How to manage tremors with pain in legs and arms?

Question

Hi doctor,

I am a 45-year-old female. I was treated with intravenous Cortisone injection therapy for a week for having acute demyelinating symptoms for almost two months that appeared together with a new lesion in the cerebellum area of my brain. There had been three others, supposedly migraine type. Lumbar showed oligoclonal zones both in the blood and spinal cord. My problem is that since then, and even if the cerebellum lesion has disappeared, I still experience symptoms not as acute as they had been during the episode, but quite annoying, disturbing my everyday life.

I have pain in my left arm and joints, left leg, and joints of both legs. I also have back pain and tremor, but not always. I get tired very easily. But tired does not mean tired. It means that I start having problems with my balance in the left leg, tingling, eyesight problems, cannot cope with too much noise, arguments and fights with family get me worse. Nobody understands that there is something going on. The last neurologist I saw said that it is a matter of stress, so he suggested that I consult a psychiatrist. My psychiatrist says stress does not cause this sort of pain, as I have been receiving depression treatment for seven years. Do you have any idea? How might I proceed?

Kindly guide.

Answer 1

Hello,

Welcome to icliniq.com.

I read your question carefully and would explain that your symptoms could be related to chronic lesions of multiple sclerosis (MS) (sometimes there is no total improvement after steroid therapy). Anyway, I would recommend starting Gabapentin for chronic pain or switching from Zoloft to Duloxetine, which is better for chronic pain. I would also recommend performing a new brain and spine MRI (magnetic resonance imaging) in order to exclude possible new lesions. It is also necessary to check thyroid hormone levels for possible hormonal imbalance and vitamin D plasma levels for possible deficiency.

I hope this helps.

Thank you.