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What Causes Pain In Neck And Back Along With Popping Joints?
Question: I'm a 23 year old male suffering from severe joint, back, neck, and tailbone pain for 5 years. No inflammation. My joints seem pop out of place. My ligaments snap over the bones when I bend and extend, it is extremely painful. Started with my right knee five years ago. 2 years later I got surgery on that knee and then month by month every other joint started to experience the same problems. My neck and back feel like they are stuck and are extremely painful, when I twist there is an audible pop that relieves some pain. No history of hypermobility prior to this. I am a former personal trainer. I've been bed ridden for all of 2015. Seen over 30 doctors. No diagnosis.
I've seen 5 rheumatologists, 5 physical therapists, an allergist, 3 physiatrists, 6 orthopedists. I've had 2 surgeries (made it worse), dry needling, prolotherapy. Nothing has helped.
I've seen 5 rheumatologists, 5 physical therapists, an allergist, 3 physiatrists, 6 orthopedists. I've had 2 surgeries (made it worse), dry needling, prolotherapy. Nothing has helped.
Brief Answer:
Please send the arthritis panel.
Detailed Answer:
Dear Sir ,
Thank you for posting your query on HCM.
Well looking into your problem I would like to tell you that since you had a major history of back pain along with knee joint involvement seronegative spondyloarthropathy needs to be ruled out . I have gone through your test results in which I found that your vitamin D was constantly low but that could not lead to all these issues . Please tell whether your HLAB 27 test , RF, Anti CCP has been done or not and if yes I would like to see those reports.
Please elaborate your history and any additional thing you think is important and relevant please mention so that we can understand the problem well and help you out in best possible way.
Take care.
Dr. Shruti
Please send the arthritis panel.
Detailed Answer:
Dear Sir ,
Thank you for posting your query on HCM.
Well looking into your problem I would like to tell you that since you had a major history of back pain along with knee joint involvement seronegative spondyloarthropathy needs to be ruled out . I have gone through your test results in which I found that your vitamin D was constantly low but that could not lead to all these issues . Please tell whether your HLAB 27 test , RF, Anti CCP has been done or not and if yes I would like to see those reports.
Please elaborate your history and any additional thing you think is important and relevant please mention so that we can understand the problem well and help you out in best possible way.
Take care.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you for the response. The tests that you mentioned all came back negative. I am working on getting the results for you. In the meantime, I've uploaded some of the scans that I've had over the last 3 years. The last rheumatologist I saw ruled out ankylosing spondylitis based on the normal MRI of the SI joints.
With regard to my history, I am happy to share any and all information- I'll do anything to get better and out of pain. However I'm really uncertain as to what is relevant. I've always been in good shape, athletic, and overall healthy. I was a personal trainer and had a carefully planned out all natural diet. In 2010, when I was 18, I was running on the treadmill one day and got this ache in the lateral side of my right knee along with clicking of the ligament during flexion/extension. It never went away after 3 years (tried physical therapy) so I got arthroscopic surgery in 2013. Ever since then, almost every month, a new joint starts having the same problems. It's as if my ligaments have suddenly become severely lax and weak. My joints feel unstable and ligaments/tendons click back and forth. In my elbows, the ulnar nerves have started to click as well and send shooting pains down my arms, making it very difficult to bring food to my face. And again, prior to this I had no history of hypermobility and no one in my family experiences these symptoms.
From 2013 to 2014, the pain was getting worse and worse but I still continued to live my life and manage the pain. Towards the end of 2014 it got to the point that I couldn't even walk anymore without pain and that's when I was forced to take oxycodone regularly and live in bed.
No one seems to have any clue where to go from here, other than throw a 7th brand of anti-inflammatories at me. I recently saw a physiatrist who ordered the metabolic workup which found the slightly abnormal hormones. He believes that the low testosterone is playing a significant role in the weakening of connective tissue. The other doctors I've spoken to don't seem to agree with his theory, but I'm of course willing to try anything. I started the testosterone injections 2 weeks ago, no improvements so far. The neurosurgeon and endocrinologist I saw in reference to the "possible pituitary adenoma" on the MRI didn't deem it significant and don't want to do anything about it. I don't know if it is or not; I just know tha something needs to be done about my joints.
