[46F] With severe muscle pain and new onset migraine

Patient Description

A 46-year-old female has been experiencing severe, continuous, dull, and tender muscle pain in the rotators, back, hands, legs, and feet for the past two months. The pain seems to have been triggered by a fall from a ladder. She also reports a new onset migraine on the left temple, relieved by sleep, and tailbone pain for the last two days, which makes it difficult to bend over. Magnesium pills have been helping with leg pain, and she takes Tylenol and ibuprofen (250mg/125mg) twice daily, along with a magnesium supplement (250mg) at night. The patient has a history of lupus, diagnosed in 2001, and is allergic to several medications, including Lexapro, Zofran, Wellbutrin, and morphine. She does not consume alcohol or use recreational drugs and has not traveled recently.

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Arora's Assessment

What might be happening

Your symptoms could be related to several issues, possibly linked to your lupus or the recent fall. Here are some possibilities:

  1. Muscle and Joint Pain:

    • Lupus can cause widespread muscle and joint pain. The fall might have exacerbated these symptoms.
    • Pain in multiple areas like your back, hands, legs, and feet could also be due to fibromyalgia, which is common in people with lupus.
  2. Migraine:

    • Stress, changes in sleep patterns, or lupus itself can trigger migraines. Since this is your first experience, monitoring is important.
  3. Numbness and Cramps:

    • These could be related to nerve compression or circulation issues, possibly worsened by lupus or the fall.
  4. Tailbone Pain:

    • This might be due to the fall, causing bruising or strain in the area.

What you can do

Muscle and Joint Pain:

  • Continue using Tylenol and ibuprofen as directed, but consult your doctor to ensure it's safe with your lupus.
  • Gentle stretching and low-impact exercises like swimming can help.
  • Use heat therapy cautiously, as it helps some people with muscle pain.

Migraine:

  • Maintain a regular sleep schedule and stay hydrated.
  • Consider keeping a migraine diary to identify triggers.

Numbness and Cramps:

  • Magnesium supplements seem to help; continue as directed.
  • Gentle leg stretches before bed might reduce cramps.

Tailbone Pain:

  • Use a cushion when sitting to relieve pressure.
  • Avoid prolonged sitting and apply ice if needed.

Consider using MDandMe to journal your symptoms and track progress. This can help provide insights and share notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Increased pain or swelling.
  • New or worsening numbness.
  • Severe headaches or changes in vision.
  • Any signs of infection or unusual symptoms.

Always consult with a healthcare professional for a formal diagnosis and treatment plan.

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29 d ago


People Also Ask


Can lupus cause widespread muscle and joint pain?

Yes, lupus can cause widespread muscle and joint pain due to inflammation and immune system activity. It is a common symptom in lupus patients.


What are some common triggers for migraines in lupus patients?

Common triggers for migraines in lupus patients include stress, changes in sleep patterns, hormonal changes, certain foods, and sometimes lupus itself.


How can magnesium supplements help with muscle cramps?

Magnesium supplements can help with muscle cramps by relaxing muscles and improving nerve function. They are often used to alleviate cramps and spasms.


What are some effective ways to manage tailbone pain after a fall?

Effective ways to manage tailbone pain after a fall include using a cushion when sitting to relieve pressure, avoiding prolonged sitting, applying ice to reduce swelling, and taking over-the-counter pain relievers as needed.

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