Not all joint pain is arthritis

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DEAR DR. DONOHUE: The only time my wife has seen a doctor or been in a hospital was to have our kids. She takes no medicines and doesn’t have a doctor. She’s 71 years old. In the past six months she has not been able to do what she used to do. She says her shoulders hurt, and she finds it painful to move her arms. Now she says the same about her hips. She insists it’s arthritis and says nothing can be done for it. Do you think you can talk some sense into her? — C.J.

ANSWER: I’ll try. Mrs. C.J., it’s not true that nothing can be done for arthritis. But frankly, I don’t think that’s what you have. Your symptoms fit those of polymyalgia (POL-ee-my-AL-gee-uh) rheumatica (rue-MAH-tee-kuh), a name you’re probably not familiar with but a condition that’s quite common. It’s stiffness and pain of the shoulders, often of the hips, too, and sometimes of the neck. Tiredness and a feeling of not being up to par frequently are present. You might experience a rise in temperature and a loss of weight. This illness doesn’t appear until after age 50, with most patients being in their 70s.

A doctor’s exam and a few simple lab tests confirm the suspicions. A test of considerable importance is the sed rate, “sed” for “sedimentation.” A small amount of blood is put in a calibrated tube. In one hour, the distance that the red blood cells have fallen from the top of the tube is measured. That’s the sed rate. In polymyalgia, the sed rate is very high.

This condition is treated with one of the cortisone drugs. Only modest doses are used, so the complications of cortisone aren’t great. The response to cortisone is fast.

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A twin illness might be seen with polymyalgia. It’s called giant cell arteritis, or temporal arteritis. It’s an inflammation of arteries. A dreaded complication of giant cell arteritis is blindness, which happens when arteries feeding the eye’s retina are inflamed.

It, too, is treated with cortisone. You should see a doctor quickly.

TO READERS: Fibromyalgia is a mysterious illness. It’s not associated with polymyalgia, but it does feature diffuse muscle aches. The booklet on it discusses it and its treatments. Interested readers can obtain a copy by writing: Dr. Donohue — No. 305, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I try to get my daily calcium requirement through foods. I have a list of the foods and their calcium content. The list mentions only plain yogurt, something I love. How about flavored yogurts, my preference? Do they have the same amount of calcium? — O.M.

ANSWER: Eight ounces of most yogurts have 300 mg of calcium. Flavored yogurt has about the same amount. Different brands and different-size containers will have other calcium contents.

DEAR DR. DONOHUE: I take verapamil for my blood pressure. My doctor calls it a calcium blocker. Does that mean it blocks calcium getting to bone? I am on treatment for osteoporosis. — V.M.

ANSWER: Calcium channel blockers don’t block calcium’s penetration into bones; they block minute amounts of calcium from entering arteries. When calcium does, arteries constrict, and blood pressure rises. These medicines keep arteries dilated and maintain a lower blood pressure.

DEAR DR. DONOHUE: Will you kindly tell me what a “lesion” is? My doctors use that word all the time. I have looked it up in the dictionary, but I am still confused. — A.D.

ANSWER: I looked up the definition of “lesion” in three medical dictionaries and two standard ones. I understand your confusion.

Its Latin root means an injury, but it’s used to describe a wide variety of medical conditions in which the affected tissue looks quite abnormal.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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