Muscle disorder explained

Q: I was recently diagnosed with inclusion body myositis at the University of California Medical Center in San Francisco. I am an 86-year-old male. What can you tell me about this disease and what it’s treatments are?

A: Inclusion body myositis (IBM) is one of a group of muscle diseases known as inflammatory myopathies. The diseases are characterized by chronic, progressive muscle inflammation and weakness. It usually begins after age 60 but can occur earlier and affects men more frequently than women. It is not uncommon for it take years to be diagnosed correctly.

In IBM weakness generally progresses gradually over a period of months or years and affects both the truck and the limbs. The weakness can occur on one or both sides of the body. Initial signs and symptoms may begin with weakness in the wrists and fingers, causing difficulty with pinching and gripping items. Thinning or loss of muscle bulk of the forearm and quadricep muscles may also be present. Half of all IBM sufferers will also experience difficulty swallowing. Falling is common.
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Horse liniment helps the pain

DEAR DR. GOTT: A couple of years ago you recommended a mint-scented sore muscle lotion for horses that was also effective in humans. I cannot remember the name of it but it worked very well when I had severe bursitis and now my knees are sore when I lay on my side in bed at night. I wonder if that lotion would help. Could you possibly tell me the name again?

DEAR READER: I believe the product you are referring to is veterinary liniment, a topical pain-relieving rub used on horses and other large livestock that can be found in many feed stores. The one with which I am most familiar is Absorbine; however, I am sure there are several other brands available which will work just as well.
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What causes joint pain?

DEAR DR. GOTT: I am a 76-year-old female. I take many supplements (too many to list here), plus Stelazine and Nexium. I take Vicodin for pain. I am not aware of any allergies. I have all over body, joint and muscle pain, especially in my shoulders and arms. I have all over body tingling every day. I have itching off and on on my fingers and toes. I also have a herniated disc, scoliosis and spinal stenosis. I have pain in my right foot which they are telling me I have arthritis and a collapsed arch. My sister also has joint pain and so does my brother. At times I feel very weak. I have occasional chest pain, am sensitive to bright lights and feel sick when I get hot. My ANA test is never normal. I have redness in the upper part of my fingernails and toenails. All blood test I’ve had done come back normal except my ANA. The doctor told me I don’t have fibromyalgia because I have no trigger points.
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Simple remedy for fibromyalgia

DEAR DR. GOTT: I was diagnosed with fibromyalgia seven years ago and went to a clinic at a local hospital where I was evaluated by a doctor and a naturopath. The doctor put me on a clinical trial of vitamin B injections and the naturopath recommended a supplement of magesium/malic acid.

I experienced relief quite quickly and thought it was due to the “miracle” injections; however, I had to discontinue them. For the past six years I have continued to take the malic acid/magnesium supplements daily and have found that they alleviate all my pain. Occasionally I will run out of supplements and after three days the pain will start to creep in again. I had previously been on many sleep and pain medications which made me a walking zombie. Avoiding sugar and alcohol also helps.
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Reader taking 10 times more than recommended

DEAR DR. GOTT: Now 67, I’ve suffered with “pings” of sharp pain in my shoulders for three years. I could hear and feel the tendons and muscles pop when I moved or reached for something. My uncle, 94, claims to have “not an ache or pain” and recommended I take 40,000 units of vitamin D3 daily. I tried 20,000 with no results. I tried 30,000 with some relief. I tried 40,000 units and am mostly symptom free. I had been to MDs, chiropractors and had acupuncture and massages all with little or no results. What might have been my diagnosis? Are there any long-term side effects from this seemingly high dose?

DEAR READER: Vitamin D is fat soluble and found naturally in very few foods (fish liver oil, fatty fish, beef liver, cheese, and egg yolks). It is best known for promoting calcium absorption, but also maintains adequate blood calcium and phosphate levels, [Read more…]

Wife concerned about husband’s pain and sleeplessness

DEAR DR. GOTT: My husband enjoys reading your articles. He thought he had cut one out for future information but cannot find it. He has muscle pain more than joint pain, hot flashes, insomnia, and sometimes what he calls “no legs” as he cannot feel them in the sense of walking.

He is 60 years old and has a very physical job. He works out with weights for his upper body and has for years. He is using prescribed testosterone cream trying to maintain strength. He takes blood pressure medication and it is under control. He takes cholesterol meds, Tramadol and Ambien. He is so bad he can hardly talk or walk from the shaking but yet his face feels hot to the touch only on his head. He worries a lot.
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Joint and muscle pain caused by allergies

DEAR DR. GOTT: I am 75 years old and have what I believe is muscle and joint pain caused by allergies, similar to the lady that wrote you a while back. For me it happens mostly in the fall but when the aches and pain come, I just take antihistamines until the first freeze and then all is okay. This note is only to tell you that there are more like her out there.

