General Tiredness Knee & Shoulder Pain

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Thought I had asked the question below...

Sorry I missed your earlier post..

Unfortunately I have been back on Warfarin since December 13th. I needed to have a colonoscopy and either dehydration caused by the laxative or else the sedative used caused my heart rate and BP to drop alarmingly. A consequence of that was that my AF started again actually worse than originally. I need to be on warfarin for 8/9 weeks before they will do a cardioversion.

My joint pain in weight bearing joints is already back again but I don't get your other symptoms. As we are have had valve replacements the new anticoagulant drugs are contra indicated for us. There is an older drug called Sinthrome (Acenocoumarol) that has been suggested to me that may have lesser side effects but will probably turn my urine orange:-) I will ask my GP about it. The practice nurse and a locum had not heard of it. Coldness seems to be the most common side effect. One person I know wears an overcoat all year.

on warfarin since August 2013 due to blood clot in the head (sinus venus thrombosis). I am going through severe shoulder, arm and finger pain and stiffness through one hip. doctors don't connect it to warfarin although my drug fact sheets did warn of joint pain.

glad to know there are other people out there having joint pain and maybe it is related to drug. going off it is not an option for me at this time.

yes I do get very cold feet, even though the rest of me will be warm, have noticed extra hair loss but am not tired at all. in fact lucky if I sleep two hours in a night some of that due to the shoulder joint pain.

am trying acupuncture right now for shoulder while waiting for physiotherapy. it's not making it worse but is still a major concern. they are treating as frozen shoulder, I am now going to go back to neurologist and haemotologist with regards to side effect possibly from the warfarin.

I am a 58 professor at the Federal University of Rio de Janeiro and had a PE after a DVT in my left femural vein last Sept 30, 2013. Everything started one year before with a symetrical plantar pain in the feet, then achieving both calves, and a permanent state of mental fatigue. Earlier 2013 i had also had thrombophlebytis in my right arm. From Oct on i am suffering from joint aches in shoulders and hips that i had not before starting on Warfarin.

I had several appointments with medical doctors from my University Hospital: haematologists, rheumatologists, neurologist, pneumologist, however no one is providing a scientific dialogue among especiallists. I did a number of TC, PET, MRI and lots of blood exams; no explanation so far. Doctors deny my allegations about the possible side effect of warfarin on the joints. It is good to see many reports on the subject from colleagues in this forum. I am considering substituting Xarelto for Warfaring, as is the current trend for DVT patients. Does anyone had such an experience?

Most medics do not want to admit to warfarin side effects. When I recently went back into AF I saw an out of hours doctor at the local hospital. I expressed disappointment at needing to go back on warfarin as during the year I had previously been on it I had pain in all of my weight bearing joints. He Suggested that Sinthrome (Acenocoumarl) might not have that effect.

When I mentioned it to a locum at our practice she had never heard of it and prescribed warfarin that again started up joint pain within two weeks.

Last week when seeing a cardiology registrar at the hospital I again asked about it and was asked if it was new. I told her it was as old as Warfarin. She had not heard of it.

As I had an aortic valve replacement the new anti coagulants are contra indicated for me.

Marcos, being in the medical profession you are better placed than we are to find the reasons for joint pain. I read that it can be caused by bleeding between the joints. When I put this to my GP he said that if bleeding occurred it would be on a massive scale causing swelling and a medical emergency.

I was not really convinced by that statement.

Thank you, Derek. Actually i am not a doctor, but rather a professor on hospital mngmt. I appreciate your comments on haemathological causes for joint aches related to anticoagulants. I am about to perform X-ray and ultrasound exams of my shoulders, trying to estimate the extension of the damage.

As to the recurrent episodes of thrombosis, i pursue four main causal areas: oncological, autoimmune, neuropathic and genetic disorders. There is no close diagnosis for any of them.

Looking for connections between haemathological and neurological disordes, I've heard from my neurologist that clots formed in tiny blood vessels that suply nerves could cause neuropathies.

It is hard to devise which imbalance - clotting or bleeding - harms the joints.

Moreover a number of autoimmune diseases can cause recurrent thrombosis and induce joint injury as well.

My rheumathologist prescribed a low dose of a drug based on quinine to investigate the presence of some autoimmunes. Still remains to clarify the synchronic events of thrombosis/anticoagulation and joint aches, however the former triggered a complete chaos im many of my blood exams, so the doctors says to dismiss these results.

