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Do Intermittent Joint Pain, Stiffness And Tingling In Hands Suggest Rheumatoid Arthritis?
Question: I have had intermittent joint pain. I has been always one of the knees, the heels, the lower back or the right elbow. The acute pain would come, stay one to two day and then just disappear completely. This has happened around twice a year during the last 8 years.
Now and since beginning of April I have permanent joint pain, stiffness in the fingers and tingling. Specially my hand and finger joints hurt and I feel tingling in my hands and arms. When I sleep more than 6 hours my hands will hurt and be very stiff for around 20 mins.
I also feel pain during the day in other parts of my body like in the knees (sometimes very intense in both knees) and the right elbow. Also my toes hurt. It is a burning and stinging pain that gets worse in the afternoon and evening. I'm also feeling tired and have problems to concentrate at work, in part because of the pain.
My grand-mother had arthritis in her knees and my aunt rheumatoid arthritis (both on my mother side). My father had anchylosing spondylitis. He passed away recently and I had severe stress because of that and some other things.
I have been to the rheumatologist twice so far and this is what I know:
- deficiency of vitamin D -> I have been taking vit. D tablets for 6 weeks now and the value is getting higher (from 14 to 35 ug/l)
- X-Ray showed nothing abnormal
- Low lymphocyte count (it went from 2 to 1.4 g/l in 3 months)
- Rheumatoid factor and anti-ccp both normal
- ESR and CRP with borderline values. Both values have increased over the last three months
- Both Cholesterol types slightly elevated
I have an appointment with the rheumatologist next week and I'm planning to ask for MRI of my hands and of my spine as well as for new blood tests.
My questions are:
- does it sound like rheumatoid arthritis?
- what else should I ask for during my appointment?
- what other conditions can cause these symptoms?
Thank you in advance for your answer.
Now and since beginning of April I have permanent joint pain, stiffness in the fingers and tingling. Specially my hand and finger joints hurt and I feel tingling in my hands and arms. When I sleep more than 6 hours my hands will hurt and be very stiff for around 20 mins.
I also feel pain during the day in other parts of my body like in the knees (sometimes very intense in both knees) and the right elbow. Also my toes hurt. It is a burning and stinging pain that gets worse in the afternoon and evening. I'm also feeling tired and have problems to concentrate at work, in part because of the pain.
My grand-mother had arthritis in her knees and my aunt rheumatoid arthritis (both on my mother side). My father had anchylosing spondylitis. He passed away recently and I had severe stress because of that and some other things.
I have been to the rheumatologist twice so far and this is what I know:
- deficiency of vitamin D -> I have been taking vit. D tablets for 6 weeks now and the value is getting higher (from 14 to 35 ug/l)
- X-Ray showed nothing abnormal
- Low lymphocyte count (it went from 2 to 1.4 g/l in 3 months)
- Rheumatoid factor and anti-ccp both normal
- ESR and CRP with borderline values. Both values have increased over the last three months
- Both Cholesterol types slightly elevated
I have an appointment with the rheumatologist next week and I'm planning to ask for MRI of my hands and of my spine as well as for new blood tests.
My questions are:
- does it sound like rheumatoid arthritis?
- what else should I ask for during my appointment?
- what other conditions can cause these symptoms?
Thank you in advance for your answer.
Brief Answer:
Likely to be rheumatoid arthritis.
Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through your detailed history. The symptoms that you have are likely to be due to rheumatoid arthritis. It is not necessary to have a positive RA factor for the diagnosis.
Other causes can be gout, inflammatory diseases like SLE, bursitis, fibromyalgia, etc. For proper diagnosis, some of the blood tests are advisable like-
1. Serum calcium levels.
2. Serum Uric acid levels.
3. Serum Creatinine. The rheumatologist will do the needed investigations for proper diagnosis.
Arthritis requires expert care with various disease modifying drugs (Imunomodulators). You can start these drugs after discussing with your doctor.
I would like to give some diet tips which might be helpful to get rid of these pain. Often the elimination of certain foods such as the following will help greatly:
Dairy products, with the exception of plain yogurt with active culture
Citrus, with the exception of lemon and grapefruit
Alcohol
Meat including beef, pork, and lamb (other sources of protein such as chicken, fish and beans are less likely to promote inflammation)
Vegetable oils (continue using olive oil and the essential fatty acids flax seed, sesame, pumpkin, sunflower oils)
I would also like to give some advice to make the life better and to fight with these pains-
Do regular physiotherapy of joints.
