Discussions By Condition: Muscle conditions

Unexplained, persistent, 24/7 wide-spread joint pain

Posted In: Muscle conditions 4 Replies
  • Posted By: GregasGP
  • October 6, 2008
  • 01:43 PM

Hi all,

To say I am desperate is an understatement. I'm looking for some advice and possible treatment options here.

Here's a little bit of history. I'm a 25 year old male and have always been physically active and fit. Never had any joint or muscle issues in the past until last September 2007 when I began having ankle pain, both ankles affected. I have been training for the Royal Air Force and was accepted in January 2008 to begin Officer Training in the Regiment - sadly that's all been shot down with my pain and unexplained condition and my dream is destroyed.

I sparined my ankles back in 2006, moderate sprains playing sport, but all seemed to heal OK. Then unexpectedly pain began in both, mild at first and only when resting not when playing sport etc. It gradually got worse and then in Jan 2008 I had to have an MRI scan. It showed some diffuse thickening of ligaments consistent with chronic ankle sprains, but no other pathology. Gave physio and prolotherapy injections a shot, seemed great for the ligaments and no tenderness there but still constant pain.

Finally opted for surgery in April 2008 where I underwent an ankle arthroscopy on left ankle. The surgeon found a small cartilage tear, still intact membrane, and performed a microfracture procedure. Was on cructhes for 4 weeks as minor damage and followed rehab to a tee. Fast forward to July and scan shows all is healed but still in constant pain.

IN JUNE, things took a turn for the worse. I woke up overnight with upper body joint pain that has progressed to all my joints. Now I have constant 24/7 pain in my wrists, ankles, knees, elbows, thumbs, index fingers, back and hips. It never ceases and is there on a daily basis. There is no swelling or redness or warmth, but a lot of pain and stiffness and creptitis in my joints. It never relinquishes and no meds seem to help. I have been to see various specialists and haven't a clue what to do.

SUMMARY OF SYMPTOMS:
Chronic pain in all joints for the last 4 months
Pain often migrates, worse in ankle joints one day and then ok and worse in knees the next. Differing pattern of pain.
NO swelling/redness/warmth/sensitivity to touch
Persistent pain and stiffness with crepitis too
No associated IBS/sickness etc

TESTS:
Two blood tests - ESR/CRP/ANA/RA/Serum calcium levels all completely normal.
MRI scans - Knees show mild case of chondromalcia Patellae but very mild and wouldn't cause constant pain. Ankles are apparently in perfect condition. No other damage in joints/arthritis
Isotope Bone Scan - perfect with normal tracer throughout and no hotspots.
Physical examinations - By physiotherapist, rheumatologist, chiropractor, podiatrist, ortheopedic surgeon, GP and pain management specialist. No ideas to to cause of unexplained pain. Physical examinations normal. No trigger points for Fibromyalgia etc.

TREATMENTS:
Diclofenac - No joy. All other NSAIDs have the same nil effect
Anti-depressents - Dosulepin and Amitriptyline. No joy with these either
Codeine/Co-Dydramol/Paracetamol - No relief at all
Physio/Various supplements - Glucosomine/HA/chondrotin etc and anti-inflammatory supplements with no success
Biomagnetic therapy and LED therapy No effect either
Prolotherapy injections - no pain relief but has repaired my ligaments very well in sprained ankle

I met with the pain management specialist who suggested I look into BuTrans patches and an anti-convulsant med like Pregabalin. Is this is a good idea?

Any ideas on diagnosis of this dehabilitating condition/ I'm finding at the age of 25 that my life is falling apart, I feel worried about the future, depressed and in all honesty quite suicidal at times.

Hoping you can help.

Thanks all

Greg

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