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Swelling, pain in fingers at night, knee joint pain. Cure for pain?

Dear doctor, my wife have major pain and swelling in her fingers at night and until early morning when she have to soak them in cold water to try to help with the swelling and then extremely hot water to loosen the joints by blood flow . she is also experiencing very bad knee joint pain and especially at night. During the day she feels very difficult to get up, the swelling will stays for like 2 days, pls advise waiting for your replay thank you
Asked On : Thu, 27 Dec 2012
Answers:  3 Views:  184
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Orthopaedic Surgeon, Joint Replacement 's  Response
Feb 2014
Thanks for writing to us.

Your wife is suffering from polyarthitis, the cause of this might be Rheumatoid arthritis (RA), systemic lupus erythematosus (lupus), psoriatic arthritis, osteoarthritis (OA), Infectious arthritis or crystal deposition arthritis.

To allow me to help you better, please let me know if she also has any of the following complaints:

Pain and stiffness that last for more than an hour upon arising
Bilateral symmetrical involvement of hands and feet joints
Hand joints and feet joints that are warm and tender to touch
History of viral illness like chikungunya.
Flu-like feeling
Finger and toe joints that "creak" when moved; this is called crepitus
Deformities in finger and toe joints
Fatigue that is not easily resolved
Presence of malar rash and photosensitivity
Presence of raised patches or lesions of dead skin cells (psoriosis).

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.

Wishing you good health...
Dr Saurabh Gupta
Answered: Thu, 27 Dec 2012
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General & Family Physician Dr. Nsah Bernard's  Response
Dec 2012

Thanks for posting in this forum
I would have loved you to mention your wife's age and the onset of symptoms ( how long she has been having the crisis). Non the less, i will throw more light into the issue.
She is suffering from arthritis which could be infectious/septic ( caused by immune consequence of the infection but not directly attributable to the infection.) or non-infectious ( gout, autoimmune diseases such as rheumatoid arthritis, SLE etc ) The septic arthritis usually affects one joint but can affect several close joints or even distant joints. most often, bacteria are the causative agents but can also be affected by viral, fungal, mycobacterial pathogens etc. The non-septic/ polyarthritis is when there is no germs that is responsible for the affection and usually affects many joints like in your case. This affection usually affects mostly aged people but can occur in any age group.
To be able to determine the specific cause of your wife's condition some specific laboratory and imagery exams need to be done. After seeing your doctor or a rheumatologist ( specialist in rheumatic diseases), the following investigations needs to be conducted
- Complete blood count
- Antistreptolysin O (ASLO) dosages
- Rheumatoid factor dosages
- Uric acid dosages
- Erythrocyte sedimentation rate ( ESR)
- C-reactive protein (CRP)
- X-ray of the affected joints
- CT scan or MRI of the affected areas
Other very specific test could be conducted depended on your doctor or the specialist and your clinical presentation and history.
For now, you will need to be placed on steroidal antinflammatory or non-steroidal antiinflammatory to manage the pain and reduce the inflammation while the cause is being investigated and subsequently treated.
Besides that, you will need to rush your wife to the hospital any irreversible changes to occur on her soft and bone tissues as this usually results as complication of arthritis.
As another differential we could think of polyarthrosis which is due to no underlying cause but usually noticed in obesity, aged people, intense physical activities etc. This can also be managed just with pain killers.

Hope this helps and w
Answered: Thu, 27 Dec 2012
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General & Family Physician Dr. Himanshu Pandey's  Response
Hi unni ! Hmmm! Along with these symptoms did she complain that pain moving in her body. If yes ! She has a symptom of rheumatoid arthritis. Need RH factor to be check for diagnose. Now at present if she has pain take pain killer like ibuprofen and diclofenac , soak finger in warm water with added salt to relieve pain. It is autoimmune disease. So the treatment is different consult with the physician with diagnostic test it sure help. Take care. Bye.
Answered: Fri, 28 Dec 2012
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