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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for wrist pain in an arthritis patient despite taking Voltaren

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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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Posted on Tue, 24 Jul 2018 in Bones, Muscles and Joints
Question: I am a 54 year old female with hx of arthritis: back, knees, hands (fingers). I had a relatively slow onset of non-dominant wrist pain which limits ROM and strength, questionable swelling, no redness or warmth and limits ADLS. Already on Volteran daily, using topical creams w/o relief. Differential/recommendations?
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Answered by Dr. Mahaveer Patil 49 minutes later
Brief Answer:
synovitis v/s soft tissue inflammation v/s early osteoarthritis

Detailed Answer:
Hi,

Thank you for posting the question.
I have gone through your medical history in detail.

If there is no raised local temperature,no redness on the affected wrist,then there less chances that there might be underlying infection.

The only possibilities include Synovitis (innflammation of the inner synovial membrane lining of the joint capsule),or a unknown mild degree of sprain or tendinitis (inflammation of the tendons around the wrist).

Also,this may be a local presentation of the systemic disease (osteosrthritis) that you are already suffering from.

I would suggest you to apply a compression bandage around the affected wrist during the daytime.

Local application of analgesic gels should be followed by hot fomentation/physiotherapy/short wave diathermy.

As far as oral medicines are concerned,adding fibrinolytic enzymes like trypsin/chymotrypsin and serratiopeptidase to anti inflammatory drugs can aid recovery process.

Getting an Xray/MRI of the wrist will make you come to a pin point diagnosis.

Chondroitin sulfate/MSM and diacerin tablets along with calcium/vitamin D supplements will help heal the synovial membrane.

Do consult an orthopedist if these measures do not help.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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