OpenHealth Q&A

Navigating Pain: Seeking the Right Specialist

I am a 23-year-old woman with a normal BMI, and for the past few years, I have endured severe chronic pain. I suspect that my issues may fall under rheumatology or orthopedics, but I am uncertain which type of specialist I should consult. Any guidance would be greatly appreciated, as I am feeling quite desperate. My troubles began in February 2022 when I started experiencing pain in my calves. This discomfort intensified with movement, and it would radiate to my quadriceps if I didn’t spend several days resting. At times, the pain became so severe that I felt nauseous. After a general practitioner could not identify the issue, I sought the help of a podiatrist. They mentioned there was a misalignment in the front part of my foot that was causing an undue distribution of my weight. Their recommendation was to perform daily calf stretches, and then I left it at that. Although the discomfort seemed to diminish over time, my stretching routine was inconsistent. Later on, I returned to a different podiatrist for an ingrown nail, where I inquired about the seriousness of my earlier foot problem, especially since I began to experience abdominal pain (as mentioned below). To my surprise, the podiatrist expressed doubt about the existence of my foot problem, explaining that the appearance of my foot would be significantly different if that were the case. The most debilitating pain arose in May 2023, when I woke up to a sharp sensation in my lower right abdomen. This pain worsened with physical activity but subsided when I lay down. It became a daily occurrence, compelling me to rely on pain relief medication to manage. After weeks of no improvement, I visited my doctor, who ordered a series of tests, including an abdominal CT scan, blood tests, a gluten sensitivity test, and a colonoscopy, all of which returned normal results. Eventually, the abdominal pain decreased somewhat, only manifesting after engaging in intensive activities. However, if I did not rest for several days during a flare-up, the abdominal discomfort would return and last for days to weeks each time I attempted to walk around. In conjunction with this, I was also grappling with significant pain during intercourse. My gynecologist conducted a transvaginal ultrasound that came back clear and directed me to pelvic floor physical therapy. During my sessions, the therapist noted that my pelvic muscles were tense and suggested that I might be hypermobile due to my history of joint popping. Although I have not experienced any dislocations, I have always noticed that my knees and hips crack when I sit for extended periods, typically around 30 to 40 minutes. Each step I take can result in a popping sound in both legs, resembling the sound of a stick breaking. Most days are enveloped in some form of discomfort, whether it's crippling abdominal pain or soreness in my legs by day’s end. I suspect that all of these symptoms could be interconnected; however, they have been treated as unrelated issues thus far. Currently, I am without a general practitioner and cannot afford to consult multiple specialists, so I want to ensure that I approach the right area for an accurate diagnosis. If you have any recommendations on which specialist would be best suited to investigate these concerns, I would be incredibly grateful. I am open to answering any further questions to clarify my situation. Thank you for your assistance!

Answers (1)

3/31/2025, 4:10:46 PM

OpenHealth AI

Based on your history of chronic pain, it’s understandable to feel overwhelmed and unsure about which specialist to consult. Given your symptoms involving muscle and joint pain, abdominal discomfort, and your experiences with hypermobility, I recommend initially seeking a rheumatologist. They specialize in diagnosing and treating musculoskeletal disorders and autoimmune diseases, which could be relevant to your symptoms.

Explanation:

Your pain appears to be multifaceted, involving various areas such as your legs and abdomen, and might be linked to conditions that a rheumatologist would be equipped to evaluate, especially with considerations of hypermobility or potential inflammatory conditions. They can also help connect the dots between your symptoms and provide a comprehensive assessment.

Next Steps:

1. Find a Rheumatologist: Look for a rheumatologist who accepts your insurance or offers a sliding scale for payments if cost is a concern.
2. Document Your Symptoms: Keep a detailed diary of your symptoms, including when they occur, their severity, activities that aggravate or alleviate pain, and any other relevant factors. This information will be valuable for your consultation.
3. Prepare for the Appointment: List all your past medical history, treatments you’ve tried, and any specific questions or concerns you have. This will help ensure that you make the most of your appointment.
4. Engage in Gentle Exercise: While awaiting your appointment, consider continuing your stretching routine and explore gentle, low-impact activities like swimming or yoga that do not exacerbate your symptoms.
5. Practice Relaxation Techniques: Since tension can contribute to pain, incorporating relaxation methods—such as deep breathing exercises or meditation—may help alleviate muscle tension and improve your overall well-being.

Remember, it's essential to advocate for yourself during your healthcare journey. You deserve to have your concerns addressed, and a rheumatologist can guide you toward a clearer diagnosis and management plan. If you need further support or specific resources, feel free to ask!