DEAR DR. GOTT: Sometime ago you had an article about muscle and joint pain caused by allergies. Well, I am one of those people. This has been going for many years and I have been to so many doctors and have had many tests but everyone tells me there is nothing wrong, it’s probably my imagination. I also have told all the doctors I have been to that after I take an antihistamine, I have relief. No one believes me.
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Trigger points may be cause of joint, muscle pain

DEAR DR. GOTT: I find your column interesting and useful, but I am often frustrated by some of your answers when they concern muscle or joint pain. In your column about tennis elbow, you left out a very likely cause of the problem, but you seemed to disregard it or are unaware of it.

Trigger points may well cause this person’s tennis elbow and, while the pain could be coming from the forearm as you suggested, it could also be coming from the triceps. The trigger points can be caused by trauma or overuse of the muscle; but physical therapy, heat and massage treatments will not cure them, just provide short-term relief. Trigger points are small knots in the muscle that can cause constant pulling at the tendon, resulting in tendonitis. If you don’t release the trigger point, you won’t cure the problem. Physical therapy, heat and massage may relax the trigger point, but it will tighten up shortly after treatment and the pain will return.
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Polymyalgia is a pain

DEAR DR. GOTT: My doctor diagnosed me with polymyalgia. I have pain in the back of my head, shoulders and lower back that usually occurs at night and goes away when I get up in the morning. I’m 78 years old, in generally good health with no diabetes, heart or other problems. I go to physical therapy three times a week for my back problem and have traction treatment as well, which seems to be working. Is there any help for me?

DEAR READER: Polymyalgia rheumatica (PMR) is an inflammatory disorder that results in widespread muscle aches, pains and stiffness of the hips, shoulders, thighs, upper arms and neck, fatigue, anemia, malaise and unintentional weight loss. Symptoms experienced are the result of mild inflammation of the joints and surrounding tissue. Stiffness can worsen following periods of inactivity, such as after a night’s sleep or sitting for too long.
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Muscle/joint pain caused by allergies?

DEAR DR. GOTT: I’m hoping this information will be helpful to many of your readers. I am a healthy 57-year-old female. Ten years ago, my husband and I lived in Virginia because he was in the Army. I became ill with tingling and numbness in my left arm and also aching joints. After numerous doctor visits, MRIs, etc., I still had no diagnosis. Then, about three months later, I awoke with my arms and torso covered in hives. I immediately went to see an allergist who told me that I was allergic to something that had caused the hives to develop, but he also said it was wreaking havoc inside my body and making my arm and joints ache. I started taking an antihistamine every day for two years and was absolutely fine.

For some dumb reason, I stopped taking it, and last year I had another strange episode: This time, it was strong pains in my breasts. It felt as though I was lactating, but I knew I could not be. Again, I had many doctor visits and also underwent a sophisticated mammogram. I was told I had fibromyalgia, because I also had aches and muscle pains. I disagreed with the diagnosis and began researching on my own.

We had gotten a new dog four months earlier, and, after talking to friends, I decided to stay away from the dog. Sure enough, I began feeling better. Then I told my boss at work, a female, about the strange breast pain, and she immediately told me that I must be allergic to the dog because her little boy had similar reactions to his new dog. His underarms swelled up painfully. I was elated to solve this!

We returned the dog to the shelter, and I was immediately tested for allergies. I was allergic to cats and dogs, not to mention many grasses, molds, trees and house dust. I will never stop taking my daily antihistamine, and I have been feeling great ever since restarting it.

DEAR READER: I have printed your letter because I find it interesting that you say you have joint, muscle and breast pain due to allergies.

Most allergies cause itchy, watery, red eyes; a runny nose and/or congestion; coughing, wheezing or other asthma-like symptoms; skin rashes, hives or swelling. The type of symptoms experienced depends on the allergen and how you came into contact with it. Pet dander, for example, is typically inhaled, so skin manifestations, while possible, are not generally seen.

I am unable to find any reliable scientific evidence that shows that any allergen, let alone pet dander, can cause joint, muscle or breast pain. I was able to find personal testimonies that claimed these symptoms due to allergies, but there is nothing to substantiate the claims. Perhaps this is something that should be further investigated by the medical and scientific communities.

I am not in any way dismissing your claims. I am simply stating that at this point there is no hard evidence to back up the claims. The fact that you have experienced relief by taking a daily antihistamine is compelling nonetheless.

To provide related information, I am sending you a copy of my Health Report “Allergies.” Other readers who would like a copy should send a self-addressed stamped envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.