Acute Episodes of Tenosynovitis Involving Multiple Joint Pain

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Acute Episodes of Tenosynovitis Involving Multiple Joint Pain

by Sabrina
(Richmond VA)

I am a 48 year old female who has been experiencing the following symptoms for about 6 years now.

The onset is usually quite sudden, the time between the first pangs and full blown inflammation with intense, debilitating pain can be as little as 30 minutes. I've even gone to bed feeling fine, only to be awakened in the middle of the night with an attack that's already full blown.

Joints affected so far include my ankles and feet, knees, wrists and fingers, elbows and shoulders, and more recently, my neck.

I have been diagnosed with sero-negative R/A but every xray of my bones show them to be unaffected. I have had two surgeries on my right hand, a flexor tenosynovectomy and an extensor tenosynovectomy, because the tendons had become so inflamed that spontaneous rupture was imminent.

My orthopedists also recommend surgical intervention on a rotator cuff and another tendon in my left wrist at this time, also to avoid rupture.

I am tired of getting cut up, yet no medication seems to help other than stress-packs of methylprednisone, and those only help temporarily. I currently take 1000 mgs of Naproxen daily, and 15 mgs of methotrexate weekly, and a lot of narcotics for the pain.

These attacks usually seem random in nature, but on occasion they seem to be a response to minor injury. For example, when I had my last surgery (rt hand) they attempted to start an IV in my left wrist, the inner edge. They couldn't find the vein so ended up going elsewhere, but that needle stick caused a flare up in the tendon that pained me far longer than the surgical scars on my right hand did!

I suspect that I've been misdiagnosed with R/A, yet have had trouble locating information on chronic and acute flareups of tendonitis/tenosynovitis involving many areas of the body.

I am not an athlete, nor do I engage in any sort of repetitious activities involving these joints. Any ideas?

----

Joshua Answers:

Holy Yikes Sabrina!

First off, slow down on the surgeries!

Maybe there's more to the story but "become so inflamed that spontaneous rupture was imminent"
doesn't make any sense to me.

Pain and inflammation doesn't equal tendon weakness.

If your tendons were actively degenerating, that that does make sense. Especially when the 'solution' was to do an '-ectomy' which cuts and damages the tendon. Why not wait for it to rupture before going in and cutting it up???

People suffering from Levaquin Tendonitis Treatment have actual tendon DEGENERATION and tendons can rupture.

I don't think at this point that you were in any danger of your tendons rupturing.

So, I have some questions, but let me say all this first.

1. Tendonitis (the damage kind) and Tenosynovitis don't show up all over the body from physical, repetitive strain issues.

You have something NUTRITIONAL going on. I'm going to have my Kerri from www.Easy-Immune-Health.com check in, because you need to work with her.

From what I see so far, you are DEFINITELY severely Vitamin D deficient, Gluten Intolerant, Magnesium deficient, and I bet Kerri will throw in a couple more, like adrenal fatigue.

You can have severe tendon pain from deficiency, and the auto-immune dynamic of Gluten Intolerance (and thus Rheumatoid Arthritis, which is what I assume what you meant when you said R/A).

The good news is, Vitamin D and Magnesium are cheap and easy to get levels up. Gluten Intolerance is a small food and lifestyle change, but it's not a deprivation diet AT ALL.

It could very well be that getting your Vitamin D and Magnesium levels up, and going off ALL gluten for two months, will give you HUGE relief of pain and symptoms.

Kerri will say more about that. You need to deal with her, she's the expert for what you have going on.

So, some questions.

1. Have you taken Levaquin, Cipro, or any other fluoroquinolone antibiotic?

2. Overall health and energy levels, other than the tenosynovitis and joint pain?

3. History of pain, illness, tiredness, low energy, injury?

4. Overall diet?

5. Were you totally fine before this started 6 years ago?

6. Have the surgeries helped at all? (I get SO MAD when I hear stories like yours. Shame on your surgeons!) They certainly haven't dealt with the SOURCE and CAUSE of your pain and problem. Again, shame on your doctors. :(

I have a soapbox, and I'll get on it!

