If you are a GP, and someone presented with these symptoms....

[overthehillswegoo]

What would you be querying?

Lower back pain for two years, mainly to the right side but can be central (pelvis x-ray came back normal). Hurst when standing still or seated, but fine when moving/exercising.
Pain/stiffness in middle of back when straightening up after bending over.
Nail psoriasis (diagnosed).
Occasional stiff neck, coinciding with headache.
Tingling/numbness in left foot (last 6 month) and sometimes up lower leg. Currently seeing a physio to help, and nerve conductor studies came back fine.
Bunions, and shooting pain in big joint.
Severe dry eye for two years (now being treated by steroid drops from opthalmologist).
Constant sore, flaky ears (previously given drops for 'eczema' in ears)
Red, sore rash on underams.
Red, sore rash around eyes (only really happens in Winter).
Genital itching/soreness.
Recurring sore elbow joint, hurts to rest it on desk whilst working.
Infrequent knee pain.

All of the above are happening now, not at different time periods.

Had brain and spine MRI to rule out MS (referred for this due to eye problems and, at the time, numb hands), both scans came back showing no lesions.

Lots of bloods tests ran for rheumatoid factor, deficiencies etc. All came back ok.

If this was your patient, what would you be thinking next? TIA

@veryfluffyfluff No meds

Have you had an ANA blood test? I had to be referred to a rheumatologist to get one but some GPs will request them - not sure if it’s different rules in different parts of the country. It sounds like something autoimmune is happening and if it’s not showing in any of the standard blood tests then this one will pick it up.

Was going to suggest this.

Occam's razor sometimes applies, and one diagnosis unifies everything, but often symptoms are just normal life.

It sounds like you have sciatica and some minor skin conditions.

Everyone's elbows hurt if they lean on them on a hard surface for a period of time....

People suggesting that OP is a hypochondriac are not helpful. I was ill for years before I could get a GP to help me and had ‘health anxiety’ written on my medical records when I knew I was only anxious about my health because I was so bloody unwell and nobody was listening to me. Eventually I was diagnosed with Sjögren’s syndrome, lupus and a rare genetic disorder. Don’t assume.

Haha @FixTheBone I wish I was talking about when I've been resting my elbows on a hard surface. I'm talking about using my keyboard whilst working, and being unable to let my elbow touch the desk....
And if that was my only symptom, I wouldn't be here talking about it 😬
I know what everyday life feels like, I managed over 30 years of it, and then a couple more years where I suddenly felt very uncomfortable but put it down to 'old age', before raising these issues.
If you are right, I'll make sure to come back to the post and let you know

I'm sure lots of people would've called me a hypocondriac before my diagnosis. It is unhelpful and when you're in pain and your symptoms are impacting on your life, the last thing you need is someone saying it's all in your head. Yes OP probably is anxious, being in pain and no-one knowing what's wrong with you and not knowing if the problems will just get worse is anxiety inducing. There are health issues that explain OPs symptoms

Yes, I am probably slightly anxious now, but I don't suffer from health anxiety. As somebody who leads a very active, physical life (other than my sedentary desk job), I value my fitness and mobility, and I'd rather be proactive at saving that if I need to

Well said autoimmune condition are difficult to diagnose. Especially how long it takes to see a consultant.
I hope your feeling better now your getting treatment and have finally been diagnosed. People don’t understand it’s no joke ke and the pain goes beyond getting old and everyday life.

The soreness around your eyes could be psoriasis. I have it

I had crippling lower back pain for 3 months in my early 40s. Turned out to be transferring from ridiculously tight hamstrings which were doing all of the work of my glutes and pulling down on my back muscles. Plus vitamin D deficiency. Now sorted with supplements and a clinical deep tissue massage once a month.

You’ve essentially described Sjrogens syndrome there, which can cause all of those symptoms. Psoriatic Arthritis also can, but also has other more obvious symptoms. Get yourself an appointment with a private rheumatologist and go from there. It will be worth the money x

Psoriatic arthritis doesn't show up in bloods, a lot of rheumatologists will dismiss you if you don't fit rheumatoid arthritis.
80% of your description matches me (with PsA) ... took 7 years for referral and diagnosis as GP would say "bloods are clear" and "it's so rare" so insist now as the waiting lists are horrendous.

I have got to admit Hypochondria came to my mind first too.

Not because I don't believe you have or have had all these issues but that you wrote a long clearly unrelated list looking for a 'magic' answer.

The answer is simply 'aging'. I also have a bad back, red skin on arms, stiff neck, migrains, siezing up while sitting etc... They are simply a collection of unrelated conditions I have aquired through life and non are unusual.

I agree with this whole heartedly. There's a lot screaming inflammation here, some of which could possibly be addressed by looking at your diet.

