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    What causes pain in the hands while on Ibuprofen?

Posted on Thu, 3 Aug 2017 in Brain and Spine
Question: I'm not sure what is causing the pain in my hand. It started in my left wrist joint. I travelled from New Zealand on the 01July. I think I strained my wrist with lifting and carrying heavy bags. It stayed sore for approx. 7days I was taking ibuprofen and rubbing a topic gel called voltraren when needed. This seemed to help. There was still a slight discomfort but it was bearable. Then this past Sunday 08July in the afternoon the back of my hand became very sore not numb but very difficult to move my thumb and limited use of my fingers. Monday it got worse and the hand was swollen and painful to touch and move. On Tuesday I tried a homoeopathic remedy rubbing essential oils for the pain and swelling. There was immediate change with the swelling but still had the stiffness. When I woke up Wednesday the pain had also lessened. I continued with this method all day Wednesday and there was considerable improvement, swelling was almost non-existent and I pretty much had 80% movement without pain back in my thumb, fingers and hand. However last night and today has been a different story. I couldn't sleep due to the pain after a couple hours in bed. I woke up and it has not let up at all today. I have tried the same essential oils and taken some extra strength acetaminophen without success. Coldness makes it feel worse, so I tried a heating pad and elevation but that doesn't help either. The pain has not been in my wrist for 5days but completely in my hand and thumb. It's pretty much impossible to do anything with my left hand without pain. Can you please help me determine what this might be or how to alleviate the pain?

Answered by Dr. Dariush Saghafi 2 hours later
Brief Answer:
Sounds benign enough....HOWEVER.....

Detailed Answer:
Good afternoon. Thank you for your question. I've read through your detailed and informative history of events and how your wrist has been bothering one almost in what one could describe as a "fluctuating" way.....coming and going...some days better, some days not. Though you've linked the event in your wrist to the trip to New Zealand and carrying heavy things....one should always keep in mind that not all obvious things are necessarily the cause of related to events of health and well being. Therefore, if New Zealand represents a place you were simply visiting and is not your permanent residence....could you have picked up an infection of some type that is affecting your wrist or thumb joint? This would be referred to as a monoarticular or possibly regional arthritic process and if that were the case then, one possible cause would be some endemic bug or agent to the area that can give these types of symptoms.

For example, on the CDC website regarding New Zealand is the following information on infectious diseases published in 2017:

Norovirus outbreaks, Risk Factors for Legionnaires’ Disease, and      
Salmonella enterica infections Associated with 14-Year Outbreak (1998-2012)

The following website is for you to peruse on the CDC website and there may be other things there that may make more sense to you with respect to symptoms to you can figure out: https://wwwnc.cdc.gov/eid/ArticleMap/NZL

Therefore, what I would do if I were in your position and have already tried all the things you've talked about in terms of anti-inflammatories, analgesics, resting the hand etc. is get a medical examination by a doctor and make sure they understand you've traveled outside the country. Have your vaccination records ready to share with the doctor. With that information available the doctor can then, begin ordering the proper tests such as an X-ray of the affected hand/wrist, and thumb as well as getting appropriate bloodwork looking for signs of arthritis, infection, or other things that could be invading the joint which you may have contracted while on the trip.

Chances are this will turn out to be a benign process and with the proper guidance for rest and good choice of anti-inflammatory with possible some physical or occupational therapy +/- some Ultrasound/Diathermy treatments or other helpful ameliorative approaches you will resolve.

But on the outside chance that there is a specific infectious or metabolic cause affecting this joint or set of joints....I would not let this go much more than a few days more because then, it could potentially spread to other joints and other organ systems. You must be sure there is nothing in the bloodstream that would suggest your body is trying to fight an infection, etc.

BTW, make sure the doctor has the radiologist specifically comment on things such as:

1. Monoarticular arthritic inflammatory process
2. Ganglion Cyst
3. Deposition of crystalline material or the presence of calcified material (possible sign of a gouty arthritis)
4. Sub or intra-articular abscess formation (infectious process)

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 27 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Dariush Saghafi 1 hour later
Thanks for you advice. I actually live in NZ and I'm here in MI visiting family. I am not due to trvl back home to NZ until 4August. Since being here I have picked up a fungal infection on my big toe of the left foot. Could this in anyway be related some how to my wrist or another infection?
Answered by Dr. Dariush Saghafi 18 hours later
Brief Answer:
Unlikely BUT that's why I also believe studies are necessary at this time.

Detailed Answer:
Thank you for your return message and clarification.

Of course, just because someone is a native doesn't mean they can't pick up an indiginous bug...happens all the time. However, I guess I was assuming you were a traveler from a foreign country which sometimes works doubly to one's disadvantage.

At any rate...common fungi of the feet rarely if ever get into the systemic circulation to cause this sort of problem and rarely would a fungal infection be found to be the agent behind an articular problem such as the one you're referring.....UNLESS the person were immunocompromised due to drugs, radiation treatments, or carrying a disease that is known to immunodeplete the host such as HIV, AIDS, etc.

I would still approach the problem the same way (except for the passports and vaccinations) and start with a good physical examination of the wrist followed by a recommendation perhaps of an X-ray or maybe ultrasound to get an idea if there were a chance that an abscess, ganglion cyst, or other type of lesion that could fluctuate a bit could be present. And of course, blood work.


Once again, if in your estimation- helpful information to your question have been provided I would very much appreciate your CLOSING THE QUERY and including some postive words of feedback along with a 5 STAR rating? I'd be very interested in knowing how things turned out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 40 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Dariush Saghafi


Practicing since :1988

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