[23M] With joint pain and muscle weakness for one month

Patient Description

A 23-year-old male has been experiencing joint pain and muscle weakness for the past month. The joint pain is particularly severe in the knees and hands, especially in the mornings, and is described as stiff and sharp when moving or putting weight on them. Swelling is noted in the affected joints, which worsens with use. The patient finds relief with Aleve and hot water baths. All joints are affected, but the knees and hands are the most problematic. Muscle weakness is rated 8 out of 10 in severity, significantly impacting the ability to work and walk. The patient also reports fatigue and a general feeling of being unwell at times. There are no reports of fever, unexplained weight loss, rashes, skin changes, changes in appetite, digestive issues, numbness, or tingling in the hands or feet. The patient has no family history of autoimmune diseases and vapes. There has been no recent travel. The patient has a history of depression, managed with Lexapro (5 milligrams daily) for the past two years, and is taking diclofenac sodium (75 milligrams once daily) for joint pain. No other medications, supplements, or herbal remedies are being used, and there are no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Rheumatoid Arthritis (RA): RA is an autoimmune disorder that causes chronic inflammation of the joints. It often affects the small joints in your hands and feet and can cause pain, swelling, and stiffness, particularly in the morning. Muscle weakness and fatigue are also common symptoms.

    • Typical Treatments: Treatment usually involves medications to reduce inflammation and pain, such as NSAIDs (like diclofenac), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs). Physical therapy and lifestyle changes can also help manage symptoms.
  • Osteoarthritis (OA): OA is a degenerative joint disease that results from the breakdown of joint cartilage and underlying bone. It can cause pain, stiffness, and swelling, especially after periods of inactivity or overuse.

    • Typical Treatments: Treatment often includes pain relievers, anti-inflammatory medications, physical therapy, and sometimes joint injections or surgery.
  • Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It can also cause joint pain and muscle weakness.

    • Typical Treatments: Treatment usually involves medications to manage pain and improve sleep, physical therapy, and lifestyle changes such as stress management and exercise.
  • Polymyalgia Rheumatica (PMR): PMR is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders and hips. It is more common in older adults but can cause significant discomfort and disability.

    • Typical Treatments: Treatment typically involves corticosteroids to reduce inflammation and relieve symptoms.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Continue taking your prescribed medications: Diclofenac sodium can help reduce inflammation and pain. Make sure to follow your doctor's instructions regarding dosage and frequency.
  2. Use heat therapy: Hot water baths and heating pads can help relieve stiffness and pain in your joints.
  3. Stay active: Gentle exercises, such as walking or swimming, can help maintain joint flexibility and muscle strength. Avoid high-impact activities that may worsen your symptoms.
  4. Maintain a healthy diet: Eating a balanced diet rich in anti-inflammatory foods, such as fruits, vegetables, and omega-3 fatty acids, can help reduce inflammation.
  5. Stay hydrated: Drinking plenty of water can help keep your joints lubricated and reduce stiffness.
  6. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your healthcare provider.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • Severe or worsening pain: If your pain becomes unbearable or significantly worsens, consult a healthcare professional.
  • New or worsening symptoms: If you develop new symptoms, such as fever, unexplained weight loss, or rashes, seek medical advice.
  • Difficulty performing daily activities: If your symptoms are severely impacting your ability to perform daily tasks, it's important to get a professional evaluation.

Remember, while this information can help you understand your symptoms, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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5 mo ago


People Also Ask


What are the common symptoms of rheumatoid arthritis?

Common symptoms of rheumatoid arthritis include joint pain, swelling, and stiffness, particularly in the morning. It often affects the small joints in the hands and feet. Other symptoms can include muscle weakness, fatigue, and a general feeling of being unwell.


How can I manage joint pain and stiffness at home?

To manage joint pain and stiffness at home, you can use heat therapy such as hot water baths or heating pads, take over-the-counter pain relievers like NSAIDs, and engage in gentle exercises to maintain joint flexibility. It's also important to rest and avoid activities that exacerbate the pain.


What lifestyle changes can help with muscle weakness and fatigue?

Lifestyle changes that can help with muscle weakness and fatigue include maintaining a balanced diet rich in anti-inflammatory foods, staying hydrated, engaging in regular low-impact exercise like walking or swimming, and managing stress through relaxation techniques.


When should I seek medical attention for joint pain?

You should seek medical attention for joint pain if you experience severe or worsening pain, develop new symptoms such as fever or unexplained weight loss, or if your symptoms significantly impact your ability to perform daily activities.


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