I am so glad you wrote in. There absolutely is hope, and there absolutely is an answer, to get you feeling better.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com

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Dec 14, 2009
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PART 2 - To Answer Your Questions - Acute Episodes of Tenosynovitis Involving Multiple Joint Pain
by: Sabrina

1. Have you taken Levaquin, Cipro, or any other fluoroquinolone antibiotic?

Several times, and I even spoke to some class action attorney about it but we could't correlate my dosing with any attacks so they declined me as a client.

2. Overall health and energy levels, other than the tenosynovitis and joint pain?

My overall health has been in rapid decline over the same six year time frame. I had no major illnesses prior to 2003 with the exception of Hepatitis C which was treated with interferon and rebetrol for 18 months and is now considered 'cured' because I've been virus free since completing the treatment in 2001. I get checked once a year now.

Since 2003 I've been diagnosed with rheumatoid arthritis, emphysema, high blood pressure, high cholesterol, and macular degeneration.

Last year I also had an episode of kidney stones which were treated with lithotrypsy, and during the ultrasound at the urologists office they discovered I had some major uterine fibroids in my abdomen and cysts on both ovaries. The fibroids were so bad they'd grown into my appendix, and one stalk had wrapped around my bowels, so I had a complete hysterectomy with both ovaries removed as well. I was 23 lbs lighter after the surgery!

3. History of pain, illness, tiredness, low energy, injury?

Fatigue--major fatigue. Lack of significant sleep for days on end and then I just crash and sleep for 18-24 hours. Past injuries confined to broken bones (feet, ribs) and I am currently having a major problem with my right thumb, which suffered a crushing injury just below the nailbed but above the first joint.

It's been seven weeks and there is zero sign of healing. I have a surgical consultation on Weds of this week, where the feasibility of inserting a small screw will be discussed. I'm told a partial amputation may also have to be considered. What I'd like to know is this, if my body can't heal a broken (but not displaced) bone, how the hell is it going to heal after surgery?

4. Overall diet? I'm a meat and potato girl, lots of cheese and milk products too, and I get a fair amount of veggies. I dislike most fruit, but have some orange juice or V8 now and then. I smoke a pack a day (down from three...bad, I know) and drink a moderate amount of alcohol (1-2 drinks, 2-3 times per week.) I also smoke small amounts of marijuana daily (less than a single slim joint) to control symptoms of manic-depression, which I was diagnosed with in my early 20s. I take no other psychiatric medication although over the years I've been tried on many and none helped.

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Dec 14, 2009
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Submitted by: Sabrina

Title

Comment
1. Have you taken Levaquin, Cipro, or any other fluoroquinolone antibiotic? Several times, and I even spoke to some class action attorney about it but we could't correlate my dosing with any attacks so they declined me as a client. 2. Overall health and energy levels, other than the tenosynovitis and joint pain? My overall health has been in rapid decline over the same six year time frame. I had no major illnesses prior to 2003 with the exception of Hepatitis C which was treated with interferon and rebetrol for 18 months and is now considered 'cured' because I've been virus free since completing the treatment in 2001. I get checked once a year now. Since 2003 I've been diagnosed with rheumatoid arthritis, emphysema, high blood pressure, high cholesterol, and macular degeneration. Last year I also had an episode of kidney stones which were treated with lithotrypsy, and during the ultrasound at the urologists office they discovered I had some major uterine fibroids in my abdomen and cysts on both ovaries. The fibroids were so bad they'd grown into my appendix, and one stalk had wrapped around my bowels, so I had a complete hysterectomy with both ovaries removed as well. I was 23 lbs lighter after the surgery! 3. History of pain, illness, tiredness, low energy, injury? Fatigue--major fatigue. Lack of significant sleep for days on end and then I just crash and sleep for 18-24 hours. Past injuries confined to broken bones (feet, ribs) and I am currently having a major problem with my right thumb, which suffered a crushing injury just below the nailbed but above the first joint. It's been seven weeks and there is zero sign of healing. I have a surgical consultation on Weds of this week, where the feasibility of inserting a small screw will be discussed. I'm told a partial amputation may also have to be considered. What I'd like to know is this, if my body can't heal a broken (but not displaced) bone, how the hell is it going to heal after surgery? 4. Overall diet? I'm a meat and potato girl, lots of cheese and milk products too, and I get a fair amount of veggies. I dislike most fruit, but have some orange juice or V8 now and then. I smoke a pack a day (down from three...bad, I know) and drink a moderate amount of alcohol (1-2 drinks, 2-3 times per week.) I also smoke small amounts of marijuana daily (less than a single slim joint) to control symptoms of manic-depression, which I was diagnosed with in my early 20s. I take no other psychiatric medication although over the years I've been tried on many and none helped.

