A hypertensive patient suffers from body ache in the shoulders and neck. What could be the cause?

Hello,

Welcome to icliniq.com.

I have read your query, and I can understand your concern.

I saw the files you have attached (attachments removed to protect patient's identity).

Interpretation of the laboratory results:

1) Vitamin D level is sufficient. There is no deficiency state.

2) Complete blood count (CBC): Nearly all parameters are in the normal range. Hemoglobin is normal. There is slight PCV (packed cell volume) and MCV (mean corpuscular volume) just below the lower limit range, but the rest hemogram panel parameters are normal and nothing to worry about.

3) Total leucocyte count (TLC) and differential leucocyte count (DLC) are normal.

4) Lipid profile test: There is increased Total cholesterol, LDL (low-density lipids) cholesterol, and triglycerides levels. This value optimizing approach would be diet control, exercise, and lipid-lowering medicine to control increased lipid levels. Is she taking any lipid-lowering medicine like statins?

5) Kidney function test (KFT): All the kidney parameters are in the normal range. According to the lab range, there is a slight increase in the uric acid level. You mention she is taking BP (blood pressure) medicine. Can I ask what BP medicine she is taking? Are there any diuretics added in the BP treatment medicine? I am asking this because diuretics cause an increase in the uric acid level. Please do mention this in the reply.

6) ESR (erythrocyte sedimentation rate): It is elevated. ESR is a nonspecific test, and increased value suggests some ongoing infection and inflammation in the body. It means some inflammatory state and the range of differential diagnosis is vast like autoimmune conditions, vasculitis, arthritis, etc. Since there is normal TLC with normal DLC, the cause is not related to infection. You have mentioned symptoms like body ache pain around the shoulder, neck and this could be the reason for the high ESR value.

Skin itching and dryness could be due to cold weather and increasing age.

I would suggest the following:

1) Take NSAIDs (non-steroidal anti-inflammatory drugs) like Acenac P once a day for body ache, neck, and shoulder pain for three days. Do not continue taking this medicine unnecessarily for long periods. Take antigas medicine if there is a problem with gas formation after taking normal pain reliever medicine.

2) Further tests and medical history would be needed to know possible causes of elevated ESR levels.

3) To control lipid value, an optimizing approach would be diet control, exercise, and lipid-lowering medicine to control increased lipid levels.

4) Please mention what BP medicine she is taking.

5) Take adequate rest, exercise, and maintain adequate hydration.

Please reply to the above questions.

Thanks and regards.