Suggest Treatment For Muscle Pain, SOB, Dizziness And Fatigue

Posted on Wed, 8 Oct 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 8 Oct 2014 Answered on

Mon, 3 Nov 2014 Last reviewed on

Question : I'm still having the same problems. Walking or going upstairs, my muscles burn/ache, SOB, lightheaded, dizziness and extreme fatigue. I have seen a Rheumatologist. She said it is not an autoimmune disease. She is recommending more labs. I had a stress test it was ok but I am now going to have an echo. We are all at a loss because the symptoms don't go together I am getting more depressed. My doctor and I feel like I'm having edema. She is trying lasix.

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Possibiities

Detailed Answer:
Good day,
Noted your symptoms and i feel sorry to hear about your symptoms. Realize that your rgeumatologist s planing to do more blood works. I would like to know if your doctors ever considered follwing diagnoses.
1) Thyroid dysfunction
2) Diabetes
3) Vitamin D deficiency
4) Poly myalgia Rheumatica/Fibromyalgia
5) Depression

These are some of the common causes of your symptoms. I was wondering if a Vitamin D level, Blood glucose and Thyroid function was ever done along with CBC, CPK and ESR.

These are simple tests and might give some clues to your diagnosis.
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (28 minutes later)

Thank you for answering. My TSH is ok. Also CBC, CPK, ESR and glucose are ok. The vitamin D has not been done yet. The fibromyalgia I don't actually have the trigger spots. All of this has been going on for at least 6 months. I have episodes daily or episodes that last all day.
Thank you

Answered by Dr. Binu Parameswaran Pillai (6 minutes later)

Brief Answer:
Fibromyalgia is a diagnosis of exclusion

Detailed Answer:
Thank you for the reply. Fibromyalgia can present in many ways. However, it is a diagnosis after excluding all other possible causes. Noted that TSH was normal. It may be worthwhile to get a Free T4 (FT4) and a vitamin D level done. It may be worthwhile to get an 8 AM serum cortisol done.

If none of the medicines are helpful, it is worth trying an antidepressant for few months. If major illnesses have been rule out, you may also consider Music therapy, Yoga and Meditation. Simple body massage also may help to releive the body pain

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (33 minutes later)

So with fibromyalgia it does not have to be trigger spots?

Answered by Dr. Binu Parameswaran Pillai (7 hours later)

Brief Answer:
Not always

Detailed Answer:
Hi,
Fibromyalgia need not always have tender points. It can present in many other ways as fatigue, diffuse muscle pains, joint stiffness etc. There need not be Tender spots always on pressing. But this is most often seen.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (31 minutes later)

After your answer earlier I realized that it is sounding more and more like fibromyalgia. The area on both hips, back, neck and head are actually pain areas. I also start to do my cne's on fibromyalgia. There is a lot of things that go with this diagnosis. The main thing that has stopped me thinking of this is the trigger spots but if I look at them as pain areas. That does change my thinking. Also I have been having more trouble sleeping. I also think I'm having restless leg after reading up on that. My legs at night feel heavy and wanting to move them. My feet and hands are very cold and sometimes tingle and numb. The edema also can go with fibromyalgia which I'm taking Lasix because I look puffy. After the echo and lab work I'm very much ok with dealing with fibromyalgia. To work with yoga, nutritional needs and other therapy's. To be honest I feel much better thinking I might understand what is going on. Thank you so much XXXXXXX

Answered by Dr. Binu Parameswaran Pillai (10 minutes later)

Brief Answer:
Fibromyalgia

Detailed Answer:
Thank you for the reply and it is a pleasure helping people always. Fibromyalgia is a complex disease , but is not serious. It can present in many ways. The important thing to remember is that " it is a diagnosis of exclusion". There are no defenite diagnostic tests. Hence other diseases which mimic fibromyalgia must be ruled out. Vitamin D deficieny must be ruled out. Hyperparathyroidism ( high calcium and PTH) is another condition to be ruled out. ( please check a fasting Serum calcium, albumin, Phosphorus, alkaline phosphatase and PTH).

Antidepressants might help. Apart from that, Stretch exercises, Yoga, etc surely help in reducing the stiffness and pain.
You are welcome to ask more questions. But if you feel there is nothing more to ask, you may please close the query.

Wish you good health.

Binu

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar