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Stiff joints and popping joint noise. Second opinion.

Resolved Question:

I need some advice about a problem I've had for some years, around 7, and how to present the problem and information to the doctor correctly.

I have problems with my joints being stiff and joint noise like popping and grinding, the worst area's being my ankles, wrists, shoulders and knees. This is worse in the mornings but seems to affect mainly all joints and muscle strength overall. I am also aware of my heart beat or pulse being fast most of the time. My Chiropractor has suggested exercising the muscles more but exercising is made difficult with this problem.

I have attached some private blood test results at different dates, but my Nhs Doctor has put this down to stress or chronic fatigue over the period of the problem. I was considering going to a private doctor to gain a second opinion but need help to explain the situation.

Many thanks

Matthew


Category: Orthopedic Surgeon

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Category: Spine Surgeon
Dr. Mukesh Tiwari is online now

Expert:  Dr. Mukesh Tiwari replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I have read your query with diligence.
Will you please answer some questions so that i can help you more-
-What is your age?
-Is there associated pain?
-Factors which aggravates & relives your symptoms?
-Any positive family history of any disease?
-How is your sleep?
-Are you overweight?
Once you reply, i will be able to help you further,
Regards.


Patient replied :

Hello,
Thank you for your quick reply.
I am 34, my weight is 12 stone 8.
My sleep is good, but I can be awoken by a stiff neck and back which seems to lock for 5-10 seconds before I can move it freely. I have always assumed that this is related to the joint problem. It seems as though every joint is affected overall rather than just an issolated spot.
The joint popping doesn't cause me any pain however my muscles seem to be weak which can cause pain if lifting or getting up from a seated position. For example my ankles pop if stuck in the same position, then suddenly moved. My arms and shoulders also seem to have the same routine. My Chiropracter suggested excercise but this usually aggravates the symptoms and sometimes causes a headache so I try to avoid this.
The only evidence I have to prove my problem is the phosphate level in the blood test, in December 2013 the level was also in the low 0.50's, up until now where the result is higher but still out of range.
Rest is the only relief, no family history of any illness. I have got used to living with the problem but feel that it is slowly progressing and may cause me issues as I get older.
I much appreciate your advice.
Kind Regards
Matthew


Expert:  Dr. Mukesh Tiwari replied 3 Days.

Hello Mathew,
Thanks for the additional information.

It looks from your history that there may be early degenerative changes in your joints. This may be putting more stress on your muscles. Your muscle and joint discomfort/pain may be due to this reason.
The low phosphate levels could commonly be due to Vitamin D deficiency. The new high levels could be due to a test error. It is best repeated and interpreted under the guidance of your doctor.

I have the following suggestions:
- You should consult a Rheumatologist for a complete workup. You can outline your history as you have mentioned it to me, along with the test results.
- You should have X-Rays of the affected joints and blood investigations at an interval of one year.
- Early degenerative changes at joint may occur due to overuse. So avoid strenuous and excessive use. However, this does not mean that you avoid healthy exercise. Mild and regular exercise is a must to maintain joint mobility.
-Consume a healthy diet. You can start a combination of Glucosamine and Chondroitin sulphates pills available OTC, once daily.
-You should start general physiotherapy to strengthen your muscles. This will prevent overloading of joint and give relief from symptoms.

I hope this was helpful. Feel free to ask queries.

Kind regards.


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
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