Hot fomentation to decrease the joint stiffness
Hot bath of Epsom salts (magnesium sulphate)-Magnesium has both anti-inflammatory and anti- arthritic properties and it can be absorbed through the skin.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Likely to be rheumatoid arthritis.
Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through your detailed history. The symptoms that you have are likely to be due to rheumatoid arthritis. It is not necessary to have a positive RA factor for the diagnosis.
Other causes can be gout, inflammatory diseases like SLE, bursitis, fibromyalgia, etc. For proper diagnosis, some of the blood tests are advisable like-
1. Serum calcium levels.
2. Serum Uric acid levels.
3. Serum Creatinine. The rheumatologist will do the needed investigations for proper diagnosis.
Arthritis requires expert care with various disease modifying drugs (Imunomodulators). You can start these drugs after discussing with your doctor.
I would like to give some diet tips which might be helpful to get rid of these pain. Often the elimination of certain foods such as the following will help greatly:
Dairy products, with the exception of plain yogurt with active culture
Citrus, with the exception of lemon and grapefruit
Alcohol
Meat including beef, pork, and lamb (other sources of protein such as chicken, fish and beans are less likely to promote inflammation)
Vegetable oils (continue using olive oil and the essential fatty acids flax seed, sesame, pumpkin, sunflower oils)
I would also like to give some advice to make the life better and to fight with these pains-
Do regular physiotherapy of joints.
Hot fomentation to decrease the joint stiffness
Hot bath of Epsom salts (magnesium sulphate)-Magnesium has both anti-inflammatory and anti- arthritic properties and it can be absorbed through the skin.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My calcium and uric acid levels are ok. Creatinin was very high in a test 3 months ago but normal in a more recent test. I don't understand why.
- What type of imaging procedure works better for detecting synovitis caused by early RA: sonography or MRI?
- How long does it take for the first signs of synovitis or inflamation to be visible in i.e. MRI? I have the symptoms for 3.5 months now and I don't know if I should wait. I just don't want the doctor to find nothing and send me away with pain killers.
- Is there a way to delay the "real" start of the condition? I have have joint redness and constant but bearable pain and no swelling
- could you give me some more tips regarding what other tests should be ordered. I'm going to a young rheumatologist (waiting for an appointment with a more experienced one) and she may not know about specific tests or even other different conditions that mimic RA
- Can RA be the reason of my lymphozice level falling so quickly?
- ANA and HLA-B27 tests were also negative. Does it rule out Morbus Bechterew and Lupus?
Thank you for your answers!
- What type of imaging procedure works better for detecting synovitis caused by early RA: sonography or MRI?
- How long does it take for the first signs of synovitis or inflamation to be visible in i.e. MRI? I have the symptoms for 3.5 months now and I don't know if I should wait. I just don't want the doctor to find nothing and send me away with pain killers.
- Is there a way to delay the "real" start of the condition? I have have joint redness and constant but bearable pain and no swelling
- could you give me some more tips regarding what other tests should be ordered. I'm going to a young rheumatologist (waiting for an appointment with a more experienced one) and she may not know about specific tests or even other different conditions that mimic RA
- Can RA be the reason of my lymphozice level falling so quickly?
- ANA and HLA-B27 tests were also negative. Does it rule out Morbus Bechterew and Lupus?
Thank you for your answers!
Brief Answer:
MRI scan is better.
Detailed Answer:
Hello.
Thanks for writing again.
- MRI scan is better to detect the soft tissue changes and synovitis.
- The appearance of changes depends on the severity of the disease. These do wax and wane with the severity. The changes may not be visible on MRI for years in case it is a mild inflammation with minimal pain.
- Regular physiotherapy and epsom salt baths can retard the progression of the problem.
- It is not necessary that various tests will detect rheumatoid arthritis. It is diagnosed on clinical basis. MRI of the affected joints and CRP will help.
- Yes. It can cause a change in lymphocyte numbers.
- Even if ANA and HLA B-27 are negative, clinical examination plays an important role in ruling out these disorders.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
MRI scan is better.
Detailed Answer:
Hello.
Thanks for writing again.
- MRI scan is better to detect the soft tissue changes and synovitis.
- The appearance of changes depends on the severity of the disease. These do wax and wane with the severity. The changes may not be visible on MRI for years in case it is a mild inflammation with minimal pain.
- Regular physiotherapy and epsom salt baths can retard the progression of the problem.
- It is not necessary that various tests will detect rheumatoid arthritis. It is diagnosed on clinical basis. MRI of the affected joints and CRP will help.
- Yes. It can cause a change in lymphocyte numbers.
- Even if ANA and HLA B-27 are negative, clinical examination plays an important role in ruling out these disorders.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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