Is it worth raising "global pain" with GP?

[JiraffDeSaki]

I recently saw a private physio for tennis elbow and wrist/hand pain. He asked me a lot of questions and it came out that I pretty much hurt all over, including my skin (it feels permanently bruised in places, has done for years) but some of my other joints hurt too - hips, ankles, feet. Lower back is sore too, but isn't everyone's! Back/sacroiliac pain has been there since my 20s when I fell from a horse, I'm now 51. This additional joint and body pain has increased over the last 6-12 months, and I've lost some grip-strength in my hands.

I have mentioned joint pain in passing to a GP and they did a "rheumatoids" blood test 3-4 months ago which came back normal. I had 4 sessions with the physio and he was urging me to ask for a referral (to a rheumatologist presumably) - I am hypermobile in many of my joints, he checked all the places I have pain (ankles and the joints in my feet, wrists and hands/fingers) and there is no heat, swelling or limited range of movement - they just hurt.

I'm laying in bed right now and the weight of the covers is making my feet throb, and my hips are aching. The worst pain is at night. I walk my dogs for 2-4 miles most days, and I am not in pain as long as I walk briskly - too slow is painful on my hips and back.

If DH gives me an affectionate squeeze or a pat I often yelp in pain, he thinks I'm peculiar.

I don't have any other symptoms, I'm not chronically fatigued or anything. I do get a bit of brain fog which I put down to menopause!

I could make an appt but I'm asking myself what it would achieve. I don't want pills, I think I want an explanation or a diagnosis so I know what I'm dealing with, if anything. Do any of you recognise this type of long term pain?

If you have insurance then go to your gp and ask for a referral to a rheumatologist. They will then refer you on if they find nothing ..

The nhs has a persistent pain dept too although I don't think there is a nhs equivalent.

The gp who commented is exactly my experience . They just seem to want help the hypochondriacs I know 🤦‍♀️..

I hardly ever go , look after myself and my weight . Don't drink / smoke / eat meat : take regular exercise and I expect to get help whej I need it but nope I don't .

Surely you actually only have one issue - global joint pain?
Reading your OP, it sounds like me! Sciatica, hip pain on one side, painful ankles, wrists and one elbow. I’ve just peeled a massive bag of potatoes and my wrists are killing me now. I also had a rheumology blood test a while ago that was normal. But I feel like something’s not right. I’m not ill, I take a Naproxen if things get too sore, but I definitely have weakness. I might speak to my GP if I can get an appointment.

Hypermobility and fibromyalgia are often seen together. I've got both and a lot of your symptoms are what I have.

I take magnesium glycinate capsules just after my evening meal. I tried magnesium citrate and had a terrible stomach with them. The company fairly refunded me immediately so I could purchase the glycinate from them. Been taking then two months I think and stomach is fine off them.

Potassium isn’t tested routinely in FBC. It’s an electrolyte test with sodium. If you have a good diet then your potassium will be fine.

citrate is the magnesium than can affect bowels. I take glycinate and have no issues.

When I have something complex, I take a typed, bullet point list and hand it over. Now, one of my GPs will say "I'll need to do a referral - can you email over a summary that I can copy into it?" Or I'll say "There's a really long form you need to complete. Do you want me to fill it in and send it over, then you can add you it and send it?"

It saves the GP time and I get what I need far quicker. But I was a nurse, so I can do that sort of thing.

I have arthritis in loads of joints and squeal if I knock myself very slightly or someone shakes my hand too firmly. It turns out my arthritis is due to a connective tissue disorder which could be worth considering due to your hypermobility. I was HM as a child, totally stiff now though.Rheumatologists deal with CTDs.

The sore-to-touch certainly sounds like fibromyalgia.

Re: Hypermobility. I'm hypermobile and have hypermobile Ehlers-Danlos Syndrome. It could be worth googling symptoms. As with any medical issue, there are variations of severity, though and the lack of fatigue means it might not be the right fit for your symptoms.

Hypermobile Spectrum Disorder could well be the right fit though, and is similar to EDS in many ways.

One thing I will say about being hypermobile is that by the time you reach your 50s, you've usually ended up with lots of joint related issues. So for example, I also have widespread osteoarthritis as well as spondylitis, facet joint arthrosis and spondyloisthesis in my spine.

