Question: I’m a 22 year old in the USA with a problem no doctor seems able to diagnose. I have been healthy all my life, eat a standard diet and have no family medical history. In high school I was very active and played on several sports teams but over the past five years I have had an increasing number of pain problems with my “joints”. It began with my knees when I stood for hours behind an ice cream counter in high school, and now includes my ankles, jaw, elbows, and wrists. This has made me unable to perform nearly all exercises including low impact swimming and even walking. After minimal exercise, such as a two hour hike, my ankles will have a low level constant ache for days. They hurt every day. I have been to a total of six doctors including a rheumatologist, orthopedic surgeon, and an orthopedic sports medicine doctor, and two physical therapists. In physical therapy, the furthest they were able to get me was resistance bands. All the obvious things have been tested for and come up negative, from Lyme disease to arthritis to any sort of infection or inflammation. No doctor has any suggestion now of what I might do to resolve this and the last group stopped without any diagnosis they could name or suggestion of whom I might go to see. Last thing I did with them was a three phase bone/joint scan with radioactive tracer. The doctors found anomalies where I had complained of pain. They said my scan looked similar to that of a marathon runner or someone who currently engaged in intense physical activities, but I have only sat a lot for the last few years. There were no signs of an inflammatory joint disease such as rheumatoid arthritis. I was told the findings are “more suggestive of stress reactive changes on the bones where tendons and ligaments attach”. As the official report said, “There was no evidence of an inflammatory arthropathy to joints. There are stress reactive changes to elbows and wrists and stress related periosteal reactions in mid right foot and in the bilateral tibial tuberosites.” Unfortunately they offered no solutions to my problem besides pain management medication, and every doctor has said they have never seen a similar condition. This issue has really taken a toll on my life, as I have seen myself go from a physically fit individual to being inactive and overweight. I was hoping for some guidance or suggestions as to what the problem is and how I can go about making myself better. Is there a nutrition related component I should pursue? If I go to another orthopedic (?) doctor what should they be looking for? What sort of specialty should I pursue? Have you ever heard of this injury w/o exercise?

I have done the beightons test and I don't come up positive on any questions, except I have had several joints with pain for more than 4 months. I never have been very flexible. But I will say that the symptoms when I read online about pain and exercise are very similar to what I have experienced. How can one not be flexible and still have this presentation? Is there any other cause to consider. I don't have inflammation or arthritis based on doctors blood test. Thankfully.

Just went to another doctor. He said Im definitely not hypermobile. But he is considered the local doctor's doctor and he had no idea. Said he would try and find a referral to XXXXXXX XXXXXXX University in XXXXXXX Its a research and training hospital and he said local University of XXXXXXX hospital not good enough although it has a good national reputation I thought. So care to outshine the big important guys and venture an opinion of what we should be doing/looking for? I got faith in you!

That has come up but I just don't have the symptoms. Pain is more localized and none of the fatigue issues and generalized problems. I have many of the hyper XXXXXXX symptoms. Most of them. But I am not limber or flexible. I am less than usual. But I am doing yoga twice a week. Makes me feel better but no reduction in pain after exercise. I wonder if some clue is in the crackling noise my joints now have and stiffness, and signs of stress reactions in X-ray in conjuncture with relative low impact exercise?