It always seems that when there is something different about the status quo in our lives, we tend to put much of our previous concerns up on the shelf. Now, it’s certainly natural to do that early on in order to adjust to our new reality. However, if we do not remain mindful of ‘other issues’ (aka common complaints) that can change our lives for the worse, chances are, they will.
Yes, pandemics and natural disasters can (and often do) affect us and potentially will change the quality of our lives forever, but so can uncontrolled hypertension, diabetes, Rheumatoid Arthritis, and Lupus just to name a few. So while we are all learning to live in our world’s current situation with COVID-19, let’s not forget other issues that can be just life-altering for us as individuals.
That’s why today I want to talk about common complaints and common conditions.
I will try to address some clinical clues through discussing ‘associated symptoms’ as well as emphasize those that are “essential” and still need to be addressed regardless of what our world is going through. So let’s get started.
1. Joint pain and the conditions that can cause it
A. Inflammatory Arthritis / Autoimmune rheumatic conditions
(needs evaluation and treatment)
Associated symptoms:
Joint Pain—typically affects many joints at the same time, joint swelling (joint can be red and/or warm), morning stiffness that typically lasts longer than 15 minutes, joint pain and stiffness improve with activity and movement, low-grade temperature, weight loss, fatigue, rash, poor sleep.
The inflammatory arthritic conditions and auto-immune disorders that create joint pain and stiffness are conditions in which our own immune system is turning on ourselves. Essentially, what is happening is that our bodies are generating the ‘inflammatory response’ to fight our own healthy cells and tissues.
These conditions will need to be addressed as the ‘inflammatory response’ is destructive and can cause erosions of our cartilage and bone, joint deformities, and abnormal organ function.
Examples of Joint Pain
- Rheumatoid Arthritis
- Lupus
- MCTD
- UCTD
- Sjogren’s
- Scleroderma
- Gout/Pseudogout: unlike the others listed, gout and pseudogout typically only affect one joint during a ‘flare’ but can affect many joints
B. Infections
(needs evaluation and treatment)
Any infection can cause joint pain and muscle pain.
Associated symptoms: fever, fatigue, poor appetite, and changes with thinking and concentration
An infected joint is usually red and warm. Usually, only one joint is affected.
The most common cause of an infected joint, such as an infected knee, is an infection in the blood.
Infection in a joint can also cause significant damage to the cartilage and the bone.
C. Non-inflammatory arthritis/Mechanical arthritis
These are conditions in which our joint pain is created from the loss of cartilage in our joint space, spurs (bony growth), or misalignment or damage.
This is the so-called “wear and tear’ arthritis.
Examples:
- Osteoarthritis
- Degenerative Disc Disease
- Spondylosis
- Scoliosis
- Sprain
- Torn cartilage (cushion)
Associated symptoms: joint pain that is worse with activity and better with rest, joints are NOT swollen, red, or warm, morning stiffness lasts less than 15 minutes
D. Medications
Medications can occasionally cause joint pain, but it is not common.
Medications that have known potential risk include:
- Actonel
- Flovent
- Effexor
- XRZyprexa
- Premarin
- Plavix
- Clonidine
- Lyrica
- Carvedilol
- Mobic
- Crestor/Lipitor/Lovastatin
- Steroid (Prednisone/prednisolone)
(steroids are worth mentioning further)
Prednisone or prednisolone: use of typically greater than 3 months can increase your risk of a condition called avascular necrosis. In essence, although the exact mechanism is not known, it is believed to result from decreased blood flow to the bone causing the bone cells to die. Typically affects the shoulder, hip, or knee. Therefore, if possible, it is best if you can control your inflammatory arthritis without the long term use of prednisone (i.e., steroid).
E. Stress, depression, anxiety (i.e., discontentment)
Therefore, #LiveYourValue
2. Numbness, tingling of hands/arms, feet/legs
Typically, anytime we are experiencing numbness, tingling, pin and needle sensation, walking on pebbles, or ants crawling on us, the underlying issue is abnormal nerve function. This is called ‘neuropathy’. There are several causes of neuropathy.
Associated symptoms: weakness, unsteady when walking or tripping often, visual loss of muscle
A. Peripheral Neuropathy – abnormal nerve function/causes
Typically, peripheral neuropathy will cause numbness and tingling of hands and feet.
Vascular disease/Vasculitis
(needs evaluation and treatment)
Vascular disease is most common from clogged arteries. This is called peripheral vascular disease. It is important for this to be evaluated and treated because if our cells and tissues do not have blood supply for an extended period of time, the cells, and subsequent tissue dies. Subsequent complications of that occurring can be infection/gangrene, infection of the bone, and amputation.
Vasculitis is inflammation of our blood vessels and is considered an autoimmune issue. There are many different types of vasculitis. But all of them can cause neuropathy and create other issues such as stroke, heart attack, vision loss, lung, kidney, and liver dysfunction.
It is important to note that many of the conditions listed under Inflammatory arthritis/Autoimmune rheumatic conditions above can also cause neuropathy.
Other causes of ‘peripheral neuropathy’ that are not as ‘emergent’ include:
- Diabetes
- Thyroid
- Vitamin deficiency (especially Vitamin B)
- Alcohol
- Medications
B. Carpel Tunnel Syndrome (CTS)
CTS is caused by an inflamed or pinched median nerve at the wrists. CTS syndrome can give us numbness, tingling, and typically affects the thumb, the index finger, and the middle finger more than the other fingers. It can be a common cause of hand weakness. Think of CTS if it awakens you from sleep, occurs with driving, when you’re doing your hair in the morning, or when you’re working on the computer.
