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

### input:
So to make this short and quick Im a 33 year old male who has been disabled by a loosely or undiagnosed condition, as I see it, including symptoms ranging from chronic neck pain, eye pain, muscle spasms, body wide muscle tension, neurologic abnormalities, cervical radiculopathy, fatigue, pain in lower back/coccyx, low testosterone, low vitamin D, osteophytes mainly in my cervical spine/lumbar spine, mild stenosis in cervical, many different blood work abnormalities(IGG IBB.... antibody, ACE high, low RBC, high rheum factor, etc. Ive been seeing my pain management dr. for about 1 1/2 years+ who is a nurse practitioner. She seems to know less about pain management than I have accumulated throughout my 3 years of debilitating pain, and treats me like Im a statistic. Ive never violated my pain contract in anyway and have passed all of my drug tests. Ive also given her permission to talk to my family, friends, girlfriend, doctors. Anyways, my question is when is it time to seek the care of a new pain doctor. Ive gotten every procedure that theyve suggested, continue to see a slew of dr.s trying to get a confirmed dx so that I can work at the core of the problem and not just the symptoms. I realize I forgot to mention my problem with her care. She has me on 75mcg fentanyl patch, which has been the only long acting medication that even keeps me moderately functional though she refuses to prescribe a short acting med for breakthrough pain. Shes been putting me on a wild goose chase where she tells me to do something like see a pain psychologist then tells me not to, then told me to see him again last week. I feel that my pain is the primary symptom that is keeping me from finishing my bachelors and being a more functional person. I dont want to be on opiates all my life but I believe that keeping me as functional as possible until I find out what is causing all of this is a lot better than not. Ive tried physical therapy, yoga, meditation, ice packs, heat, hot baths w/ magnesium, distraction, etc. and nothing else seems to help. My PCP, psychiatrist, and family all believe its a logical idea but she does not. There is a Dr. in charge of the pain center and the last ditch effort is to ask him to intervene but Im afraid of getting nowhere and if I have to find a new Dr. I know that many are reluctant to take on patients whove seen pain doctors in the past. I hope you may help steer me in the right direction. Thanks in advance. Sincerely,Matthew Olsen

### output:

Hi Dear Mathew welcome to ChatDoctoryour concern regarding your health is normal, and you have got degenerative changes in your bones very early due to inflammation of joints and synovial membrane, I will advise you to visit again your orthopedic Doctor and ask him for further investigation like CRP, ANA, and HLAB27there are some immunomodulator which can retard the progress of ailment and some time reverse it, for pain management you can try Chat Doctor. 