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Q&A with Australian Health Practitioners
Do I have Polymyalgia /Arthritis Flare?
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I have been having a lot of joint pain and stiffness diagnosed with bursitis in hip but also, because I have spinal stenosis in lower back, been told that the pain may be coming from there. A short course of anti-inflammatory medication helped but Dr would not let stay on for more than 5 days. I have tried everything - steroid shot in hip, oral inflammatory and other drugs, physio etc nothing has helped. After 14 weeks Chiropractor brought up Polymyalgia and my Dr says it's possible but we should wait and see as the blood test last week day after stopping antinflammatory medicine was inconclusive. I have had rheumatic fever in the past and was told that I may have Rheumatoid Arthritis years ago. I live a long way from specialists, can anyone advise what should be my next step? I also have no Thyroid, so this affects what medications to use. -
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Brian Lee
Physiotherapist
I graduated from the University of Melbourne in 2004 and have worked in various healthcare settings, including primary care, private practice and community health services, … View Profile
I would agree with your GP that you shouldn't jump to the conclusion in thinking that you have something instead, ie Polymyalgia, when you still got an active diagnosed condition that is left unresolved, ie bursitis. Regardless whether this pain is a result of bursitis, spinal stenosis, tight/weak glu med, polymyalgia, or even fibromyalgia, or some other conditions with fancy names, at the end of the day, you still need to have the confirmed condition treated first, or you will be lost to gradual development of chronic pain and eventually made to think you have some permanent condition (that can't be treated) when there is a good chance that your condition may be well resolved in the right hands. My advice for you will be to get a 2nd physio's opinion, as physio should be in the better position to rule out most possible causes and he should communicate with your GP and surgeon re his finding, in order to coordinate your care.
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Anonymous
I have already had 10 visits with a physiotheraphist and 5 treatments of accupunture the condition has not resolved and I now have pins and needles and nerve pain in most joints I am awaiting appointments to consult with rhuemotologist and back clinic in Melbourne also the bursitis has not resolved with any treatment it is now 18 weeks thanks for your answer but using strong pain relief as my Dr wants me to do to me is not an option it is not fixing anything by covering up the pain hopefully within the next 8 weeks I will have some answers and hopefully a soloution
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Brian Lee
Physiotherapist
I graduated from the University of Melbourne in 2004 and have worked in various healthcare settings, including primary care, private practice and community health services, … View Profile
I often come across people with chronic pain, ie even up to 26 yrs, and still able to get quite a satisfatory outcome. Some of these pain become chronic, could have been avoided from the very beginning. One of my ex-patients also had hip bursitis, she same said cortisone injection only worked for 2 days before everything back to normal, and she had 2 cortisone already and saw physio but no better, when she came to me, she was in wheelchair and by that time, her pain already drag on for 5 months. At the end, I did fix her hip pain, she was grateful and walk without pain and aids, but that was of course came with quite a bit of disagreement, debate and convincing at the start. She praised me for being magical, but unfortunately to say, I do think her physio back then could have done a better job.
In your case, it'll be hard for anyone to draw a precise conclusion re other possible causes as you still have an active issue, bursitis remains unresolved. Medically we treat complex conditions in a method like peeling an onion, that is addressing the confirmed issue in hands, and once resolved but other pain remain, then we can investigate further. In my opinon, most people expect medical diagnosis works in the way like shooting the dart, ie hit or miss; but in fact, process of medical diagnosis functions more like a method of exclusion.
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