[44F] Experiencing chronic muscle pain, numbness, and insomnia

Patient Description

A 44-year-old female has been suffering from chronic muscle pain predominantly in the arms, rated as 8 out of 10 in severity, along with numbness and tingling sensations throughout the body. These symptoms have been present for ten years without a clear trigger or relief. The patient also struggles with insomnia, having difficulty both falling and staying asleep. Anxiety and headaches, described as ocular migraines with a severity of 6 out of 10, have been experienced on and off for a couple of years. Vision issues include dry eyes, night vision difficulties, and trouble reading small print, persisting for two years. Additionally, the patient has injuries to the ankle, shoulder, and low back that are not healing as expected. Medical history includes Crohn's disease diagnosed in 2007, and allergies to sulfa medications, penicillin, and amoxicillin. The patient is currently not on any medications, except for Ambien as needed.

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Arora's Assessment

What might be happening

Based on the information you provided, possible explanations for your symptoms include:

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It is often considered when a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.

    • Treatment often involves a combination of medications, exercise, stress management measures, and healthy lifestyle habits.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest. Other symptoms can include headaches, difficulty concentrating, and insomnia.

    • Treatment for CFS can include medication to control symptoms, lifestyle changes, and management of other health problems.
  • Vitamin B12 deficiency: This can cause a wide range of symptoms, including fatigue, weakness, numbness and tingling in the hands and feet, difficulty walking, mood changes, memory loss, and anemia.

    • Treatment usually involves supplementation of vitamin B12.
  • Autoimmune diseases: These are conditions in which your immune system mistakenly attacks your body. Crohn's disease, which you have, is an example of an autoimmune disease. Some autoimmune diseases can cause symptoms similar to yours.

    • Treatment usually involves managing symptoms and preventing complications.

Please note that these are potential explanations and not a definitive diagnosis. It's important to consult with a healthcare provider for a formal evaluation.

What you can do

  1. Schedule an appointment with your primary care provider to discuss your symptoms. They may refer you to a specialist, such as a rheumatologist, for further evaluation.
  2. Keep a symptom diary. Note when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider in making a diagnosis.
  3. Practice good sleep hygiene. This includes maintaining a regular sleep schedule, creating a quiet and comfortable sleep environment, and avoiding caffeine and electronics before bedtime.
  4. Engage in regular, gentle exercise, such as walking or swimming. This can help manage symptoms of fibromyalgia and CFS.
  5. Consider seeking support from a mental health professional to manage symptoms of anxiety.

What you should look out for

Seek immediate medical attention if you experience:

  • Sudden, severe headache or headache that is accompanied by a stiff neck, fever, or confusion
  • Sudden, severe pain in any area of your body
  • Difficulty breathing or chest pain
  • New or worsening symptoms

Please remember that while I strive to provide accurate and helpful health information, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

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People Also Ask


What are the common symptoms of fibromyalgia?

Common symptoms of fibromyalgia include widespread musculoskeletal pain, fatigue, sleep disturbances, memory issues, and mood problems. Patients may also experience headaches, depression, and anxiety.


How can chronic fatigue syndrome be managed?

Chronic fatigue syndrome can be managed through a combination of medication to control symptoms, lifestyle changes such as pacing activities, and addressing other health problems. Cognitive behavioral therapy and graded exercise therapy may also be beneficial.


What are the signs of a vitamin B12 deficiency?

Signs of a vitamin B12 deficiency include fatigue, weakness, numbness and tingling in the hands and feet, difficulty walking, mood changes, memory loss, and anemia. It is important to consult a healthcare provider for diagnosis and treatment.


How can sleep hygiene be improved to help with insomnia?

Improving sleep hygiene involves maintaining a regular sleep schedule, creating a quiet and comfortable sleep environment, avoiding caffeine and electronics before bedtime, and engaging in relaxing activities before sleep. These practices can help improve the quality of sleep and manage insomnia.


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