DEAR DR. DONOHUE: I get pain in my upper arms when I raise them to do things like turn on the lights on my medicine cabinet. The switch is at the top of the cabinet, and it really hurts to reach up. When I shower, the pain is so bad that I can raise my arms only halfway up to wash under them. I am sending you a list of the medicines I take. I thought one of them might be the cause of the pain. My doctor doesn’t think so. I am 93. — S.C.

ANSWER: Your list of medicines is impressive. The only one that might be implicated as a cause of muscle pain is Zocor (simvastatin), the cholesterol-lowering drug. You take a small dose, only 10 mg, so it’s not a prime suspect.

I don’t know if your pain is a shoulder problem or a muscle problem. I bet it’s a shoulder problem. One common cause of pain like yours is a tear of the rotator cuff. The “cuff” is four tendons coming from back muscles that wrap around the top of the humerus, the upper arm bone, and keep it in its socket. Tears of the cuff create pain when a person reaches upward or off to the side. Tylenol, anti-inflammatory medicines (Aleve, Advil) or a shot of cortisone into the joint can reduce the pain. Surgery is often the definite answer.

Shoulder arthritis is another possibility. Arthritis pain makes itself known when you try to touch your right hand to the tip of the left shoulder or left hand to the right shoulder. The same kind of nonsurgical treatment used for rotator cuff tears works for arthritis. Bursitis, impingement syndrome and many other conditions cause similar pain.

If it’s your muscles that hurt, then one consideration is polymyalgia rheumatica. A simple lab test can provide evidence of this condition. It’s treated with a low dose of cortisone medicine. I’m at a disadvantage. I can’t examine your arms and shoulders.

FOR READERS: Questions on fibromyalgia recur with great regularity. The booklet on that mysterious illness explains it and its treatments. 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: My daughter, 50 years old, has had bullous pemphigoid for a year. She has been on cyclosporine, and the rash is almost gone. Can you help us with advice about this disease? — R.D.

ANSWER: The “bullous” of “bullous pemphigoid,” in everyday language, is blisters. “Pemphig” is the Greek word for blister. “Pemphigoid,” therefore, describes a skin disease that causes blistering. The blisters often itch. It’s an autoimmune disease. Your daughter’s immune system is waging a war against her skin. Her medicine reins in the immune system, and she has had a good response to it. Other medicines are available should she experience a recurrence of the illness or an intolerance to this drug.

DEAR DR. DONOHUE: I am a male, in my early 60s and in good shape. My blood pressure is controlled with one medicine. My pulse is between 50 and 60. A nurse at work checks my blood pressure and pulse once a week. About two months ago, she felt my heart skip a beat. This was after my doctor’s physical and an EKG. For several weeks after, she sometimes felt the skipped beat and sometimes did not. She said not to worry about it. Should I cut back on my exercise? I jog three to four days a week and play racquetball a few times a week. — J.M.

ANSWER: Everyone has skipped beats. They’re really not skipped; they’re extra beats. The extra beat causes a pause before the next regular beat, so it seems like a beat has been skipped. Some people feel a thud in their chest.

You don’t need to do a thing. They’re innocent. Ignore them.

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.