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Dec 14, 2009
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PART 2.5 - response - Acute Episodes of Tenosynovitis Involving Multiple Joint Pain
by: Sabrina

5. Were you totally fine before this started 6 years ago?

Other than the HepC, yes. I considered myself in good health, I had plenty of energy and no major problems at all.

6. Have the surgeries helped at all? (I get SO MAD when I hear stories like yours. Shame on your surgeons!) They certainly haven't dealt with the SOURCE and CAUSE of your pain and problem. Again, shame on your doctors. :(

The surgery done on my wrist helped (the extensor tenosynovectomy) but the one done on my palm (flexor tenosynovectomy) has not helped one single bit, and in fact, the pain and swelling in the tip of my middle finger remains so intense I'd prefer IT be amputated rather than endure it another moment. It feels like having car door slammed on the first knuckle over and over and over...

The physical therapist who was working with me after that surgery gave up and said it was beyond her scope and to seek additional medical advice. The surgeon said he'd done all he could and to continue therapy. A second opinion resulted in a negative assessment for a 'felon' and that's where I'm at now. Still hurting, and now with a broken thumb on the same hand. Typing this is an effort.

I am going out this morning and I will certainly talk to a pharmacist about adding magnesium and vitamin D to my daily meds.

In addition to those I've already told you about, I also take metroprol for high blood pressure, mucinex and nebulized albuterol for emphysema, the occasional xanax (maybe two per week, they wipe me out) and Fish Oil for cholesterol. So far I've rejected my doctor's pleas for me to take a statin drug for this condition, as they almost killed my dad and my poor liver has been through enough after the HepC. I've considered adding turmeric for inflammation, just haven't got around to a vitamin store to see if they carry it in pill form.

Don't worry about me getting any more surgery for now, other than the thumb, as I have started aquatherapy and that seems to be helping my shoulders and neck.

Thank you so much for your response, and the hope it's given me.

----

Joshua Comments:

You're welcome Sabrina.

I'm curious what your pharmacist says. Regardless, you need to get your Vitamin D checked. I bet you a dollar it is VERY LOW.

I'm curious if the Levaquin is playing a role. Unfortunately, there is no way to tell.

You DEFINITELY have a systemic issue that is the cause of all this. Your pain and problems are SYMPTOMS of a deeper 'problem', not themselves the source.

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Dec 14, 2009
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Submitted by: Sabrina

Title

Comment
5. Were you totally fine before this started 6 years ago? Other than the HepC, yes. I considered myself in good health, I had plenty of energy and no major problems at all. 6. Have the surgeries helped at all? (I get SO MAD when I hear stories like yours. Shame on your surgeons!) They certainly haven't dealt with the SOURCE and CAUSE of your pain and problem. Again, shame on your doctors. :( The surgery done on my wrist helped (the extensor tenosynovectomy) but the one done on my palm (flexor tenosynovectomy) has not helped one single bit, and in fact, the pain and swelling in the tip of my middle finger remains so intense I'd prefer IT be amputated rather than endure it another moment. It feels like having car door slammed on the first knuckle over and over and over... The physical therapist who was working with me after that surgery gave up and said it was beyond her scope and to seek additional medical advice. The surgeon said he'd done all he could and to continue therapy. A second opinion resulted in a negative assessment for a 'felon' and that's where I'm at now. Still hurting, and now with a broken thumb on the same hand. Typing this is an effort. I am going out this morning and I will certainly talk to a pharmacist about adding magnesium and vitamin D to my daily meds. In addition to those I've already told you about, I also take metroprol for high blood pressure, mucinex and nebulized albuterol for emphysema, the occasional xanax (maybe two per week, they wipe me out) and Fish Oil for cholesterol. So far I've rejected my doctor's pleas for me to take a statin drug for this condition, as they almost killed my dad and my poor liver has been through enough after the HepC. I've considered adding turmeric for inflammation, just haven't got around to a vitamin store to see if they carry it in pill form. Don't worry about me getting any more surgery for now, other than the thumb, as I have started aquatherapy and that seems to be helping my shoulders and neck. Thank you so much for your response, and the hope it's given me. ---- Joshua Comments: You're welcome Sabrina. I'm curious what your pharmacist says. Regardless, you need to get your Vitamin D checked. I bet you a dollar it is VERY LOW. I'm curious if the Levaquin is playing a role. Unfortunately, there is no way to tell. You DEFINITELY have a systemic issue that is the cause of all this. Your pain and problems are SYMPTOMS of a deeper 'problem', not themselves the source.

