[45F] Experiencing muscle weakness and pain with fatigue

Patient Description

A 45-year-old female presents with muscle weakness in the arms, arm pain that feels like sore muscles, and fatigue. The muscle weakness has been ongoing for approximately 4 months, rated at 6/10 in severity, and improves with movement. The arm pain, rated at 3/10, worsens with rest and has been present for about 3 months. The patient experiences morning stiffness but no joint swelling or symmetrical joint pain. Vision has been worsening over the past few months. There is no jaw pain or muscle atrophy reported. The patient has a history of ITP and a severe septic shock episode 3 years ago that led to kidney and liver shutdown. Current medication includes Sertraline 100 mg for depression and anxiety, with no side effects noted. The patient has allergies to the flu shot, penicillin, Keflex, erythromycin, and sulfur. No family history of autoimmune diseases. The symptoms have impacted the patient's physical activity levels.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Polymyalgia Rheumatica (PMR): This condition causes muscle pain and stiffness, often in the neck, shoulders, and hips. It can start quickly and is worst in the morning. It's most common in women over 50, but it's not impossible in your age group. The exact cause is unknown, but it's thought to be an autoimmune disorder.

    • Treatment usually involves a low dose of an oral corticosteroid, like prednisone. Your doctor may also recommend over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, to help with pain and inflammation.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It's more common in women and often starts in middle adulthood. The exact cause is unknown, but it's thought to involve a variety of genetic, environmental, and psychological factors.

    • Treatment often involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.
  • Chronic Fatigue Syndrome (CFS): This is a complex disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue often worsens with physical or mental activity, but doesn't improve with rest. The cause of CFS is unknown, but it may be related to a combination of factors.

    • Treatment usually focuses on symptom relief.

Please note that these are just possibilities based on the information you've provided. It's important to see a healthcare provider for a formal diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may refer you to a specialist, like a rheumatologist, for further evaluation.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing when they happen, and how long they last. This can help your healthcare provider identify patterns and make a diagnosis.
  3. Try gentle exercises, like walking or swimming, to help improve muscle strength and reduce pain and stiffness. But be sure to talk to your healthcare provider before starting a new exercise program.
  4. Practice good sleep hygiene. This includes going to bed and waking up at the same time every day, keeping your bedroom dark and cool, and avoiding caffeine and electronics before bed.
  5. Consider over-the-counter pain relievers, like ibuprofen or acetaminophen, to help manage your pain. But be sure to follow the package instructions and talk to your healthcare provider if you need to use these medications for more than a few days.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe pain or swelling in your joints
  • Difficulty breathing or chest pain
  • Sudden, severe headache
  • Sudden, severe abdominal pain
  • Any other new or worsening symptoms

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for accurate information.

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9 mo ago


People Also Ask


What are the common symptoms of Polymyalgia Rheumatica (PMR)?

Common symptoms of Polymyalgia Rheumatica (PMR) include muscle pain and stiffness, particularly in the neck, shoulders, and hips. These symptoms are often worse in the morning and can start suddenly.


How is Fibromyalgia typically treated?

Fibromyalgia is typically treated with a combination of medications, such as pain relievers and antidepressants, along with exercise, stress management techniques, and healthy lifestyle habits.


What lifestyle changes can help manage Chronic Fatigue Syndrome (CFS)?

Managing Chronic Fatigue Syndrome (CFS) often involves lifestyle changes such as pacing activities to avoid overexertion, maintaining a regular sleep schedule, and incorporating gentle exercise. Stress management and a balanced diet can also be beneficial.


What should I do if I experience severe joint pain or other alarming symptoms?

If you experience severe joint pain, difficulty breathing, chest pain, a sudden severe headache, or any other new or worsening symptoms, you should seek immediate medical attention.

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