Thought of some more info I could add in regard to the testosterone. One of the reasons the other doctors don't think the low T is causing the problem is because I've had no difficulty putting on muscle. I was in great shape a year ago and able to bench 225 lbs. I've barely moved since January and I've lost muscle and gained fat, but I still have more muscle on me than the average guy. However, I did experience some ED starting in 2013. This was also before I had started taking the oxycodone regularly, so that would suggest the the oxycodone is not responsible for the low T.
This part is probably unrelated but it can't hurt to share. I've started noticing all these nodules all over my torso over the last couple years. Some of them are tender when pushed on. None of the doctors I showed them to seemed to find it significant. The only other weird thing I can add about my body is that I have a very strange rectus abdominis. On the right side it is normal, but on the left there are 2 "abs" rather than 3. It's not a question of developing them, you can feel it and there is just not a 3rd one there. When I was in shape, this was very visible. Probably unrelated, but I don't know- maybe it's some crazy genetic defect.
Again, happy to answer any and all questions and open to anything you have to offer. If you want to collaborate with other doctors of different specialties, that would likely be helpful and I'd be happy to answer any of their questions as well.
I am open to any suggestions and happy to provide you with any additional information you need. Thanks.
With regard to my history, I am happy to share any and all information- I'll do anything to get better and out of pain. However I'm really uncertain as to what is relevant. I've always been in good shape, athletic, and overall healthy. I was a personal trainer and had a carefully planned out all natural diet. In 2010, when I was 18, I was running on the treadmill one day and got this ache in the lateral side of my right knee along with clicking of the ligament during flexion/extension. It never went away after 3 years (tried physical therapy) so I got arthroscopic surgery in 2013. Ever since then, almost every month, a new joint starts having the same problems. It's as if my ligaments have suddenly become severely lax and weak. My joints feel unstable and ligaments/tendons click back and forth. In my elbows, the ulnar nerves have started to click as well and send shooting pains down my arms, making it very difficult to bring food to my face. And again, prior to this I had no history of hypermobility and no one in my family experiences these symptoms.
From 2013 to 2014, the pain was getting worse and worse but I still continued to live my life and manage the pain. Towards the end of 2014 it got to the point that I couldn't even walk anymore without pain and that's when I was forced to take oxycodone regularly and live in bed.
No one seems to have any clue where to go from here, other than throw a 7th brand of anti-inflammatories at me. I recently saw a physiatrist who ordered the metabolic workup which found the slightly abnormal hormones. He believes that the low testosterone is playing a significant role in the weakening of connective tissue. The other doctors I've spoken to don't seem to agree with his theory, but I'm of course willing to try anything. I started the testosterone injections 2 weeks ago, no improvements so far. The neurosurgeon and endocrinologist I saw in reference to the "possible pituitary adenoma" on the MRI didn't deem it significant and don't want to do anything about it. I don't know if it is or not; I just know tha something needs to be done about my joints.
Thought of some more info I could add in regard to the testosterone. One of the reasons the other doctors don't think the low T is causing the problem is because I've had no difficulty putting on muscle. I was in great shape a year ago and able to bench 225 lbs. I've barely moved since January and I've lost muscle and gained fat, but I still have more muscle on me than the average guy. However, I did experience some ED starting in 2013. This was also before I had started taking the oxycodone regularly, so that would suggest the the oxycodone is not responsible for the low T.
This part is probably unrelated but it can't hurt to share. I've started noticing all these nodules all over my torso over the last couple years. Some of them are tender when pushed on. None of the doctors I showed them to seemed to find it significant. The only other weird thing I can add about my body is that I have a very strange rectus abdominis. On the right side it is normal, but on the left there are 2 "abs" rather than 3. It's not a question of developing them, you can feel it and there is just not a 3rd one there. When I was in shape, this was very visible. Probably unrelated, but I don't know- maybe it's some crazy genetic defect.
Again, happy to answer any and all questions and open to anything you have to offer. If you want to collaborate with other doctors of different specialties, that would likely be helpful and I'd be happy to answer any of their questions as well.
I am open to any suggestions and happy to provide you with any additional information you need. Thanks.
Brief Answer:
Follows.
Detailed Answer:
Dear Sir,
Thank you for reverting back.
Well I have looked at the reports that you have sent and what I could assess is that the possibility of arthritis seems very low in your case.Your MRI Pelvis is normal . And the markers that I have asked earlier are also normal so it practically rules out arthritis .
There is a strong possibiilty of benign joint hypermobility syndrome (BJHS) . Also this pituitary adenoma issue also needs to be sorted out but endocrinologist is the best judge for this thing . Have you been examined for BJHS ?
