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Muscle weakness, tendon pain after hip injury. Treatment?

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My first symptoms were muscle weakness and tendon pain in ankles and knees. This came on after a hip injury when i tore a ligament last October and I thought it was from my hobbling for three weeks, but it persisted. Bad after sitting / resting. After about 6 - 8 weeks of this i got tingling. First in legs, then over whole body. When i scratch my skin I always have an odd tingling sensation; I 'tingle'most of the time, and feel 'fuzzy'' - sometimes just through my body, but often fuzzy headed too for a a couple of hours at a time. i did see a local doctor but English is an issue, he diagnosed possible osteoporosis and gave me muscle relaxants and painkillers. These really had no effect. Also it does not feel like bones, there is no local pain, no swelling. I took a lot of vit D, and take vit B12 and maganesium now regularly but no effect on whatever this is.

A full year plus ago i did have a mysterious stiffness in my right Achilles when i got up in the mornings - this went away, but this is were it started again in December. maybe triggered by hip injury? A couple of times i have had similar discomfit in one arm and no sure if that even related, it really is mainly my legs in terms of muscle weakness and tendon pain.

I started taking prednisone three months ago. I take 10gm in the morning and 10 in the evening. It reduces the tingling and takes away what feels like tendon pain and reduces the muscle weakness. I am worried about taking this for so long - I want to take more and try and feel normal but am worried about doses. Living in Phuket with limited medical insurance I cannot afford to go through the system here.

Category: Orthopedic Surgeon

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Category: Spine Surgeon
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Hello,
Thank you for your query at DoctorSpring.com
I have read details provided by you.It looks like you are having 10 mg of steroids twice a day instead of 10 gm. The dosage mentioned is probably wrong.
Looking at your symptoms it is evident that you are having rheumatolgical symptoms. In such case a proper evaluation should be done before starting of treatment. At present you should have a complete blood test including Hb TDLC ESR. CRP RA factor. following which a opinion from a rheumatologist should be taken for better evaluation. You can come back with your test reports, we will request the rheumatologist on our panel to help you.
Hope this was helpful,
Regards.
Hope this will help you.


Patient replied :

Yes I did state that dosage wrong. Is it safe for me to up the dosage a little as in 6 tabs a day?
I have looked up all the rhematological symptons... i have tingling evrywhere but my hands. My eyes are atually quite watery - some dryness in mouth at night but i am a mouth breather, this is a norm. No rashes. Pains are not symmetrical. Weakness is, but when the tendons are painful it is one side or the other. Mmm.... but shall do those tests.


No,It is not safe to increase the doses by yourself.Sometimes it is life threatening to increase the doses beyond recommendation or without prescription.
I hope you will get complete relief from a rheumatologist.
With best wishes.


Patient replied :

Hello Dr Mukesh, I now have lab results from bloods. I am hopoing you can explain these too me. Regarding my general issues, pain has been worse late, it is tendons down the outside of my right knee and what feels like nerve pain shooting up into my hip. I have taken neurofen for the past three days. This conditon has rarely requierd pain relief. I have noticed my mouth is more dry than usual at night. Also on my feet and ankles a light rash, small raised brown spots.

I want to add the rash is not itchy, and the knee pain... maybe ligament more than tendon? I am not sure!! In ankle today today, all down outside of leg. And pain shoots up more into bottock than hip. It can be awkward sitting. No swelling.


Hello Ms Corbett,
I have read your reports.Your reports are completely in normal range.These tests are basic tests to check about rheumatological diseases.These also show that there is no any infection in your body.Your basic rheumatological profile is normal.
It looks that dryness in mouth is due to mouth breathing.
Tingling sensation in limbs,if present continuously then this point towards presence of any nerve compression or stimulation due to any pathology.This can be due to deficiency of vitamin B12 or local compression.It may also be due to stress.
I used to give a combination of tramadol with paracetamol like ULTRACET ,in such symptoms.
You should also do yoga & meditation for relief.


Patient replied :

Thank you Dr Mukesh. does this also explain the pain in my knee and ankle ligaments and tendons? And the rough skin rash on ankles? Or are these different unrelated things? Should I stay long term with the prednisone? It does relieve the stiffness and tingling. Why does this work so well? I am pleased to have rheumatology ruled out.
Iniitially i had stiffness in both legs, now it is down one side of my left leg. Could that hip injury last year have pinched a nerve that is causing this? A lot of questions sorry; but this has been going on for a long time and cost me a lot now so I am really seeknig all my answers.


Hello,
Welcome.
For rash at ankle a dermatologist opinion will be very helpful .
Your pain at ankle and tendons may be due to non rheumatological reason which I have explained in previous post.
Having these test negative does not remove the possibility of having rheumatic diseases.
Further advanced tests are necessary for that but these basic tests help in giving directions.
The pain due to pinched nerve is continuous pain ,which is not with you.
The prednisolone is one of the basic hormone which prevent the inflammatory process so that you are having relief with this.
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
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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