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What Causes Shoulder Pain And Fatigue When Diagnosed With Scoliosis?
Question: I have a number of different complaints/symptoms at the same time, and i've never experienced this before. (I think I forgot to mention recent diagnosis of moderate scoliosis. I;m having shoulder pain neck pain lower back pain,muscle weakness in my Rt calf; walking balance issues and generalized muscle twitches/spasms. I also have gout treated with allopurinol. My recent internet research indicates that allopurinol can cause elevated muscle enzymes. Recent blood tests show my ck level above 900. I was taken off simvistatin abruptly about one month ago because of the high ck level The rheumatologist told me to stop the allopurinol which I briefly did. However, I put myself back on when I experienced significant great toe pain. I seem to be in a catch 22. As I am writing I'm having considerable Rt shoulder pain as well as pain in my Rt medial forearm My various complaints and generalized muscle pain, lumbar radiculapathies at several levels including T11-12 and at L3.4 5 and S1 in addition to scoliosis and of course very high ck levels combine to make me feel confused, concerned and unsure how to prioritize the problems. Oh by the way, I have an appointment with a neurosurgeon.( I almost forgot to mention an EMG study one month ago. Can you help me sort out and triage my complaints and give me an idea how serious these overlapping issues. Thank you in advance for your kind advice
Brief Answer:
Approach and triage of complaints
Detailed Answer:
Hi xxxx, thanks for asking from HCM.
I can understand your concern. You are suffering from
- Gout
- Scoliosis
- Lumbar and cervical radiculopathies
- Spasm of lower limb muscles and balancing problem (most probably ataxia or spastic gait)
- Drug side effects (muscle enzyme rise)
Now if you try to correlate these complaints, we can see that
" scoliosis is causing radiculogpthy, muscle spasm and balance problem while gout is causing toe pain, drug intake and side effects."
You are suffering more due to "scoliosis". Because it is affecting your most spine and causing generalised symptoms. Gout almost always involve feet and toes. So give priority to "Scoliosis" over gout. Both are treatable disease.
To treat scoliosis and its symptoms, you should keep in mind that your spin is hard now. Scoliosis surgery results are not that good as age advances. But postural exercise along with surgery can help. It will at least relieve some symptoms. Discuss about possibility of surgery with your neurosurgeon.
For radiculopathic pain, you can take painkillers like Gabapentine/Pregabaline or combination of these with nortriptyline. For muscle spasm, physiotherapy and baclofen, vitamin E, clonazepam tablets will help. Balance will improve about relief in spasm. But there is need to rule out sensory system damage also. The neurosurgeon will examine you for it. It is a subjective test.
For gout, you must consult your rheumatologist about allopurinol. It is damaging your muscles. Ask him to start you on new drug like colchicine or NSAID's or steroids. Avoid alcohol, mushroom and meat products. These cause rise in uric acid.
Keep yourself very well hydrated. It will prevent acute attacks.
Hope it will help you. If still in doubt, do let me know.
Thanks. Take care.
Approach and triage of complaints
Detailed Answer:
Hi xxxx, thanks for asking from HCM.
I can understand your concern. You are suffering from
- Gout
- Scoliosis
- Lumbar and cervical radiculopathies
- Spasm of lower limb muscles and balancing problem (most probably ataxia or spastic gait)
- Drug side effects (muscle enzyme rise)
Now if you try to correlate these complaints, we can see that
" scoliosis is causing radiculogpthy, muscle spasm and balance problem while gout is causing toe pain, drug intake and side effects."
You are suffering more due to "scoliosis". Because it is affecting your most spine and causing generalised symptoms. Gout almost always involve feet and toes. So give priority to "Scoliosis" over gout. Both are treatable disease.
To treat scoliosis and its symptoms, you should keep in mind that your spin is hard now. Scoliosis surgery results are not that good as age advances. But postural exercise along with surgery can help. It will at least relieve some symptoms. Discuss about possibility of surgery with your neurosurgeon.
For radiculopathic pain, you can take painkillers like Gabapentine/Pregabaline or combination of these with nortriptyline. For muscle spasm, physiotherapy and baclofen, vitamin E, clonazepam tablets will help. Balance will improve about relief in spasm. But there is need to rule out sensory system damage also. The neurosurgeon will examine you for it. It is a subjective test.
For gout, you must consult your rheumatologist about allopurinol. It is damaging your muscles. Ask him to start you on new drug like colchicine or NSAID's or steroids. Avoid alcohol, mushroom and meat products. These cause rise in uric acid.
Keep yourself very well hydrated. It will prevent acute attacks.
Hope it will help you. If still in doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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