A unified approach is presented for investigating coupled spin-orbital fluctuations within a realistic three-orbital model for strongly spin-orbit coupled systems with electron fillings $n=3,4,5$ in the $t_{2g}$ sector of $d_{yz},d_{xz},d_{xy}$ orbitals. A generalized fluctuation propagator is constructed which is consistent with the generalized self-consistent Hartree-Fock approximation where all Coulomb interaction contributions involving orbital diagonal and off-diagonal spin and charge condensates are included. Besides the low-energy magnon, intermediate-energy orbiton and spin-orbiton, and high-energy spin-orbit exciton modes, the generalized spectral function also shows other high-energy excitations such as the Hunds coupling induced gapped magnon modes. We relate the characteristic features of the coupled spin-orbital excitations to the complex magnetic behavior resulting from the interplay between electronic bands, spin-orbit coupling, Coulomb interactions, and structural distortion effects, as realized in the compounds $rm NaOsO_3$, $rm Ca_2RuO_4$, and $rm Sr_2IrO_4$.