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Having inflammation on toe, pain and stiffness in back, diffuse problems with hips and pain in hips. Cause?

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Practicing since : 2008
Answered : 2366 Questions
Dear Dr,

I'm writing to you on behalf of my female friend. These past few years she has been suffering from several different kinds of problems.

In 2010, she started getting inflammations in her toe (possible bursitis) which now comes and goes about 4 times a year. She also started getting pain in her foot soles when walking.

In 2011 she stated experiencing pain and stiffnes in her lower back and started getting muscle inflammations near her shoulder blade whenever lifting her arms.

2012, difuse problems with her hips when walking.

2013. She got home after a 40 min walk experiencing pain in her right hip. The pain could be described as burning and the hip felt very stiff. She says that it feels like the pain is either coming from the muscles in the hip or the joint. Her hip is so stiff that it actually feels like one leg i shorter than the other. She has problems walking because of the pain.

What could be the root cause of all of this and what can be done about it?

Currently the biggest problem is the pain in the hip. We've tried etoricoxib, ibuprofen, paracetamol but nothing helps.

Posted Sun, 23 Jun 2013 in Lupus
Answered by Dr. Shruti Rijhwani 8 hours later
Hi !

Thank you for your query.

Well looking into your problems I think that either it can be an inflammatory back pain or can be an orthopaedic problem. But complaints of back and stiffness along with stiff hips points towards spondyloarthropathy.

She also has complaints of foot pain while walking which may be due to enthesitis and that inflammation in toes due to dactylitis accompanying this problem.

I advise you to immediately consult a rheumatologist for for above problem because physical evaluation of stiffness and movement of spine is very necessary for a diagnosis.

Routine blood tests like CBC, ESR, CRP, Platelet count for assessing disease activity are necessary. An X XXXXXXX Pelvis - AP view needs to be done. If necessary specialized tests like HLA B27 and MRI pelvis and spine may be necessary. Kindly do not delay and seek medical help at earliest. Taking anti inflammatory agents as you have mentioned will not be helpful alone as if diagnosis is established specialized medications for these problems needs to be started

Hope you are satisfied with the answer.

Wish you good health.

Take care.

Dr. Shruti
Above answer was peer-reviewed by
Follow-up: Having inflammation on toe, pain and stiffness in back, diffuse problems with hips and pain in hips. Cause? 14 hours later
Hi Dr,

Thank you for your answers.

I would like to clarify the back and hip pain. The back feels stiff but the pain could be described as aching and nerve pain. The hip is also stiff but the pain could be described as burning pain. Lying down on the hip causes pain. Given the clarification, would you still consider this to be spondyloarthropathy? If yes:

1. How is spondyloarthropathy treated?
2. What could be done from home? Should one rest or try to move even if moving is painful?

Answered by Dr. Shruti Rijhwani 11 hours later

Thanks for your query .

Well I told you earlier also that yes Spondyloarthropathy is a possibility but it needs physical evaluation for assessing the stiffness, range of movements, tenderness etc. at joints. Your symptoms are suggestive of the disease but nothing can be said with surety until you are evaluated by a specialist and specific investigations are done. It can be an orthopedic problem also.

Treatment of spondyloarthropathy depends on the extent of disease. Many drugs like Methotrexate, NSAIDS, biological therapy are available but these are individualized for every patient.

Well staying at home won't solve the problem and until diagnosis is made nothing can be suggested whether you should be resting or moving about. I will suggest you to seek medical help at earliest.

Take care.

Dr Shruti
Above answer was peer-reviewed by
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