Chronic Joint Pain for 26 Years: Seeking Answers and Effective Solutions

Q: Chronic Joint Pain for 26 Years: Seeking Answers and Effective Solutions

Hello： It seems that you may have a problem with widespread pain. <br>Conditions that can manifest as widespread pain include inflammatory or degenerative arthritis, thyroid disorders, vitamin D deficiency, systemic lupus erythematosus, polymyositis, liver disease, kidney disease

I have been troubled by joint issues for approximately 26 years, and all examinations have yielded no results?

Hello, I have been experiencing issues with my joints since the fourth grade, and I am now 36 years old, with these problems still persisting.
I have undergone preliminary examinations at various hospitals (both in my childhood and in my twenties), including blood tests (in rheumatology, general orthopedics, etc.) and X-rays, all of which have reported that I am very healthy and have no medical conditions.
When I was younger, doctors could not determine the cause and diagnosed it as growing pains, but this pain significantly affects my sleep and rest.
However, I am still able to perform activities that most people can do, such as squatting, standing up, running, walking briskly, and lifting heavy objects.
There is no record of similar diseases in my family, and I have no history of joint surgeries.
Due to this pain, I have often been regarded as a liar, as it is believed that pain that cannot be diagnosed by doctors is simply a child's excuse to avoid something.
As I grew older, I was not trusted regarding this pain because there was no medical proof, and it was merely my word, which is very frustrating.
I can only endure the pain at night and live like a normal person during the day, no longer mentioning this pain to others.

The situation is as follows:
1.
The pain usually occurs at night during sleep, causing me to wake up.
I can relieve the pain temporarily by moving and stretching my joints, which may produce sounds, but this relief is not always immediate and can sometimes last a long time, with the joints continuing to make noise.
2.
The pain episodes can last from 1 to 2 days, or sometimes occur for several months at night, leading to poor sleep.
3.
Occasionally, when I try to exert myself, certain joints may suddenly feel unable to bear weight.
4.
The areas where the pain is most severe include the knees, hips, elbows, shoulders, various finger joints, and cervical spine joints.
5.
I also experience headaches, which I am unsure are due to lack of rest or related to the joint pain; the headache feels like a squeezing pain that can be temporarily alleviated with pain relievers.
Additionally, I would like to ask if an MRI can be performed to check for any underlying issues.
Is there any risk associated with MRI? Or are there other suggestions for more effective examination methods?

Quan Xiao Cao, 30~39 year old female. Ask Date: 2021/03/19

Dr. Jiang Junyi reply Neurology

Hello: It seems that you may have a problem with widespread pain.
Conditions that can manifest as widespread pain include inflammatory or degenerative arthritis, thyroid disorders, vitamin D deficiency, systemic lupus erythematosus, polymyositis, liver disease, kidney disease, leukemia, hypercalcemia or hypocalcemia, hyperkalemia or hypokalemia, infections, etc.
Magnetic resonance imaging (MRI) is primarily used to assess water-containing tissues, thus it has a higher sensitivity for lesions in neural tissue.
It is recommended that you continue follow-up at the same hospital to accumulate comprehensive information, which will assist clinicians in making a diagnosis.
It is advisable to consult with specialists in rehabilitation medicine and rheumatology for further discussion.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Internal Medicine, Taoyuan Hospital, cares about you.

Reply Date: 2021/03/19

More Info

Chronic joint pain can be a debilitating condition, especially when it has persisted for many years without a clear diagnosis. Your experience of joint pain starting from a young age and continuing into adulthood is certainly challenging, particularly when medical evaluations have not yielded any definitive answers. It is understandable that you feel frustrated and unheard, especially when your pain affects your quality of life and sleep.

From a medical standpoint, chronic joint pain can arise from various causes, including inflammatory conditions, autoimmune diseases, degenerative joint diseases, and even psychological factors. Given that you have undergone multiple evaluations, including blood tests and X-rays, and have been deemed "healthy," it may be worthwhile to consider a few potential avenues for further investigation and management.

1. Consider a Rheumatological Evaluation: Since you have already seen rheumatologists and other specialists, it might be beneficial to revisit this option, especially if you have not had a comprehensive evaluation for conditions such as fibromyalgia, chronic fatigue syndrome, or other systemic conditions that may not show up on standard tests. These conditions can cause widespread pain and may not always be detected through routine blood tests or imaging.

2. Magnetic Resonance Imaging (MRI): An MRI can provide a detailed view of soft tissues, including cartilage, ligaments, and muscles around the joints. It is a non-invasive imaging technique that does not involve radiation, making it relatively safe. While there are minimal risks associated with MRI (such as discomfort from lying still or potential reactions to contrast agents if used), it is generally considered safe for most individuals. An MRI could help identify any underlying issues that X-rays might miss, such as early signs of arthritis, tendonitis, or other soft tissue problems.

3. Pain Management Strategies: Since your pain tends to disrupt your sleep, exploring pain management techniques could be beneficial. This may include medications such as non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, or even alternative therapies like acupuncture or massage therapy. Cognitive-behavioral therapy (CBT) can also be helpful in managing chronic pain by addressing the psychological aspects of pain perception.

4. Lifestyle Modifications: Maintaining a healthy lifestyle can also play a significant role in managing chronic pain. Regular low-impact exercise, such as swimming or cycling, can help maintain joint function and reduce stiffness. Additionally, ensuring adequate sleep hygiene and stress management techniques can improve overall well-being and potentially reduce pain episodes.

5. Support Groups and Counseling: Connecting with others who experience similar chronic pain can provide emotional support and coping strategies. Sometimes, sharing experiences with others can help validate your feelings and provide new insights into managing your condition.

6. Further Testing: If you feel that your symptoms are not being adequately addressed, you might consider asking your healthcare provider about more specialized tests, such as a comprehensive metabolic panel or specific autoimmune markers that may not have been previously tested.

In conclusion, while your situation is complex and has been ongoing for many years, there are still avenues to explore for diagnosis and management. It is crucial to advocate for yourself and seek out healthcare providers who will listen to your concerns and work with you to find effective solutions. Chronic pain is a multifaceted issue, and a multidisciplinary approach may yield the best results in improving your quality of life.

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