Dear Derek and colleagues, i moved from Warfarin to rivaroxaban ten days ago. Still have extensive body pain, bilateral legs and arms, as well as joint pain in shoulders, knees etc. i will keep making monthly blood exams and scans each four months (TCs and MRIs) to monitor and try to catch any malignancy in its beginning. I am also licensed from my job at the University, since i can't stand for more than half an hour without increasing leg pain from DVT and despite compression socks, which i use for a daily forty minutes walking.

Hi i have been taking warfarin for over 8 to 10 years now and i am on 13-14mg a day . I'am 53 year old and have been getting joint pain in my fingers and knees,back,ankles and my hips and its been getting wors.I have been tested for arthritis and the test came back negative so the Dr pout it down to wear and tear?.

Now have to take co-codamol and Tramadol.

A doctor suggested that I change to Sinthrome (Acenocoumarol) I asked a locum at our practice and she had not heard of it. I asked a cardiology registrar at the hospital and she had never heard of it.

It has evidently been around for a long time and is very similar to warfarin but just might not affect us in the same way. I forgot to ask my GP about it but will next time I see him.

There are three new and expensive alternatives that do not require you to have frequent tests for your INR.

Cardiologist was willing to prescribe them to me but then found that they are contra indicated for patients who have had aortic valve replacements.

Dabigatran etexilate, rivaroxaban and apixaban are relatively newer oral anticoagulants. Dabigatran etexilate is a direct thrombin inhibitor, whilst rivaroxaban and apixaban inhibit activated factor Xa.

Dabigatran etexilate, rivaroxaban and apixaban do not require monitoring of the INR.

Found this on the web

Along with its needed effects, warfarin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking warfarin:

Less common

Abdominal or stomach pain with cramping

bleeding gums

blood in the urine

bloody stools

blurred vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain or discomfort

confusion

coughing up blood

difficulty with breathing or swallowing

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

excessive bruising

headache

increased menstrual flow or vaginal bleeding

nosebleeds

paralysis

peeling of the skin

prolonged bleeding from cuts

red or black, tarry stools

red or dark brown urine

shortness of breath

sweating

unexplained swelling

unusual tiredness or weakness

Rare

Arm, back, or jaw pain

blue-green to black skin discoloration

blue or purple toes

change in consciousness

chest tightness or heaviness

chills

clay-colored stools

diarrhea

dizziness

fainting or loss of consciousness

fast or irregular breathing

fast or irregular heartbeat

fever

itching

light-colored stools

loss of appetite

nausea and vomiting

pain in the toes

pain, redness, or sloughing of the skin

pale skin

skin blisters

skin rash

small red or purple spots on the skin

stomach pain

swelling of the eyes or eyelids

tightness in the chest or wheezing

troubled breathing with exertion

unpleasant breath odor

unusual bleeding or bruising

upper right abdominal or stomach pain

vomiting of blood

yellow eyes and skin

Incidence not known

Painful or prolonged erection of the penis

Some side effects of warfarin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Joint pain

muscle pain

Rare

Bloated

change in taste, or bad, unusual, or unpleasant (after) taste

cold intolerance

excess air or gas in the stomach or intestines

full feeling

general feeling of discomfort or illness

hair loss or thinning of the hair

hives or welts

lack or loss of strength

pain

passing gas

red, sore, or itching skin

sores, welting, or blisters

unusual drowsiness, dullness, or feeling of sluggishness

Re Pain in the toes as a side effect. It is happening to me. The first four toes on my left foot have had what I'm told is shortening tendon problem for some years and I cannot move them individually only as a group. They were slightly clawed. Since staring warfarin again on December 13th they have really bunched up and the joint on the big toe has stiffened into a bent position, is painful and the joint now rubs on my shoe. The area under the first four toes feels hot and stingy but no visible sing of athletes foot. The big toe on the other foot is also painful but at least has not turned blue:-) I read that a side effect of Losartan is that toe nails can fall out.Speaking to an orthopaedic consultant and complaining about joint pain from warfarin he commented that practically any drug can cause it.

I last had an NHS podiatry appointment on December 19th and certainly did not need have the problem then. I'll phone to try to get another appointment for their opinion.

For the past three days I have had a yellowing over a wide area on the outside of my knee, as well as the joint being painful it is numb to the touch. I have not had a fall or knowingly knocked it.