My patient is 54 years old and is having seronegative ra for past ten years.now only on symptomatic treatment.not a dm or ht.she complains of severe bodypain whenever she travels for about 100 -200 kms.she says having pain in each and every fibre of the body and feels very much exhausted for about three days and try to manage with tramadol and paracetamol as she is having reflux  esophagitis. This complain is only for past three years and previously she was alright....