@Ninalon I also had a massive and long lasting auto-immune reaction after the Covid vaccine. Not anti-vax at all, I was happy to get it until it made me seriously ill. Have met others since. Some journal articles out now too.

I wrote in an earlier message for the Op to consider if there was a trigger/put together a timeline. Should be useful whatever the cause.

@JusthereforXmas you may think these symptoms are unrelated but with auto immune conditions there are quite often seemingly unrelated issues that are completely related.it can effect skin, joints and eyes etc for example ankylosing spondylitis causes horrendous back pain but around half of people with the condition get uveitis which is inflammation in your eyes, can cause heart problems etc
It's not always easy to say they're not related when it's not a mechanical issue

they are likely not related

Lower back pain for two years, mainly to the right side but can be central (pelvis x-ray came back normal). Hurst when standing still or seated, but fine when moving/exercising.
- likely whilst exercising have pulled a muscle or something,

Pain/stiffness in middle of back when straightening up after bending over
. -as above

Nail psoriasis (diagnosed).—inflammation, look at diet.

Occasional stiff neck, coinciding with headache.

-see back pain, likely linked

Tingling/numbness in left foot (last 6 month) and sometimes up lower leg.
-likely linked to back pain

Currently seeing a physio to help, and nerve conductor studies came back fine.

Bunions, and shooting pain in big joint.

need to see a podiatrist if bunions are bothering you as they e got too bad.

Severe dry eye for two years (now being treated by steroid drops from opthalmologist).

-infection likely, look at make up, cleansing routine etc also probably work environments

Constant sore, flaky ears (previously given drops for 'eczema' in ears)

• do you scratch them?

Red, sore rash on underams.

• look at deodorant and hygiene,

Red, sore rash around eyes (only really happens in Winter).

• see eye infection above

Genital itching/soreness.

look at personal hygiene practices and detergents used.

Recurring sore elbow joint, hurts to rest it on desk whilst working.
Infrequent knee pain

likely caused by exercise.

This looks like a possible lead, although I was going to say fibromyalgia.

For people saying it couldn't be possibly related issues you can see from these symptoms they could well be, it is worth a rheumatology visit even if just to rule it out

@Littlethingsmeanalot
I think it's a no to a pulled muscle.
It's been ongoing for over two years, I exercise daily (mix of cardio and strength training), I know a pulled muscle.
Also, after 8 sessions with a physio, and her being able to reproduce the foot tingling sensations by moving me in certain ways, I think she will agree it's not a pulled muscle.
You've agreed to the foot tingling being linked to back pain, surely it's not linked to back pain caused by a pulled muscle for so long..?

Red rash around eyes isn't infection. Already diagnosed as psoriasis
Dry eye - isn't infection as you suggested. Have seen Opthalmologist (this week) and been prescribed steroid drops for inflammation. No sign of infection

My husband is 39 and was diagnosed with psoriatic arthritis in his early 30s. This was after years of joining the dots with various symptoms: psoriasis, joint inflammation, night sweats, high white blood cells. The list was long, but he would have periods of remission which made them easier to dismiss as symptomatic of one condition.

I think the diagnosis was likely reached when confirming family history, as his grandmother also had many symptoms. There is also a strong link between PsA and Crohn's (brother) and diverticulitis (father).

It could be worth making a note of family history as this could be the case for other conditions.

similar issues here. Was told each individual complaint was ‘nothing’ or ‘menopause’ or ‘cos you is fat’ 1 not allowed to talk about more than one complaint at appointments with gp.

then just after Christmas I was struck down in agony - legs, hips, feet etc. Unable to walk etc. Told by gp this was ‘pulled muscles’
demanded gp look at autoimmune.

six months later I am now under a rheumatologist with a provisional diagnosis of Ankylosing spondylitis- waiting for some more tests then to start methotrexate. Consultant thinks all of my aches and pains have been mini flares. The two episodes of covid and two episodes of flu in 2022 just confused my immune system and now it is running at 11 unable to switch off.

i have gone from being an active person to using a stick ( on a good day) to walk.

i am now disabled

i thought I was a hypochondriac/ health anxiety

much love being sent

I agrée with many other posters that it sounds like autoimmune and your best bet is rheumatology.

By any means, carry on the investigation in your back.
But I’d go private whilst pushing the GP for a referral to a rheumatologist.

Forgot to add that DH has always had very dry, itchy ears - drives me mad as he's always scratching, especially in bed at night.

Also, he is very fit (football, gravel biking, walks everywhere).

We were at a podiatric appointment this morning for a toe joint inflammation first x-rayed in 2015!

Reading your more recent posts, I would chase up the referral for PsA to get the ball rolling. Sadly, there can be months between appointments.

Btw never ever settle for health anxiety/hypochondriac.

There is a lot if research around the fact women are very easily dismissed when they present with complex conditions like yours. It’s all in your head and anyway women tend to be hysterical anyway. That myth is still well alive.