Brief Answer:
Myalgia: Take NSAIDS, if not try Anti-Depressants.

Detailed Answer:
Dear XXXX,

1. Muscle cramps are called as myalgia. You report taking flexeril and magnesium oxide. You mention that these medicines have not worked well enough for you.

2. You have the option of taking another medication of a class of drugs called as NSAIDS. These are useful in myalgia. You definitely need to try these out, before
anything else.

3. I feel that cramps and aches can be due to an electrolyte imbalance. Kindly check this out.

4. Kindly write back to me mentioning whether you have been taking any other medicines, ever, even if they have been taken in the recent past.

5. You mention PTSD. Cramps in the muscles can be a remnant of what we call as a masked depression. You do not feel sad or low or perhaps down either. Masked depression is a medical term that is used where psychological conditions cause
physical symptoms, particularly of the kind you are experiencing.

6. I would kindly ask you to visit a doctor in person for a definite diagnosis and a prescription. I feel that a low dose of anti depressant medication should indeed relieve the pain, if it is not an electrolyte imbalance.

7. This is not to say that you are "crazy", therefore you need antidepressants.
Neither are you "sad", "mad" or "bad" or "depressed". These are the usual terms and misconceptions associated with these medicines.

8. It just happens that people, just like you, take these medicines not for depression, but for pain relief. Right.

9. The facts that you have 1) Tinnitus 2) "Recovery" from alcohol 3) your ex- smoking status... these three things are apart from your real issues, though I would like to thank you for being so precise and meticulous in your history.
It helps.

Kindly revert back to me as regards your opinions on this line of treatment.

Thanks,
Dr. Neel Kudchadkar

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