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What causes numbness and tingling sensation in the elbows while on Naproxen?

Answered by
Dr.
Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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Posted on Fri, 26 Aug 2016 in Bones, Muscles and Joints
Question: I am a state of the most intense pain i've ever felt. It is throughout my body, but especially the joints of the elbows, fingers, wrists, feet and toes. I can only stand on my feet for several minutes, having to walk on my heels, before the aching and throbbing in my ankles becomes unbearable. The worst pain areas are my lower back and left elbow. I can no longer move my left arm and hand in any way without intensfying the pain. There is also numbness and tingling, throbbing and a grabbing sensation in the elbow, as if a rubber band is attached from he elbow to the hand.

Each morning my ankles and hands are swollen, nearly unable to bend. I have been treating the pain with anti-inflammatory and opiate based pain relievers (Ibuprofen 6 to 1200 m daily; Narco from 7.5 to 10 3 to four times daily; Naproxen 880 ml each day. for the last year I have been titrating this medications, starting at low but effective doses and now they are no longer effective..I hurt despite them.

in the past year I was treated by a Rhuematologist, Dr. XXXXXXX Rosenstock in XXXXXXX XXXXXXX where I tested negative for rheumatoid arthritis. I have attached medical records from him as files named Jainah 2 thru 5. You have my expressed consent to access all my medical records. The attached x-rays were taken last November and since then nothing has been treated. I stopped going to this doctor in XXXXXXX 2016 because he would not explain to me his findings, but just gave me the complicated attached medical records. Since then this pain and other symptoms have worsened. In addition, I am starting to lose functionality in my left arm.

Also, I suspect I have been enduring a chronic vitamin D. defeciency for 7 to ten years, an estimate based on my newly discovered understanding of what causes it. I haven't gone in the sun for years. I live like a hermit. But no doctor ever told me I needed sunlight to produce vitamin D.

Dr. Rosenstock told me last year that i needed surgery on my left elbow without additional explanation. I looked up a couple of the terms on the reports on my own and learned how the bones of my elbow are pressing that important nerve, potentially damaging it.I

I feel like I need immediate surgery and that I have been procrastinating and have waited too late; and subsequently the vitamin D. issue has effected my entire skeleton. ltwo months ago i barely stub my big toe, and it resulted in a fracture, placing me on crutches. I did not understand how that light contact, when I bumped it, could cause a fracture in the bone. Please tell me if I should go to the ER or find a surgeon or what. I cant go another day with this pain. It's everywhere.Corrections. The medical reports are from a doctor visit last September 2015, not last November as I mistakenly indicated.
doctor
Answered by Dr. Mahaveer Patil 6 hours later
Brief Answer:
nothing to worry about

Detailed Answer:
Hi xxxxxxxx

Welcome to HEALTHCARE MAGIC..

How was your day?

Hope this message finds you in good health.

I have gone through your query in detail and understand your concern.

I generally see many cases like this at my clinic and found out only two major causes for such crippling pain throughout the body-
1. Rheumatoid arthritis
2. Severe calcium deficiency-may/may not be secondary to vitamin D deficiency

In your case,as you have mentioned, the RA factor test was negative. And if you do not have a positive family history, its less likely that you may have it.

But there are a few instances of SERONEGATIVE ARTHRITIS- meaning that there wont be a positive RA FACTOR IN BLOOD BUT YOU WILL STILL HAVE SYMPTOMS OF ARTHRITIS.

In 2nd case, as your reports have suggested, there is severe vitamin D deficiency in your body and its very sad that none of your doctors suggested you to take a sunbath, which could have lessened the intensity of pain even before you experiencing it.

At this stage, i feel you should consult a good endocrinologist, considering the low vit D that you have, just to find out the root cause..e.g- whether there is any metabolic disturbance causing such low vit D levels.

Also, i would suggest you to see another good rheumatologist.
Pain killers are going to harm your kidneys and liver, so better to avoid. But i know,its not that easy considering the unbearable pain that you have.
As a last resort, there are a few DMARDS (disease modifying anti rheumatic drugs)- like leflunamide, methotrexate etc, that are potentially effective in curing such seronegative arhthropathies

You should eventually get back to normal in coming few days.Nothing to worry about, as long as i am there to help you.
     
I hope your question has been answered.
Feel free to consult me anytime for follow-up queries. Take care,God bless.
Wish you a healthy life : )
If you do not have any clarifications,you can close the discussion.

Kind Regards..
Dr Mahaveer Patil, (MBBS,MS,Mch)
Consulting Orthopaedic and Trauma Surgeon

-     If you were satisfied and happy with my answer ,PLEASE RATE THIS ANSWER AND LEAVE YOUR SINCERE FEEDBACK .

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mahaveer Patil 2 hours later
did u see the reports attached to this questions. The xrays i sent seem to show actual damage, changes to the various joints, all centered around osteopenia. Also, the most important question is about the left elbow, where bone spurs are pressing against the nerve. Should I have surgery on that elbow, considering the symptoms i described. also my RA factor is positive but i was anti-CPPs. And there was no nodules at joints. so can i be Seropositive without a positive CPPs?
doctor
Answered by Dr. Mahaveer Patil 23 minutes later
Brief Answer:
query answered

Detailed Answer:
HI

I did see all your attached images, there are no xray images, all are attached written reports with findings.Considering the findings mentioned in these reports and your history,you definitely should get operated on the elbow to salvage the nerve .

In the previous messaage, you had mentioned about NEGATIVE rheumatoid arthritis test.
If you have positive RA factor, then there should be no doubt about the diagnosis being SEVERE FORM OF RHEUMATOID ARTHRITIS.

you definitely need to start on DMARDs that i had mentioned to arrest the progression of damage and the disease
Yes, its possible to be seropositive, without positive CPPs, depending upon the blood levels of RA factor

I hope your question has been answered.
If you have any follow-up queries,feel free to consult me anytime.

If you do not have any clarifications,you can close the discussion. Wish you a good health.Have a great day : )

Take care,God bless.      

YOUR RATING FOR THIS ANSWER MATTERS A LOT AND WILL BE HIGHLY APPRECIATED.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mahaveer Patil 4 hours later
i have attached the RA factor test. Despite this, that RA doctor told me I don't have RA, even though i suffer from the five basic symptoms that indicate RA, like imflamations, 5 r more joints, symmetrical occurrences, etx. Can you elaborate on the the xray reports? What does all those complex terms mean? What does it mean for my joints? What is happening? why are all those problems listed on that repor?
doctor
Answered by Dr. Mahaveer Patil 15 hours later
Brief Answer:
query answered

Detailed Answer:
hi
As far as reports are concerned, You definitely havbe rheumatoid arthritis and you have to start on DMARDS as early as possible
You are right that you do have almost all symptoms of RA
All these complex terms in the report pertaining to the joints mean thatRA is destroying all the joint fluid and the cartilage inside the joints which is actually meant for lubrication and prevention of friction of adjoining bones to each other.

This friction is causing the bone surfaces to erode and become rough leading to inflammation. This has become a vicious cycle now and has to be broken somewhere, for which DMARDS are recommended.

All the reports indicate the same thing- your joints contents are being destroyed by RA

thanks
If you have any follow-up queries,feel free to consult me anytime.
If you do not have any clarifications,you can close the discussion. Wish you a good health.Have a great day : )
Take care,God bless.
     
YOUR RATING FOR THIS ANSWER MATTERS A LOT AND WILL BE HIGHLY APPRECIATED.


Above answer was peer-reviewed by : Dr. Priyanka G Raj
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