[67F] Experiencing severe muscle and joint pain with weakness

Patient Description

A 67-year-old female has been experiencing constant muscle and joint pain alongside muscle weakness for the past year, with the muscle and joint pain having a longer history of 20 years but worsening recently. The muscle weakness is severe, rated 8 out of 10, hindering her ability to climb stairs or stand up from a sitting position. Muscle pain, described as aching, is particularly severe in the upper thighs and arms, currently rated 9 out of 10 in severity, and is exacerbated by activities like walking and pushing a grocery cart. Joint pain, affecting primarily the elbows and knees, is described as sharp, throbbing, and aching, with a severity rating of 9 out of 10. This pain often wakes her up at night, though rubbing the affected areas provides some relief. Additionally, she has recently noticed double shadow vision in her right eye. Her medical history includes the installation of a pacemaker and diagnosis of AFib in 2018, and a recent diagnosis of a Mycobacterium infection in her lungs. She is currently on multiple medications including Torsemide, Ramipril, Eliquis, Metoclopramide, Prozac, Pramipexole, Carvedilol, Spironolactone, Nexium, and Sotalol, with specified dosages and frequencies.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be contributing to your symptoms:

  • Polymyalgia Rheumatica: This condition causes pain and stiffness in the muscles, particularly in the shoulders and hips. It typically occurs in people over 65 and can come on suddenly. It's often accompanied by fatigue, weight loss, and a low-grade fever.

    • Treatment usually involves low doses of corticosteroids, which can provide dramatic relief within days.
  • Myasthenia Gravis: This is a neuromuscular disorder that causes weakness in the skeletal muscles, which are responsible for breathing and moving parts of the body, including the arms and legs. The weakness tends to get worse with activity and improve with rest.

    • Treatment options include medications to help improve nerve-to-muscle communication and suppress the immune system, therapy to manage symptoms, and surgery if necessary.
  • Rheumatoid Arthritis: This is a chronic inflammatory disorder that can cause joint pain and damage throughout your body. The joint damage usually happens on both sides of your body, so if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will probably be affected too.

    • Treatment focuses on controlling symptoms and preventing joint damage, and often involves medications, physical therapy, and sometimes surgery.

Please remember that these are possibilities, not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

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 or a neurologist, for further evaluation.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing when they occur, and how long they last. This can provide valuable information to your healthcare provider.
  3. Try gentle exercises, like walking or swimming, which might help reduce muscle pain and stiffness. But be sure to rest when you need to and don't overdo it.
  4. Eat a balanced diet and get plenty of sleep. These can help boost your immune system and improve your overall health.

What you should look out for

Seek immediate medical attention if you experience:

  • Difficulty breathing or swallowing
  • Sudden, severe pain in any joint
  • Fever, chills, or unexplained weight loss
  • Any new or worsening symptoms

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

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8 mo ago


People Also Ask


What are the common symptoms of Polymyalgia Rheumatica?

Polymyalgia Rheumatica commonly causes pain and stiffness in the shoulders and hips, fatigue, weight loss, and sometimes a low-grade fever. It typically affects people over the age of 65.


How does Myasthenia Gravis affect muscle function?

Myasthenia Gravis affects muscle function by causing weakness in the skeletal muscles, which worsens with activity and improves with rest. It can impact muscles responsible for breathing and moving parts of the body.


What are the typical treatments for Rheumatoid Arthritis?

Treatments for Rheumatoid Arthritis often include medications to control symptoms and prevent joint damage, physical therapy to maintain joint function, and sometimes surgery to repair damaged joints.


Can medications for other conditions cause muscle and joint pain?

Yes, some medications can cause muscle and joint pain as side effects. It's important to discuss any new or worsening symptoms with a healthcare provider to determine if medications might be contributing to these issues.


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