Tulsa World: Long-term pain could be fibromyalgia, but it's hard to diagnose

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Long-term pain could be fibromyalgia, but it's hard to diagnose

By PETER GOTT, M.D. Newspaper Enterprise Association
Published: 10/21/2009 2:20 AM
Last Modified: 10/21/2009 3:50 AM

Dear Dr. Gott: I read your article in the newspaper about fibromyalgia and was very interested. My 77-year-old husband just had his physical. Everything was great, and he is a picture of health. He wonders how this can be when he complains to the doctor every time about how he hurts so much. He suffers from all the things you mentioned in the article that go with fibromyalgia, yet no test or doctor can tell him this is what he is suffering from.

Some background information is that he has had three back surgeries. The first was for spinal stenosis, the second was to put in a plate, and the third was to remove it again because it was thought the screws might have been the cause of his discomfort. He is taking Accupril once a day and hydrochlorothiazide for high blood pressure.

Dear Reader: Your husband's physicians are correct in saying that there is no test that will diagnose fibromyalgia. There is also no cure, and treatment can often be difficult, because each sufferer can have a wide variety of complaints, and what works for one person may not help another.

If your husband's back problem has worsened, causing pressure on his spinal cord, his discomfort could be directly related. Pain can also wear the body out very quickly, leading to persistent fatigue such as your husband is experiencing.

Next, your husband is taking two blood-pressure medications. Accupril carries the side effects of both back and joint pain. The hydrochlorothiazide also carries the side effect of generalized weakness. This should be looked into, because if his pain and fatigue developed after starting one or both of these medications, you may have the answer.

I suggest your husband ask for a referral to a rheumatologist for further investigation of his muscle and joint pain. Perhaps it is due to arthritis.

Write Dr. Gott c/o United Media, 200 Madison Ave. 4th floor, New York, NY 10016. By PETER GOTT, M.D. Newspaper Enterprise Association

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