i used to. My bladder keeps me up a lot. I forgot to mention that i have some difficulty completely emptying my bladder. I have also had some instances of fecal incontinence. I have not had an ENA profile. I dont even know what that is. The jaw pain comes at random times. Chewing gum can help bring it on sometimes so i do not chew it anymore but it happened at other times as well. I have been more forgetful and my husband would say I have been more irritable.

Answered by Dr. Naval Mendiratta (15 hours later)

Brief Answer:
Further ADvise

Detailed Answer:
Good evening

Sorry for the delayed reply. Had a long duty

Well, there are a lot of symptoms happening together. COnsidering your ANA positive, it is advisable to get an ENA PRofile done. It is more like ANA being a big state and ENA being the small cities in it which checks for the particular antibody associated with particular disease.( around 10-15 further subtypes of ANA are checked) .Since you are getting repeated Jaw pains as well, probably due to Trigeminal nerve involvement, it is important to evaluate further as all this can all be a part of autoimmune condition( something Like Sjogrens Syndrome)

But yes, if it is negative My diagnosis would go more in favour of Fibromyalgia as you do have lot of symptoms pertaining to it like the pains, irritability, forgetfullness, difficulty in sleep, urinary problems. All can be a part of it. But then again it is a diagnosis of exclusion. SO we need to rule out anything serious before commencing you on the treatment for Fibromyalgia

So my suggestion would be to get an ENA profile, ESR, Complement C3, C4, Vitamin D 3 levels done. IF it is all negative we are rest assured it is not something serious

Hope the information was useful

Do let me know for more queries. Would be happy to help out

REgards
Dr Naval

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar