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.
PLEASE help me!
DEAR READER: Initially, there is the possibility you have an autoimmune disorder that is present when your immune system incorrectly attacks its own cells and tissues. One example of this is rheumatoid arthritis. The condition results in inflammation and pain. There are different types of pain, including that which is symmetrical, acute and chronic.
The treatment for an autoimmune disorder of this type might be treated with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or even aspirin. Your physician may choose to give you a more powerful pain reliever, oral steroids, or a disease-modifying anti-rheumatic drug. Be sure to remain as active as possible through walking or some other method as endorsed by your physician.
Polymyalgia rheumatica is an inflammatory disorder that results in stiffness and muscle pain, primarily presenting in the hips, thighs, neck, shoulders and upper arms. It is often treated with anti-inflammatory steroid drugs, the use of which must be carefully monitored by a physician.
Your spinal stenosis occurred because of narrowing of your spinal column that puts pressure on your spinal cord. It may also be caused by a herniated disc, spinal arthritis, a tumor in the spine, and a host of other possibilities. Symptoms include gait abnormalities, numbness, pain, and cramping. Perhaps physical therapy, cold and/or heat packs, prescription medication, massage and acupuncture will work in your favor.
Constant numbness and tingling (known as paresthesias) can present in the hands, arms, feet and legs. Unfortunately, there are countless possibilities for the condition to occur. You may have pressure on your spinal nerves from your herniated disc. Other reasons include an under-active thyroid gland, atherosclerosis, nerve injury, and pressure on your peripheral nerves from a tumor or scar tissue. You could also have an abnormal level of calcium, sodium or potassium in your body –especially because of your many supplements. You may have Lyme disease, especially if you live in an endemic area. The place to begin is with your family physician. Make a list of all the drugs and supplements you take, the number of times per day you take them, and the doses. Review that list with him or her and combine that information with your lab results. Perhaps one answer is to simply abandon most or all of your supplements and replace them with one good multi-vitamin taken daily. You will save money and may actually eliminate paresthesias from your long list
An ANA (anti-nuclear antibody test) is performed to determine if a person’s immune system is predisposed to causing inflammation against body tissues. ANAs indicate the possible presence of an autoimmune illness as mentioned above and may be linked with lupus, rheumatoid arthritis, Addison’s disease, Hashimoto’s thyroiditis, pernicious anemia, chronic infection, and a great deal more. To help with a diagnosis, ANAs present with different patterns which can give a physician a clue as to what illness to lean toward. If he or she hasn’t investigated this, that might be a good place to start.
Scoliosis is an abnormal curving of the spine. When symptoms occur they can include low back pain, fatigue following extended periods of standing or sitting, and more. Depending on the severity of your symptoms, a brace or medication might help.
Stelazine is used to treat anxiety and other disorders. Side effects include neck muscle spasms, rigidity of the back muscles, a shuffling gait and more. Your Nexium was likely prescribed to treat symptoms of gastroesophageal reflux disease. Lastly, Vicodin is a narcotic pain reliever. Common symptoms include constipation, dizziness, nausea, vomiting, mood changes, and more.
My recommendation is that you make an appointment with a rheumatologist and/or a pain management specialist who can sort out the issues you are experiencing to hopefully bring you some relief. Be sure to bring all back-up paperwork from your PCP for his or her review.
Readers who would like related information can order my Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
