Every morning, I experience swelling and pain in the joints of my fingers and toes, but it improves immediately after soaking them in hot water?
Hello, Dr.
Lin! Every morning when I wake up, the joints in my fingers feel very swollen (numb) and painful (unable to touch).
The first thing I do each morning is soak them in water at about 40 degrees Celsius for 10 minutes, which improves the condition by about 90%.
Until bedtime, the joints only feel slightly stiff but not painful.
The joints in my toes also hurt; wearing tighter socks or shoes, or pressing on my toes while walking causes pain.
I have seen several doctors, and blood tests confirmed that I do not have rheumatoid arthritis.
X-rays also showed no uric acid crystals.
One doctor suggested it might be degenerative arthritis.
I have taken anti-inflammatory pain medication for three months, but there has been no improvement.
Ultrasound and wax therapy have also been ineffective.
One doctor mentioned that it could be cervical spine compression affecting the nerves, so I am currently undergoing cervical traction therapy.
My knee joints hurt significantly when going up and down stairs, but walking is generally okay.
I feel uncomfortable when exposed to air conditioning, so I need to use knee warmers for extended periods in winter.
May I ask which specialist I should consult for these issues? Additionally, how can I maintain my condition at home? Thank you!
JASON, 60~69 year old female. Ask Date: 2006/07/16
Dr. Lin Xiaoyi reply Orthopedics
Hello:
1.
Finger issues: They may originate from the cervical spine, but could also be due to carpal tunnel syndrome compressing the median nerve.
Although the absence of rheumatoid factor makes rheumatoid arthritis less likely, it cannot be completely ruled out.
Gouty arthritis is also less likely.
2.
Toe pain: This may simply be due to localized tendonitis or degeneration of the toe joints, or it could be neuropathic pain caused by compression of cervical or lumbar nerve roots.
Additionally, since both your fingers and toes are painful, it is important to consider whether this is neuropathic pain due to a neuropathy, and to rule out peripheral neuropathy caused by diabetes.
3.
Knee pain symptoms are more indicative of osteoarthritis.
It is recommended to strengthen the quadriceps muscles in the front of the thigh.
Recommendations:
1.
Consult a rheumatologist to confirm whether rheumatoid arthritis is present.
2.
See a rehabilitation specialist to determine if there is neuropathy, tendonitis, or osteoarthritis, and to receive appropriate rehabilitation treatment.
If necessary, appropriate medication should be administered.
3.
For older patients, cervical traction therapy (commonly referred to as neck pulling) should be approached with caution.
If any discomfort arises, it is important to inform the therapist immediately to achieve the best treatment outcomes.
Wishing you good health,
Lin Hsiao-Yi
Rheumatology and Immunology Department, Taipei Veterans General Hospital
Reply Date: 2006/07/16
More Info
Hello! It sounds like you are experiencing a complex set of symptoms that are affecting your daily life significantly. Based on your description, it seems that you are dealing with joint pain in your fingers and toes, as well as discomfort in your knees, particularly when going up and down stairs. You have already consulted multiple doctors, undergone various tests, and tried different treatments without significant improvement.
Given that you have ruled out rheumatoid arthritis and gout through blood tests and imaging, and considering the possibility of degenerative joint disease (osteoarthritis) as suggested by one of your doctors, it may be beneficial to explore a few different avenues for both treatment and self-care.
Recommended Specialists
1. Rheumatologist: Even though you have ruled out rheumatoid arthritis, a rheumatologist specializes in joint diseases and may provide further insights into other forms of arthritis or autoimmune conditions that could be causing your symptoms.
2. Orthopedic Specialist: An orthopedic doctor can evaluate your joint health and may suggest imaging studies like MRI to assess soft tissue structures around the joints, which could be contributing to your pain.
3. Physical Therapist: A physical therapist can design a personalized rehabilitation program that includes exercises to strengthen the muscles around your joints, improve flexibility, and reduce pain. They can also provide guidance on proper body mechanics to avoid aggravating your symptoms.
4. Pain Management Specialist: If your pain is severe and persistent, a pain management specialist can offer various treatment options, including injections, nerve blocks, or alternative therapies.
Home Remedies and Self-Care Strategies
1. Warm Water Soaks: As you mentioned, soaking your hands in warm water helps alleviate pain and stiffness. You can also try alternating between warm and cold compresses to reduce inflammation and improve circulation.
2. Gentle Stretching and Strengthening Exercises: Engage in gentle stretching exercises for your fingers, toes, and knees to maintain flexibility. Strengthening exercises can help support the joints and reduce pain. A physical therapist can guide you on appropriate exercises.
3. Compression Garments: Wearing compression gloves for your hands and compression socks for your feet may help reduce swelling and provide support. Make sure they are not too tight, as this can cause discomfort.
4. Heat Therapy: Applying heat to your knees, especially during colder months, can help alleviate stiffness. You can use heating pads or warm towels.
5. Cold Therapy: If you experience swelling, applying ice packs to the affected areas can help reduce inflammation. Make sure to wrap ice packs in a cloth to protect your skin.
6. Diet and Supplements: Consider incorporating anti-inflammatory foods into your diet, such as fatty fish, nuts, seeds, fruits, and vegetables. Omega-3 fatty acids and turmeric supplements may also provide some relief, but consult your doctor before starting any new supplements.
7. Ergonomic Adjustments: Evaluate your daily activities and make ergonomic adjustments to reduce strain on your joints. For example, using tools with padded grips can help reduce stress on your fingers.
8. Mind-Body Techniques: Practices such as yoga, tai chi, or meditation can help manage pain and improve overall well-being. These techniques can also help with relaxation and stress reduction.
Conclusion
It is essential to continue seeking medical advice and not to hesitate to get a second opinion if you feel your concerns are not being addressed adequately. Keep a detailed journal of your symptoms, triggers, and any treatments you have tried, as this information can be valuable for your healthcare providers. Remember, managing joint pain often requires a multifaceted approach, combining medical treatment with lifestyle changes and self-care strategies. I hope you find relief soon!
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