OpenHealth Q&A

Seeking Answers for Persistent Pain and Symptoms

Greetings. I’m a 56-year-old diagnosed with rheumatoid arthritis (RA). Interestingly, I developed antibodies against the condition and have refrained from using any rheumatological medications for the past month. Currently, I manage with just 10 mg of prednisone and 15 mg of Mobic daily. Additionally, I take 70 mg of Vyvanse, a daily dose of 5000 IU of Vitamin D, and I use estradiol patches. Last December, I visited the emergency room due to intense discomfort in my left shoulder, arm, and hand, which I perceived as nerve pain. I wasn't sure what the issue was, but I hoped the doctors could provide clarity. Later in the spring, I received a diagnosis of RA. Following my ER visit, I was placed under stroke protocol and spent the night for observation, during which numerous tests were performed. The next day, I was discharged with assurance that I had not suffered a stroke, yet without additional explanations. Since that ordeal, I have been plagued by persistent spasms in my left shoulder, which fluctuate in terms of their severity but never cease entirely. The discomfort extends up into my neck and around the back of my head, affecting my jaws as well. Notably, the discomfort tends to intensify as the day progresses. Recently, I have started to experience the same sensations in my arm that prompted my ER visit. After reviewing my cervical MRI, it raises questions for me—shouldn’t they have informed me about what the scans revealed? It seems pertinent to my ongoing symptoms. Additionally, I encounter brief yet intense episodes of nausea each day along with episodes of blurred vision. Strangely, I’ve also had a persistent runny nose from my right nostril for the last few months. My attempts to get definitive answers from medical professionals have been frustrating. If there is indeed a need for treatment, could you advise which specialist I would need to consult? I am enduring significant pain and discomfort, and visibly noticeable swelling in my neck highlights my distress. **Patient History:** Numbness on the left side; swelling in the left hand. **Comparison:** MRI of the cervical spine conducted on December 29, 2015. **Technique:** Multiple images of the cervical spine were captured. **Findings:** - **Soft Tissues:** Appeared normal. - **Bones:** Normal bone marrow signal detected. - **Spinal Cord:** No irregularities found. - **Craniocervical Junction:** Intact structure with no cerebellar tonsillar ectopia. - **C2-3:** Arthropathy noted on the left side more than the right, no narrowing of the spinal canal or neuroforamina. - **C3-4:** Minor disc height reduction observed, with a disc osteophyte complex leading to mild narrowing of the spinal canal and uncovertebral hypertrophy causing slight bilateral neuroforaminal narrowing. - **C4-5:** Similar minor disc height loss and osteophyte presence contribute to slight spinal canal narrowing, with bilateral foraminal narrowing due to uncovertebral hypertrophy. - **C5-6:** Minor disc height loss accompanied by a disc osteophyte complex resulting in mild spinal canal narrowing and significant neuroforaminal narrowing on the right, moderate on the left due to uncovertebral hypertrophy. - **C6-7:** Again, mild loss of disc height, uncovertebral hypertrophy causing severe narrowing on the left and mild on the right, with no spinal canal narrowing. - **C7-T1:** Uncovertebral hypertrophy noted leading to moderate narrowing on the right side, no narrowing detected on the left or in the spinal canal.

Answers (1)

9/4/2025, 2:50:53 AM

OpenHealth AI

Thank you for sharing your detailed history and current symptoms. It sounds like you’re experiencing a combination of complex issues related to your rheumatoid arthritis and possibly other underlying factors. Let's break down your concerns and create an actionable plan.

Main Points:

1. You have persistent pain and spasms in the left shoulder and arm, with additional symptoms including nausea and blurred vision.
2. Your cervical MRI showed areas of concern, which may relate to your symptoms.
3. You’re frustrated with the lack of clear communication regarding your health status from medical professionals.

Explanation:

Rheumatoid arthritis (RA) can lead to various complications, including nerve pain and muscular spasms. The MRI findings suggest some spinal changes that might contribute to your shoulder and arm discomfort. The fluctuating nature of your pain could indicate underlying inflammation or nerve involvement, especially since you're experiencing swelling in your hand. The nausea and blurred vision may be signs of other conditions that should also be evaluated.

Next Steps:

1. Consult with a Specialist: Given your symptoms, a Rheumatologist should be your primary point of contact to evaluate your RA treatment and manage ongoing symptoms. Additionally, seeing a Neurologist may be beneficial to address the nerve pain and visual disturbances.

2. Follow-Up on MRI Results: Request a follow-up appointment to go over your MRI in detail with a healthcare provider. It's crucial to understand what the findings suggest about your neck and any potential implications on your symptoms.

3. Symptom Management:

   • Pain Relief: Continue using Mobic and prednisone as prescribed but discuss with your doctor about optimizing your pain management strategy, possibly adjusting dosages or considering other medications.
   • Physical Therapy: A referral to a physical therapist specializing in RA can help with the spasms and improve mobility. Gentle stretching and strengthening exercises may alleviate discomfort.
   • Lifestyle Adjustments: Ensure you’re drinking enough water and maintaining a balanced diet, which can support overall health and immune function. Avoid activities that trigger pain.

4. Keep a Symptom Diary: Document your symptoms, including timing, intensity, and any associated factors (like what you ate or activities done). This can help your healthcare providers in diagnosing and tailoring treatment.

5. Monitor Episodes of Nausea and Blurred Vision: If these symptoms persist or worsen, they should be addressed urgently to rule out neurological issues.

These steps should guide you toward managing your symptoms more effectively while advocating for the clarity and support you deserve in your healthcare journey. If you have any specific questions or need further information about managing your condition, feel free to reach out. Remember, your comfort and understanding are paramount.