Chronic Fatigue and Pain: Neurological Symptoms Explained

Severe fatigue, body aches, brain fog, eye pain, dizziness, and a feeling of head pressure?

I have already undergone blood tests in the neurology department and the rheumatology and immunology department, and there were no significant issues.
During the visits, I only emphasized my abnormal fatigue and generalized muscle pain, which have been ongoing since early April of this year until now.
Later, I started experiencing brain fog, pain behind my eyes, blurred vision, glare sensitivity, and a bit of a grid-like visual disturbance.
Every day I wake up feeling extremely tired as if I haven't slept at all, and I also have muscle soreness, which has led to a very low mood.
My emotions often collapse due to physical reasons.
In 2021, I had a brain CT scan that showed no significant problems, but I did not have these symptoms back then.
Should I get another scan?
The doctor prescribed muscle relaxants, Celebrex, Lyrica, Lysteda, and Mirtazapine.
Initially, I was afraid to take the muscle relaxant because it made me feel like I was about to have a panic attack.
Later, I took Celebrex, which provided slight relief from the muscle pain after several hours, but the fatigue remained severe.
I usually take Celebrex only when the pain becomes unbearable.
I took Lyrica one night, and the next day I felt even more fatigued.
Should I continue taking it? I have not taken Lysteda or Mirtazapine because I still manage to sleep about 8 hours a day.
Do I need to take something to help me sleep? I am afraid of side effects and worry that taking medication might make me feel even more tired.

Could you please advise if I need any further tests for my symptoms? Also, can hyperbaric oxygen therapy or helium-neon laser treatment help alleviate my issues?

Wu, 30~39 year old female. Ask Date: 2024/05/01

Dr. Chen Weida reply Neurology

Hello, Wu! In response to your inquiry regarding symptoms such as severe fatigue, widespread pain, brain fog, eye pain, dizziness, and head pressure, a preliminary assessment suggests that it may be fibromyalgia.
It is recommended that you consult a neurologist or a rheumatologist for further evaluation and to determine the necessary treatment.
Wishing you health and safety!

Reply Date: 2024/05/01

More Info

Chronic fatigue and pain, particularly when accompanied by neurological symptoms, can be complex and multifaceted. Based on your description, it seems you are experiencing a combination of symptoms that include persistent fatigue, muscle pain, brain fog, and visual disturbances such as light sensitivity and blurred vision. These symptoms can be indicative of several underlying conditions, and understanding them requires a comprehensive approach.

Firstly, it is important to recognize that chronic fatigue syndrome (CFS) and fibromyalgia are two conditions that often present with similar symptoms. CFS is characterized by profound fatigue that does not improve with rest and is often worsened by physical or mental activity. Fibromyalgia, on the other hand, is primarily characterized by widespread musculoskeletal pain accompanied by fatigue, sleep disturbances, and cognitive difficulties, often referred to as "fibro fog." Both conditions can lead to significant emotional distress, as the chronic nature of the symptoms can impact daily functioning and quality of life.

Your symptoms of brain fog, fatigue upon waking, and muscle pain suggest that you may be dealing with a condition that affects both your physical and mental health. The fact that you have undergone various tests, including blood tests and imaging, and found no significant abnormalities is common in cases of CFS and fibromyalgia. These conditions often do not show up on standard tests, which can lead to frustration for patients seeking answers.

Regarding your concerns about medication, it is crucial to communicate openly with your healthcare provider about the side effects you are experiencing. Medications like pregabalin (Lyrica) and muscle relaxants can be helpful for some patients, but they may not work for everyone and can sometimes exacerbate feelings of fatigue. If you are hesitant about taking certain medications due to fear of side effects, it may be beneficial to discuss alternative treatment options with your doctor, including non-pharmacological approaches.

In terms of further evaluation, if your symptoms have changed or worsened since your last imaging study in 2021, it may be reasonable to consider a follow-up MRI or CT scan to rule out any new developments, especially if you are experiencing new neurological symptoms. Additionally, consulting with a neurologist or a specialist in chronic pain management could provide further insights into your condition.

As for the potential benefits of hyperbaric oxygen therapy or helium-neon laser therapy, while some patients report improvements in symptoms with these treatments, the scientific evidence supporting their efficacy for chronic fatigue and pain is limited. It is essential to approach such therapies with caution and to discuss them with your healthcare provider to determine if they are appropriate for your specific situation.

In summary, your symptoms warrant a thorough evaluation and a multidisciplinary approach to treatment. This may include physical therapy, cognitive behavioral therapy, lifestyle modifications, and possibly medication adjustments. It is also vital to address any psychological factors, such as anxiety or depression, that may be contributing to your overall experience of fatigue and pain. Engaging in stress-reducing activities, maintaining a regular sleep schedule, and seeking support from healthcare professionals can help you manage your symptoms more effectively.

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