C. Ulnar neuropathy
Ulnar neuropathy is caused from a pinched ulnar nerve at elbow. It is usually from resting an elbow on hard surfaces for prolonged period of times. Typically the numbness and tingling affects the pinky and the second to last finger more than the other fingers.
D. Pinched nerve in the neck/back
Pinched nerves in our spinal cord can cause numbness and tingling of an arm or leg as well as weakness of the affected extremity. We can pinch one of the nerves that come off our spinal cord if we have a herniated disk, ruptured disk, spurs (or bony growths on our spine), or degenerative disc disease and arthritis of the spine.
Unlike CTS, ulnar neuropathy, a pinched nerve from our spine typically gives us symptoms that involve the entire extremity and not just part of it. And unlike peripheral neuropathy, a pinched nerve from our spine typically only involves one extremity and not both. The weakness of an extremity can occur but currently, procedures to help alleviate these conditions would not be considered ‘emergent.’ 30% of the time, a cause for nerve pain (especially peripheral neuropathy) cannot be determined.
3. Fatigue, feeling tired, lack of energy
There are several common causes of fatigue, feeling tired, lack of energy. Some are more critical from a medical viewpoint, while others are less so. I have broken them down into those two categories. Those more critical can, and do, often affect other organ systems. Each of them can create irreversible damage and as such, they are listed under the ‘need evaluation and treatment.’
Causes that are more critical from a medical viewpoint
- Autoimmune rheumatic disease (RA, Lupus)
- Congestive heart failure
- Emphysema/COPD
- Sleep Apnea
- Liver/Kidney disease
- Diabetes
- Iron deficiency and bleeding
- Thyroid/Parathyroid disease
- Medications
- Poor diet
- Overweight/Obesity
- Stress, Anxiety, Depression (i.e. not actively #LiveYourValue)
Common causes of fatigue, feeling tired, lack of energy that are less critical from a medical viewpoint not yet reported to affect other organ systems:
- Fibromyalgia Syndrome
- Chronic Fatigue Syndrome
4. Muscle pain/weakness
Common conditions that can cause muscle complaints that need evaluation and treatment include the following.
Inflammatory arthritis/Autoimmune rheumatic conditions—all of them but especially:
- Polymyalgia Rheumatica (PMR)
- Mixed Connective Tissue Disease
- Lupus
- Myositis (inflammation of the muscles)
Vascular disease/Vasculitis: If our muscles do not have enough blood (i.e. they lack nutrients and oxygen) they hurt and become weak (see more information above under Neuropathy).
Neuropathy: If we do not have the appropriate nerve supply OR too much nerve stimulation to our muscles, they can hurt and become weak.
Emphysema/COPD/Sleep Apnea/Hear Failure: If our muscles with the appropriate amount of oxygen, they can hurt and become weak.
Infections
Medications such as:
- Statin meds for cholesterol
- Diuretics/water pills
- Aricept for Alzheimer’s
- Prostigmine for Myasthenia Gravis
- Nifedipine for blood pressure
- Evista, Fosomax, Actonel, Boniva for thin bones
- Brethine, Proventil, Ventolin for asthma
Vitamin and Mineral Deficiencies such as:
- Vitamin D3, E
- Calcium, Magnesium, Potassium
- Omega 3 Fatty Acids
Other Causes
- Thyroid/Parathyroid disease
- Overuse of muscls/Underuse of muscles
- Poor Diet
- Stress, Anxiety, Depression (i.e. not actively #LiveYourValue)
- Fibromyalgia Syndrome
All of these, with the exception of Fibromyalgia Syndrome, should be evaluated and treated sooner rather than later as these conditions can affect other organ systems.
5. Poor Sleep
Common conditions that can cause muscle complaints that need evaluation and treatment include:
- Nasal/Sinus/Allergies
- Asthma/Emphysema/COPD
- Obstructive Sleep Apnea
- Heartburn/Reflux
- Arthritis (Inflammatory and Non-inflammatory)
- Hyperthyroidism
- Restless Leg Syndrome
- Parkinson’s
Poor Sleep can also be caused by Medications:
- steroids
- thyroid medications
- birth control pills
- antihistamines and allergy medications
- some blood pressure/heart disease medications
- anti-depressants
- weight loss medications
- Caffeine/High sugar diet
- Stress, Anxiety, Depression (i.e. not actively #LiveYourValue)
6. Headache
Yes, many headaches (as I posted earlier this month) are due to allergies, or, are migraines. However, I wanted to mention a couple of other things to keep in mind that certainly would need attention. These include….
- High Blood Pressure
- Temporal Arteritis (a type of vasculitis)
- Intracranial bleeds
High blood pressure is very common. Most of us appreciate that high blood pressure increases our risk of heart disease. However, something we also need to know is that uncontrolled blood pressure is a major risk factor for abnormal kidney function.
KEY POINTS:
Rarely—okay, VERY rarely—is it only ONE thing that is causing any one of our complaints. Therefore, I encourage you to look through the list and see what you think.
The next question that we need to ask ourselves is a two-part question.
1. What are my health care providers doing for these conditions?
2. What am I doing for these conditions?
Remember, 99.9% of the time it’s our thoughts and feelings that will drive our choices and very often, when something like COVID -19 has changed our status quo, we can become so focused on it that we start to lose sight of other potential issues that can exist.
So remember, live your value one choice at a time. Not only through the current CDC recommendations regarding COVID – 19, but also through choices that affect other aspects of your health and contentment.
The more content we are, the healthier we become. The healthier we become, the more content we will be.
—Dr. D
