Dear Dr. Gott: I am having aches and pains throughout my body. My family doctor did blood tests but says I show no signs of arthritis.

He recommended I see an internist, but when I saw him, he only told me to take Tramadol (which I already take for my Restless Legs Syndrome) and Tylenol.

When I said I didn't want to treat the pain without knowing why I had it, he told me I should see someone else. I am frustrated.

I am an 80-year-old woman but feel ancient because of the pain. How do I go about finding out what is wrong with me?

Reply: You have already taken the appropriate first steps by seeing your family physician and having blood work done.

I believe your doctor appropriately referred you to an internist, who specialises in diagnosing. In your case, however, the internist dropped the ball by refusing to determine the cause of your pain.

It is difficult to treat any condition without first knowing what it is. You were correct to decline treatment until the cause is known. From here, you have several options. You can find another internist or an arthritis specialist, who can examine and test you. Get a referral to a gerontologist, who specialises in medical conditions of the elderly, or be referred to a pain clinic

Your first step is to see a gerontologist. Physicians in this category are familiar with what ails the older generation. He or she can examine and test you for common age-related disorders, such as osteoarthritis and other health problems that can cause pain.

A determination can also be made at that time regarding your RLS and whether it has any connection to the pain you experience. If your RLS isn't under good control, a remedy as simple as magnesium, calcium and Hawthorne berry might bring needed relief.

Perhaps gentle physical therapy at your local hospital or rehabilitation centre will be recommended. In any event, once the cause of your pain has been determined, your doctor can provide appropriate treatment.

You may also wish to try another internist, who will most likely provide the same care as the gerontologist but may not be as familiar with disorders and conditions of the elderly.

If this is your choice, speak with an older friend or neighbour for a recommendation of someone in your area.

A pain clinic has many different specialists who work with patients to determine the cause and best course of treatment for pain.

Some clinics include neurologists, orthopaedists, anaesthesiologists, physical therapists, psychologists and more.

Most pain clinics provide pain medication and narcotics only as a last resort and rely on physical therapy and alternative treatments, such as acupressure or acupuncture, massage and others.

Regardless of the route you choose, you need a diagnosis first. Let me know what happens.

To give you related information, I am sending you copies of my Health Reports "Managing Chronic Pain" and "Dr. Gott's Compelling Home Remedies".

Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, Ohio 44092. Be sure to mention the title.

Dr. Gott is a retired physician and the author of 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook'. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.