Dr. Shruti
Follows.
Detailed Answer:
Dear Sir,
Thank you for reverting back.
Well I have looked at the reports that you have sent and what I could assess is that the possibility of arthritis seems very low in your case.Your MRI Pelvis is normal . And the markers that I have asked earlier are also normal so it practically rules out arthritis .
There is a strong possibiilty of benign joint hypermobility syndrome (BJHS) . Also this pituitary adenoma issue also needs to be sorted out but endocrinologist is the best judge for this thing . Have you been examined for BJHS ?
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
That's what I was thinking and fearing. The thing is none of my joints hyperextend and I've never been flexible, nor is there any family history. I have an appointment at the Johns XXXXXXX Connective Tissue Clinic in July, they would probably be the best people to assess this, right?
Are there any other rare or abnormal causes of weak ligaments that can strike an adult? I've been perfectly healthy and strong my entire life and so is my entire immediate and extended family.
The rheumatologist a I've seen already said they don't see any evidence of hypermobility and ruled it out.
Are there any other rare or abnormal causes of weak ligaments that can strike an adult? I've been perfectly healthy and strong my entire life and so is my entire immediate and extended family.
The rheumatologist a I've seen already said they don't see any evidence of hypermobility and ruled it out.
Brief Answer:
Follows.
Detailed Answer:
Dear Sir,
I think you should get beck to me after seeing the XXXXXXX XXXXXXX centre , because this disease is diagnosed by subjective assessment and cant say anything without examining you. So better to wait and watch for what they say and then think further .
Dr. Shruti
Follows.
Detailed Answer:
Dear Sir,
I think you should get beck to me after seeing the XXXXXXX XXXXXXX centre , because this disease is diagnosed by subjective assessment and cant say anything without examining you. So better to wait and watch for what they say and then think further .
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Understood. However, I am in horrible pain and the appointment is in over a month. Can we brainstorm other potential possibilities (no matter how unlikely) in the meantime?
Are there any other causes of weak connective tissue?
Are there any other causes of weak connective tissue?
Brief Answer:
there is no such history.
Detailed Answer:
Dear Sir,
That case will be very unlikely because all such disorders are rare and generally are a part of syndromes in which their are other features also . Plus they will generally present in child hood so I dont see a reason for you to be suffering from any such syndrome because there is no such history.
Dr. Shruti
there is no such history.
Detailed Answer:
Dear Sir,
That case will be very unlikely because all such disorders are rare and generally are a part of syndromes in which their are other features also . Plus they will generally present in child hood so I dont see a reason for you to be suffering from any such syndrome because there is no such history.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Shanthi.E
Doesn't BJHS fall under that category as well? Shouldn't there have been childhood symptoms if that was the problem?
Brief Answer:
Follows.
Detailed Answer:
Dear Sir,
Thats always not true , in BJHS symptoms can show up in adulthood also specially in minor cases where it is not very classical .
Dr. Shruti
Follows.
Detailed Answer:
Dear Sir,
Thats always not true , in BJHS symptoms can show up in adulthood also specially in minor cases where it is not very classical .
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Oh wow. I didn't realize that. That really scares me because BHJS has no cure and patient reports indicate a life of pain. What about the fact that my joints don't hyperextend? They feel weak and loose, but neither as a kid or now have they hyperextended. Is it possible to still have BHJS without my joints hyperextending? (Also by the way, is BHJS not the same thing as ehlers danlos hypermobility type?)
Can I ask whether you've heard of this before and what your thoughts are on it? This seems to fit very well with my symptoms and history.
http://www.elixiawellness.com/dev/wp-content/uploads/2012/09/Connective_Tissue_Damage_Syndrome.pdf
Can I ask whether you've heard of this before and what your thoughts are on it? This seems to fit very well with my symptoms and history.
http://www.elixiawellness.com/dev/wp-content/uploads/2012/09/Connective_Tissue_Damage_Syndrome.pdf
Brief Answer:
Follows.
Detailed Answer:
Dear Sir,
Frankly , I havent heard of this entity and even after reading this I dont find it that convincing regarding your disease .
Dr. Shruti
Follows.
Detailed Answer:
Dear Sir,
Frankly , I havent heard of this entity and even after reading this I dont find it that convincing regarding your disease .
Dr. Shruti
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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