Seeking Guidance After Months of Unresolved Pain
Hello everyone, I’m a 27-year-old woman dealing with persistent discomfort in both elbows, feet, and the central area of my lower legs for the past ten months. This all began after I spent time grilling large sausages at a Christmas market. Recent tests show that my ANA is positive, along with DFS 70 and Mi 2 markers; however, my blood work indicates no signs of infection, and my CRP levels are low (0.7). Despite numerous consultations, I have yet to receive a formal diagnosis. I do not experience flares, stiffness, or swelling, but the pain has significantly impacted my quality of life. Here’s how I would characterize the pain: 1. **Feet and Legs**: The pain feels like it’s jumping or traveling, almost as if there’s pressure being applied. It mostly affects the soles and arches of my feet, intensifying when I stand or walk. After about 15 minutes of walking, I require a break, and the discomfort persists from the moment I wake up until I go to sleep. 2. **Elbows**: The pain here is associated with movement, resembling golfer's elbow, and is sometimes unpredictable. It radiates inside the elbows, affecting my ring and pinky fingers, along with the inner part of my hand. I now struggle to open my right ring finger when I count, something I could easily do just ten months ago. 3. Additionally, I experience occasional muscle twitches throughout my body—sometimes in my legs, and other times in my arms or even my glutes. These twitches last for just a moment. Perhaps I am too stressed? After consulting with four different rheumatologists, I find myself feeling completely bewildered: 1. They suggest it might indicate an autoimmune condition, but paramedics conclude that there's no inflammation, so the recommendation is simply to manage pain with medication. 2. One option is a tapered course of Prednisolone (20 to 5 mg over four weeks). If the pain eases but then reoccurs, it may confirm an autoimmune issue. However, this logic seems flawed since it could help with other conditions as well. 3. Another diagnosis was an undifferentiated autoimmune disease, warranting 1-2 years of Hydroxychloroquine. 4. Finally, one believes it’s definitely autoimmune and advocates immediate treatment with 5 mg of cortisol plus Sulfasalazine for a minimum of six months. I also consulted a psychiatrist, who advised me against using any medication until a definitive diagnosis is reached, suggesting I simply try to move on from this situation—easier said than done. Is there anyone here who could offer some advice or insights? I appreciate your time and support!
Answers (1)
7/28/2025, 11:31:06 AM
OpenHealth AI
It sounds like you have been experiencing a challenging journey with persistent pain and uncertainty about your diagnosis. Your symptoms, paired with the positive ANA and specific markers, suggest a complicated situation that may relate to an autoimmune process, but the lack of inflammation and absence of clear diagnosis only adds to your frustration.
Main Points:
- You have persistent pain with no clear diagnosis despite various tests.
- Symptoms suggest possible autoimmune involvement, but inflammation is low.
- Pain management options have been proposed, but clarity is lacking.
Understanding Your Situation:
Your pain in the elbows and feet is significant and affects your daily life. The "jumping" sensation and discomfort in specific movements indicate that your nerves or muscles could be involved. While autoimmune diseases can sometimes present without classic inflammation, the lack of definitive findings can make it challenging for doctors to pinpoint an exact cause.
Prioritized Next Steps:
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Track Your Symptoms: Keep a detailed diary of your pain, noting what activities worsen or relieve it, the times of day it’s worst, and any patterns you notice. This can provide valuable insights for your healthcare providers.
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Pain Management Techniques:
- Rest and Limit Strain: Pay attention to your activity levels and rest when necessary. Consider a supportive footwear option that may help relieve pressure on your feet.
- Gentle Stretching and Strengthening Exercises: Engage in low-impact exercises or physical therapy focused on maintaining mobility without exacerbating your symptoms. This can help improve function and manage discomfort gradually.
- Mindfulness and Relaxation: Techniques like deep breathing, meditation, or gentle yoga might help manage stress and muscular tension, which can contribute to pain perception.
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Follow-Up with Rheumatologists: If further consultations feel necessary, seek opinions from additional specialists who focus on autoimmune diseases or pain syndromes. Sometimes getting a fresh perspective can lead to new insights.
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Communicate with Mental Health Support: Continue discussions with your psychiatrist about how you’re feeling. Anxiety about your health is natural, so having coping strategies could improve your overall well-being.
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Evaluate Medication Options: Based on the recommendations you received, consider starting with the lowest effective dose of pain relief (like NSAIDs, if suitable) to monitor if there's any improvement in your symptoms. Keep open communication with your providers about how it's working over time.
Conclusion:
While the uncertainty can be unsettling, your proactive approach is vital. By systematically managing your symptoms and remaining engaged with your healthcare teams, you can take meaningful steps toward improving your situation. Let me know if there’s a particular area you’d like more advice on, and I’m here to help!
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