Sir can sudden unbearable pain leads to unconsciousness. When ever patient have sudden chronic pain start from low back ,sometime start from knee around and sometime from ankle around he cry loudly for 1-2 minute and become unconscious. Then we give nsaid, the pain reduced and he regained consciousness. Pain accompanied by headache .walking instability/imbalance. DM and hnt managed. Psoriasis skin conditions is worst in April/may month. But now it Look good. Lab /non lab test- ecg and echo is normal. Rf, uric acid and anticcp is normal. Mild anemia, low vitamin D.Crp and ESR is positive .ESR is 125.