[36F] Experiencing joint pain, swelling, and nerve pain

Patient Description

A 36-year-old female has been experiencing intense joint pain for a few years, which has worsened over the past 6 months. The pain affects her wrists, elbows, shoulders, knees, ankles, and toes, with the right side being more severely affected. The joints sometimes swell up and appear lumpy, particularly in the right elbow and knee. The pain is alleviated by heat and rest, and it does not occur during sleep. Additionally, she has been experiencing burning nerve-like pain in her arms and legs for about 2 years, with numbness and tingling sensations that are more pronounced upon waking but resolve quickly. She has a long-standing history of psoriasis, high blood pressure, high cholesterol, and was diagnosed with central sensitization syndrome a year ago. She underwent a partial hysterectomy four weeks ago due to adenomyosis and has been on low dose naltrexone (4.5mg) for the central sensitization syndrome and inflammation.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Psoriatic Arthritis: This is a type of arthritis that affects some people who have psoriasis. The main symptoms are joint pain, stiffness, and swelling, which you've described. The fact that you have a history of psoriasis and are experiencing these symptoms could suggest this condition.

    • Treatment often involves medications to reduce inflammation and slow the progression of the disease. Physical therapy might also be helpful.
  • Central Sensitization Syndrome (CSS): This is a condition where the nervous system is stuck in a state of high reactivity. This can lead to increased pain sensitivity, which could explain the burning nerve-like pain you've described. You mentioned that you've been diagnosed with CSS, which could be contributing to your symptoms.

    • Treatment often involves a combination of medications, physical therapy, and cognitive behavioral therapy.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. It's often considered a rheumatic condition, a medical condition that impairs the joints and/or soft tissues and causes chronic pain.

    • Treatment often involves a combination of medications, exercise, stress-reduction measures, and dietary changes.

What you can do

While waiting for a formal assessment from a healthcare professional, you might find the following tips helpful:

  1. Try to maintain a regular sleep schedule. Sleep is important for overall health and inadequate sleep can worsen pain and other symptoms.
  2. Engage in regular physical activity. Regular exercise can reduce pain and improve physical function.
  3. Consider relaxation techniques, such as deep-breathing exercises and meditation, to help reduce stress and improve mental well-being.

What you should look out for

Reasons to seek urgent medical attention:

  • If you notice a sudden increase in the severity of your pain
  • If you develop new symptoms, such as a fever or unexplained weight loss
  • If your symptoms significantly interfere with your daily activities

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What is psoriatic arthritis and how is it related to psoriasis?

Psoriatic arthritis is a type of inflammatory arthritis that affects some people with psoriasis, a skin condition characterized by red, scaly patches. It causes joint pain, stiffness, and swelling, and can lead to joint damage if not treated. The presence of psoriasis increases the risk of developing this type of arthritis.


What are the common symptoms of central sensitization syndrome?

Central sensitization syndrome (CSS) is characterized by an increased sensitivity to pain due to changes in the central nervous system. Common symptoms include widespread pain, burning sensations, and heightened sensitivity to touch. It can also lead to fatigue, sleep disturbances, and cognitive difficulties.


How can fibromyalgia be distinguished from other similar conditions?

Fibromyalgia is distinguished by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Unlike other conditions, fibromyalgia often includes symptoms like sleep disturbances, cognitive issues (often called 'fibro fog'), and mood disorders. Diagnosis is typically based on symptom history and ruling out other conditions.


What lifestyle changes can help manage chronic joint pain and nerve-like pain?

Lifestyle changes that can help manage chronic joint and nerve-like pain include maintaining a regular sleep schedule, engaging in low-impact exercises like swimming or walking, practicing stress-reduction techniques such as meditation or yoga, and following a balanced diet to reduce inflammation.


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