### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi there. My name is Toni and I was wondering if a referral to a rheumatologist would be the best thing for me. I take Cymbalta for unknown nerve pain causes in hands arms legs feet, back and neck pain, and I would say tendon problems. also depression which I think was cause from the pain being untreated and facing the unknown future of my heath. after about 6 weeks of being on this I started to mostly feel like my self again so I start doing more housework like I used to be able to do over 5 months ago. little to be known I star having hip and shoulder pain and I would say is a 4 or 5 on the pain scale. I was told by one doctor I have RLS and was put on 50mg ?tramazone? for this originally. then had to be uped to 100mg because it was not affective. new doctor says that not even what that is for and now I have recently just started on Requip for that. my vitamin d level was 15.8 a few months ago and the norm is about 30 from what I hear so I take 5000 iu a day for that. I have only had blood test done. Also emg came back great. although no x-rays no cat scans, no MRI have been done. I don t know what all auto immune disorders I have been tested for but those came back fine. normal blood work ok along with vitamin d, Iron test are in the process. I m pretty frustrated at this point and really want some answers. my new doctor is really nice and seems to care. I just feel its time to see a specialist and want to know what you think about that, what kind of specialist, how to approach my doctor with this? Please help :-(

### output:

Hi, from what you have said it appears that you have tried at least 3 different medicines (Cymbal ta, Trazodone and Equip) but still have pain in multiple joints. Normal tests are reassuring. The one thing I did not see in there was physical therapy- if you have not done that I would recommend discussing with your primary doctor about that. It's also possible that you may have an underlying depression contributing to your symptoms (since they improved witChatDoctorbalta, an antidepressant). So, it might be worth discussing with your doctor about behavioral therapy or seeing a psychiatrist to determine if depression is contributing to your physical symptoms. Pool therapy (swimming/water exercises) are often very helpful too. I do not feel strongly about seeing a specialist, I would suggest discussing your frustrations with your primary doctor and the things I discussed above and work with him/her. But if you feel your concerns are not being ad Chat Doctor. 