I'd personally ask for a referral to Rheumatology, or if you can afford to pay private, do that.

I really appreciate all the replies and input, thank you.

I'm still not feeling confident about speaking to GP, I know they have so little time. I must say that in my lifetime I've only been fobbed off a few times, generally speaking I've had good experiences and anything potentially serious has always been dealt with quickly (some notable exceptions that I won't bore you with).

This global pain has become so familiar to me that I wonder if I might as well just keep soldiering on, I have all-over pain daily but 'm lucky enough not to be incapacitated or horribly fatigued and I still work full-time from home. I am keen on a diagnosis because I'm interested, but realistically what good would it do.

I am keen on a diagnosis because I'm interested, but realistically what good would it do.

Depends what it is. If it's Lupus then it's also attacking your internal organs and shortening your life so you'll need medication to slow or prevent that harm. RA is also another nasty one without medication. Find out what it is first.

I had this for a couple of years, after I’d been in perimenopause for a few years. I started HRT at 51, and it’s almost all gone, like a sort of miracle.

Bloody hell, no offence, I'm a GP and you'd make my heart sink with that!
Appointments are 10 minutes long here

Bloody hell, no offence, but you need retraining. Your bedside manner is missing too.

This.

Heaven help anyone inconvenient enough to be suffering from something complicated 😳

I don't get why a GP would not want to know ALL the symptoms- surely they could be related? And it took me nowhere near 10 minutes to read OP's post..

Anyway, I have very similar OP and I have been diagnosed as "fibromyalgish", slightly low but not too low ferritin (11), a bit hypermobile...it seems I don't have anything enough to merit any help but in the meantime I feel like I'm falling apart! Over the last year I have gone from being active to mostly sedentary and have started putting on weight. I don't know what else to do! I hope you manage to get some help.

Getting the feretin up will / would help

Iron rich foods -, blue berries -, dried apricots , wheatabix, kale , broccoli , peas

@worldwidetravel2017 True but I have been trying for years to little effect!

Have u discussed possible malabsorbtion ?

Has your gp offered solutions re feretin ?

No and no. My GP says low ferritin is normal, unfortunately! I did pay for a coeliac assessment that came back negative.

As previous pp has said could be menopause linked. I had very similar symptoms in my early 40s even though I was super fit at the time.

I now have an RA diagnosis and fibromyalgia. The global pain of fibro is largely managed with HRT. (I'm 46). Including allodynia (The skin bruise pain you have)

My inflammation markers are only slightly raised on tests but I most definitely have RA you can see it in my finger joints.

Definitely worth pursuing as it will affect your quality of life so much. I'm so much better on HRT even though I still suffer a bit.

Definitely start investigating this through GP and all other relevant medical pathways that people have suggested.

But also (and this is going to sound left of field) see your dentist. My sister and a colleague who both suffer with pain fatigue had the same unexpected experience of getting a tooth issue fixed and finding it made a huge difference to their overall pain levels. I believe it's A Thing and might be worth investigating.

GPs are not seeing patients in our practice but the nurses are working hard and can ask advice from a GP.

Has your vit d been checked ?

I was low in b12 - feretin - vit d - all @ same time and felt horrendous

Low feretin is not normal - the cause of it should also be investigated

When my feretin was low - i had a positive qfit test / poop test - then urgent colonoscopy and had polyps removed

Have u ever done a Qfit test / poop test ?

I strongly recommend u ask gp 4 one - your entitled to it

Why are Gps not seeing patients ?

Additionally

Feretin of 11 IS Low.

Nice guidelines want it to be at least 30

Do push 4 help

You can buy a private qfit test online

U can ask 4 second opinion

They gave me a gastroscopy and checked my stomach 4 bleeds when mine was low

Do persist

Our GPs almost stopped seeing patients during Covid and have not started again. I went to our dentist during Covid and he was very concerned about me as he knew I had been quite ill. He pulled his stool next to me and checked me out.
He said that he thought the doctors should not be paid!
It is the worst practice in the area so I will probably change.

Deffo sounds like changing is wise