Ask a doctor on the topic of Orthopedics

Unexplained neck pain and joint pain with body stiffness

May 12, 2014 | 75,00 EUR | answered by Dr. med. Kathrin Hamann

Dear expert,

I have asked questions here before, but I am currently at the point of despair. I am plagued by severe neck tension that comes in waves, always accompanied by an extremely bloated stomach. The top vertebra (Atlas?) is extremely sensitive to pain, even small, sudden noises make me twitch. Everything feels very stiff and awkward. The neck turning muscle on the left side is very tense. Sometimes my joints hurt as if I have the flu, sometimes I sneeze, sometimes my eyes water, I become hoarse. I have been thoroughly examined from head to toe: nothing can be found.

Rheumatism, Lyme disease, diabetes, thyroid, cancer, intestines, stomach: all without the slightest finding. The strange thing is: painkillers have absolutely no effect. Ibuprofen, Naproxen, Paracetamol and all the others: no effect. Then I thought maybe it was a histamine intolerance and took an antihistamine a few times: no effect at all (except tiredness). My general practitioner believes it could be a muscle tension disorder. Acupuncture, physio, osteopathy: nothing helps. Heat seems to subjectively make it worse, damp weather and gloomy weather make it worse, I sometimes feel like I have a stick in my spine. And as a 40-year-old man with a pregnant-looking belly: not very attractive. The only confirmed diagnosis: atopic dermatitis. My stool was examined: nothing, absolutely nothing.

Could it still be a form of rheumatism? Fibromyalgia? Nothing tangible? The pain and stiffness are terrible. It can come and go as quickly as within a day. One possible clue could be that I subjectively felt better when taking Cymbalta (only 30mg a day), but I gained 12 kilos in 2 months - so I slowly weaned myself off the medication as much as possible and have been off it for 4 days now. Are physical withdrawal symptoms possible?

I just don't know what to do anymore, and it seems like the doctors don't either... I am available for further questions.

Dr. med. Kathrin Hamann

Good evening, the way you describe it, I would label it as a somatoform pain disorder. This could be assessed as fibromyalgia, with the pain medication you mentioned often not showing any helpful effects.

It would be advisable to start with a low dose therapy of Pregabalin, which is pain relieving in this low dosage. An antidepressant effect only kicks in at higher doses (75mg). It fits that Cymbalta provides relief for you. You should really taper off this medication very slowly. Do not stop abruptly.

Losing weight is important, as well as relaxation exercises and distraction. Try adding magnesium, which you can get over the counter, as this will slightly relax your muscles.

Ortoton or Mydocalm could also be considered as therapy, but your primary care physician would need to prescribe it as it is only available by prescription.

Drink plenty of still water or herbal tea. Avoid sweet and acidic foods, as they can lead to acidification of the body, worsening your problem. Support with Basica (capsules, available without a prescription) can be very helpful in this regard.

All the best and a speedy recovery!

Kind regards,
Dr. K. Hamann