Q: I am a 34 years old female suffering from a vague kind of muscle pain in my left knee and at one point at the lumbosacral joint from the last 3 years. For a few months I have developed pain in my right shoulder extending to my arm. Recently I have developed some numbness in my right hand as well but there is no loss of sensation. The changes of cervical spine in X-ray report showed spiking, which the doctor labelled as early cervical spondylosis but told that they were consistent with my age. I have mild scoliosis as well. I have started taking Neurobion and am exercising as well. Will this pain be relieved? Can the nerve compression cease?

A:The description of pain that you have given in the knee and shoulder is not adequate to make the diagnosis. At your age X-ray cervical spine may show some spiking but that does not mean that, that is the cause of your symptom. Cervical spondylosis is a diagnosis of exclusion. When we see symptoms like yours especially with numbness and radiating pain, we do think of other causes also. Cervical disc is more common among the younger patients. However, your description again did not seem to fit in the severe radicular pain that cervical disc patients have. You have also not mentioned whether which part of your hand is numb or is it the whole arm? How many fingers are affected? Is the numbness restricted to the little finger and the ring finger or is it on the thumb index and middle finger? Being a doctor you would understand the implication for the nerve involvement is different in these cases.

The knee pain that you refer to is also common in your age group especially in the women in the 30-35 years age group. The knee cap under surface cartilage shows early degenerative changes. This is different from the age related osteoarthrosis. There are different theories on the causation of chondro-malacia patella. However, with some precautions and exercises it can be self limiting.

Occasionally symptoms of aches and pains – knee, shoulder, back may be a symptom of systemic problem, quite often hypothyroid problem.

All in all you need to be seen by a good internist or a good orthopaedic surgeon who can put everything together and make a diagnosis with careful clinical correlation and relevant investigations.