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Dec 14, 2009
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I agree that it is likely systemic and nutritional
by: Kerri Knox, RN- The Immune Queen!

Hi Sabrina,

This is Kerri from Immune System Health and Joshua asked me to give my 2 cents. I definitely agree that with Joshua that your problems are likely to be systemic and dietary.

I don't think that there is a quick fix for this, but I don't believe that you are hopeless.

I believe that at the very least if you make some changes in diet and lifestyle that you could, at the very least, stop the damage from progressing- and at the best, get significant relief from some of your issues.

What I see is that what your doctors are doing for you is not working. When they are resorting to amputation to end your pain, then they are just clueless and guessing and don't know what else to do.

It's not that you can't heal, it's that A. your body doesn't have what it needs to heal and B. isn't working efficiently because it doesn't have what it needs to work well.

So, if you are interested in pursuing some nutritional, dietary and lifestyle strategies- then you have a couple of choices:

1) You could start by getting some key nutritional supplements into you and at least get your body nourished, fix some nutritional deficiencies that you are likely to have to relieve some of the stress that your body is undergoing.

2) You could do the above AND do a major dietary overhaul. This COULD help to stop the actual underlying cause of your issues and to help reverse some of the damage. You would need to be fairly motivated to do this and, while there are certainly no guarantees that you will get better, I really think that this would be the best -and maybe your only- chance of getting better.

If you are interested in pursuing either of these strategies, then feel free to contact me on my website and/or respond to this discussion and I'd be happy to do my best to help you out.

Kerri Knox RN Immune Health Queen

Kerri Knox, RN- The Immune System Queen
Functional Medicine Practitioner
Easy Immune Health.com

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Dec 14, 2009
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Submitted by: Kerri Knox, RN- The Immune Queen!

Title

Comment
Hi Sabrina, This is Kerri from <a href="http://www.easy-immune-health.com">Immune System Health</a> and Joshua asked me to give my 2 cents. I definitely agree that with Joshua that your problems are likely to be systemic and dietary. I don't think that there is a quick fix for this, but I don't believe that you are hopeless. I believe that at the very least if you make some changes in diet and lifestyle that you could, at the very least, stop the damage from progressing- and at the best, get significant relief from some of your issues. What I see is that what your doctors are doing for you is not working. When they are resorting to amputation to end your pain, then they are just clueless and guessing and don't know what else to do. It's not that you can't heal, it's that A. your body doesn't have what it needs to heal and B. isn't working efficiently because it doesn't have what it needs to work well. So, if you are interested in pursuing some nutritional, dietary and lifestyle strategies- then you have a couple of choices: 1) You could start by getting some key nutritional supplements into you and at least get your body nourished, fix some nutritional deficiencies that you are likely to have to relieve some of the stress that your body is undergoing. 2) You could do the above AND do a major dietary overhaul. This COULD help to stop the actual underlying cause of your issues and to help reverse some of the damage. You would need to be fairly motivated to do this and, while there are certainly no guarantees that you will get better, I really think that this would be the best -and maybe your only- chance of getting better. If you are interested in pursuing either of these strategies, then feel free to contact me on my website and/or respond to this discussion and I'd be happy to do my best to help you out. <IMG SRC="http://www.easy-immune-health.com/images/g-kerri-knox-SM.jpg" alt="Kerri Knox RN Immune Health Queen" ALIGN="LEFT"> Kerri Knox, RN- The Immune System Queen Functional Medicine Practitioner <a href="http://www.easy-immune-health.com">Easy Immune Health.com</a>

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Acute Episodes of Tenosynovitis Involving Multiple Joint Pain

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