My mother-in-law has early stages of dementia. She has several ailments. She complains of pain, no cause found. Could it be the dementia?

Is it possible that her pain is muscular? If she sits for long periods she may be stiff and sore from not moving.

My aunt had once been an army nurse, and could be stoic, so when she complained of pain, I paid attention.  Unfortunately, she was no longer able to tell me where it hurt.  After one of her falls she said her Coccyx had pain, and she had struggled to get the word.  Well, it was xrayed and nothing wrong.  After 2 days observation and being sent home, she kept complaining and couldn't get herself upright.  Another ER trip and the nurse found a raised area mid-way up her back, which had not been x-rayed.  Turned out to be combination hairline fracture in spine and muscle pain all around it also.  With dementia it was hard to know where the pain really was, but it was real.

Hi She could have some arthritic joints. Have you tried some pain relievers? My Mom had some knee  and lower back pain and some Tylenol Arthritic would usually do the trick.

I do know that she is way more sensory sensitive now, and anything wet cold or hot will make her shriek as if in horrible pain!

I have been administering cannabis edibles to my wife since 2013. She has bvFTD Dementia, late stage and cannot communicate.

We were never users of anything, including alcohol. We rarely even used over the counter medicines. We do not like to mask symptoms and we do not like being high or buzzed. Our children are the same.
In administering the cannabis to Christy, I have accidentally ingested her medicine.
I hated when that feeling came over me, the high that some people seek.

I have enjoyed good health all my life, rarely any hurts.
Then last year, I suddenly ended up in the hospital for five months with pancreatitis and other complications.
I became acquainted with Morphine Fentanyl Oxydodone. Hated opioids. I hated the muscle weakness and the mental fog.
I discovered that nothing stop extreme pain. Medicines only lessen it, temporarily.
The only true relief came when I was put out for procedures,

I now have chronic pain from my shoulders to my fingers.
Recovering at home I had oxycodone 5 mg.

Since I now require medication, I can better understand Christy's need for relief.
I started taking the same cannabis dose when I administer it to her.
It has been interesting to experience the calming and warming at the same time as she does.
I now understand how it settles the chaos of the dementia and the general pain relief in the body.
I had always felt guilty giving Christy a medication that she probably would not have taken in her previous life, but I know now that it is right for her.

It is interesting that the RSO provides exactly the same relief as the oxy.

I learned about Percocet while in the hospital. Percocet is a combination of oxycodone and acetaminophen and it’s one of the strongest prescription pain medicines for the treatment of as-needed relief.
Percocet was the only medicine that offered total relief, but for a very short time and the doctors were reluctant to use it.
https://www.therecoveryvillage.com/oxycodone-addiction/oxycodone-vs-percocet/#gref

RSO and Tylenol offer the same relief as Percocet when the pain is severe, without the concern of addiction.
Otherwise RSO alone offers all day relief of the dementia chaos and general physical discomforts.

I would be more concerned about the pain pills than the cannabis. They r addictive. Be careful

Make sure her doctors do complete blood tests. Many sources of pain can be exposed and this is nominally invasive.

I read that often signs of depression will manifest in the form of pain for the elderly. They don’t think “I’m sad, I’m depressed”. Often the older generation is not accustomed to thinking about depression - they have always just trudged on. My father in law was this way after his wife passed. We had the doctor speak with him about this and she ended up placing him on an anti depressant. I believe it also aids w appetite, which is often a struggle as we age. Need to eat but don’t feel the desire or need. Best to you. I hope you have an excellent doctor that will speak with your mom and determine if this is the case.

I'd have thought, as a lay person, that there are zillions of causes of hip and knee pain that don't show up on imaging, before you go straight to dementia.

How mobile is she? And what are the main ailments? And what are the main medications?

Any other joints or just the hips and knees? Both sides, about the same? Does anything make it more comfortable?

What species of doctor has ordered these tests, by the way?

They did xrays and CAT scans and didn't find arthritis? How old is your MIL?

There is a certain amount of wear and tear that occurs in knees and hips over time. Nothing that needs surgery or intervention beyond otc pain relief, but the pain is real!

What is she taking for the pain? Is it helping?

I don't know any people past 70 or so that don't have aches and pains, mostly arthritis. In some cultures, old people just got on ice floes and disappeared because they were no longer useful. Now they are useful because they provide employment opportunities to younger people who serve as caregivers.

Polymyalgia is a possibility for the pain she is experiencing.  Just a thought!  My mother had that diagnosed and she had dementia.

It's possible that it's dementia related. The fact that you do know - It's real to her! My mother is in assisted living. With advancing dementia, she still has very good health except for her feet, which has been an issue for years before. She mainly focuses on her index finger of left hand, mild arthritis. We gently take her hand, look at it intently as she tries telling & showing us, acknowledge it and mention to her that we'll tell the doctor again at her next appointment. Then she moves on and not mention it again for a while. Anything anywhere she mentions pain or problems we acknowledge it in this manner, then redirect.

If your mother is 76 and has early dementia, I'd likely get the medical tests, which it sounds like you have done and then treat her pain as best as possible. Because, if she's feeling it, it exist for her, even if there is no actual cause that can be found. I'd find a geriatric doctor to help or a pain specialists. There are pain medications that are not opiods, which might be too sedating.

Have you gotten a second opinion? I know that I have gone to my primary doctor, who is super sharp, a couple of times with back pain and once hip pain. He took no x-rays, but, based on my symptoms, recommended at home stretches, along with anti-inflammatory meds HELPED so much and the pain went away in a couple of days! So, maybe, you need the right doctor to really figure it out. Could this be nerves, muscles, etc.

And, if it's a delusion, it's still real pain to her and I'd try my best to figure out how to have it treated.

If nothing is found wrong after all of the testing, try giving your Mother 2 Tylenol once a day to see if that helps. Let her think it is a prescription from the Doctor. Maybe bump it up to 2 tablets twice a day (that is still well within the range of advised dosages). The power of suggestion is a powerful thing. If she knows the “medicine” is from her Doctor, it might relieve her pain.

Just because testing hasn't picked anything up doesn't mean that the pain doesn't exist. I would never assume it isn't real. I would take a holistic approach and look at her habits. Does her favorite chair need replacing, mattress flipped, switch sides of the bed for getting in and out of? Is she sitting for long periods of time? Can she receive physical therapy to strengthen muscles or provide deep tissue relief? Sometimes, some simple changes can make a big difference...by trying one thing at a time, she will know that you believe her, possibly lowering any feelings of frustration.

It might be arthritis.

I am a Power of Attorney to someone who constantly complained of pain but after endless testing and examinations, it was determined she is mentally ill and is now in a mental area of the nursing home. She is as healthy as a horse. It is most likely the dementia kicking in.