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I have low back pain with joint pain, fatigue and high ANA. Please help.

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My ANA is 1:2560. I am having pain in the lower back, dry mouth, and joint pain in my hands. I feel very fatigued, and I have a history of celiac disease.

Answered by Dr. Nupoor Acharya

Education:

DM

Professional Bio:

Dr. Nupoor Acharya is a skilled Rheumatologist. She specializes in diagnosing and managing autoimmune and musculoskeletal disorders such as rheumatoid arthritis, lupus, vasculitis, and gout. With her expertise in clinical evaluation and advanced therapies, she focuses on improving patients’ joint function, pain management, and overall quality of life.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

The symptoms you are describing are suggesting a connective tissue disease, most likely primary Sjogren's syndrome. It is an autoimmune disease that presents with dryness of the eyes, mouth, dental caries, fatigue, mild to severe joint pains, body aches, and sometimes neuropathy. However, the possibility of other connective tissue diseases cannot be ruled out without further tests. Do you have any other symptoms like photosensitivity, oral ulcers, rashes anywhere, Raynaud's, any muscle weakness, tingling, or numbness of limbs? Some tests that you need to get done are ENA profile (qualitative), C3, C4, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), CBC (complete blood count), LFT (liver function test), KFT (kidney function test), urine analysis. Once you get the above test reports, a final diagnosis can be made, and treatment will be started accordingly. For now, you should start Hydroxychloroquine at 400 mg once at night.

Thank you.

Patient's Query

Hello doctor,

I have photosensitivity and a rash on my leg and the abdomen, and muscle weakness. My CRP is slightly elevated. Does ENA help to diagnose lupus?

Answered by Dr. Nupoor Acharya

Education:

DM

Professional Bio:

Dr. Nupoor Acharya is a skilled Rheumatologist. She specializes in diagnosing and managing autoimmune and musculoskeletal disorders such as rheumatoid arthritis, lupus, vasculitis, and gout. With her expertise in clinical evaluation and advanced therapies, she focuses on improving patients’ joint function, pain management, and overall quality of life.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome back to icliniq.com.

Yes, ENA (extractable nuclear antigen) will help make the diagnosis, and so will the rest of the tests that I advised, like C3, C4, and DCT. Photosensitivity is also seen in Sjogren's syndrome sometimes, as well as mixed connective tissue disease. ENA will help us to determine the type of CTD. Treatment will be similar, with some changes according to your symptoms. Lupus is certainly a possibility that needs to be ruled out.

Medically reviewed by Dr. Vinodhini J.
Published At January 24, 2021
Reviewed At December 4, 2025

Education:

DM

Professional Bio:

Dr. Nupoor Acharya is a skilled Rheumatologist. She specializes in diagnosing and managing autoimmune and musculoskeletal disorders such as rheumatoid arthritis, lupus, vasculitis, and gout. With her expertise in clinical evaluation and advanced therapies, she focuses on improving patients’ joint function, pain management, and overall quality of life.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Vinodhini J. is a Dental Surgeon with extensive years of clinical experience. She specializes in the diagnosis, prevention, and treatment of dental and oral health issues, including restorative, surgical, and cosmetic procedures. With a patient-centered approach, she focuses on maintaining oral health, alleviating discomfort, and enhancing smiles. Her expertise ensures comprehensive care tailored to each patient’s dental needs and overall wellbeing.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

DM

Professional Bio:

Dr. Nupoor Acharya is a skilled Rheumatologist. She specializes in diagnosing and managing autoimmune and musculoskeletal disorders such as rheumatoid arthritis, lupus, vasculitis, and gout. With her expertise in clinical evaluation and advanced therapies, she focuses on improving patients’ joint function, pain management, and overall quality of life.

This doctor is not available for online consultations on the platform anymore.

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