Question: I have been diagnosed with Sjogren's syndrome. I also have Type 1 diabetes and degenerative issues in my spine. At times I have severe pain on both sides from my hips down to my ankles. What could be causing the pain and what can I do about it?
Dr. Hibberd's answer:
Many patients with Sjogren's syndrome (an autoimmune disorder involving dry eyes and dry mouth) and Type 1 diabetes develop pains in their lower extremities related to neuropathy (a nerve disorder). In some cases, it may be due to myopathy (muscular disorder or inflammation) or a circulatory problem. These conditions can lead to a slew of joint, soft tissue, and bone disorders that may cause pain.
Certain disorders and syndromes are more common in different age groups, so you should be evaluated by physician to get to the bottom of your pain. Also, with degenerative issues in your spine, you may be experiencing referred pain from a spinal disorder such as spinal stenosis or a degenerative disc disorder. Both can cause painful nerve or spinal cord compression.
An ankle brachial index test, combined with a physical examination, will help your doctor evaluate your lower leg circulatory system. Sometimes an ultrasound can identify a vascular obstruction. Your doctor may also order a test for muscle enzyme elevations (such as CPK), screening tests for blood clots, or other blood tests. Once the cause of your pain is identified, then you are in the best position to evaluate treatment options available.
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