[33F] Experiencing joint and tendon pain with warmth in hands

Patient Description

A 33-year-old female presents with a five-month history of joint pain in the hands, affecting the thumb, pinky, and pointer fingers, sometimes extending to the middle finger. The pain is described as dull and hot, with a severity rated at 6 out of 10, and may worsen in the evening. The patient also experiences sharp tendon pain and joint warmth. There is no clear pattern or trigger for the pain switching between joints, and it is not definitively related to activity level or overuse. The patient's medical history includes a gallbladder removal two years ago. She tested negative for rheumatoid arthritis and has no family history of autoimmune diseases. Current medications include Meloxicam (15 mg once daily) for joint pain, Wellbutrin for depression, and supplements of vitamin D and reishi mushroom. No known drug allergies or adverse reactions to medications have been reported.

Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

Rheumatoid Arthritis (RA): Despite your negative test, RA can still be a possibility. It's an autoimmune disorder that can cause pain, swelling, and stiffness in joints, often symmetrically. It can also cause warmth around the joints. The pain can sometimes switch between different joints. However, morning stiffness is a common symptom, which you didn't mention.
- Treatment usually involves medications to reduce inflammation and slow the disease's progression, such as nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and disease-modifying antirheumatic drugs (DMARDs).
Psoriatic Arthritis: This is a type of arthritis that affects some people with psoriasis, a condition that features red patches of skin topped with silvery scales. It can cause joint pain, stiffness, and swelling. Like RA, the pain can sometimes switch between different joints.
- Treatment often involves medications to control inflammation and prevent joint damage, such as NSAIDs, DMARDs, and immunosuppressants.
Osteoarthritis (OA): This is a degenerative joint disease that can cause pain and stiffness in the joints, especially after use. It's more common in older adults, but it can occur in younger people, too.
- Treatment typically involves lifestyle changes, physical therapy, over-the-counter pain relievers, and sometimes surgery.
Tendinitis: This is inflammation or irritation of a tendon, which can cause pain and tenderness just outside a joint. Overuse of a joint can cause tendinitis.
- Treatment usually involves resting the affected area, taking over-the-counter pain relievers, and sometimes physical therapy.

Please note that these are potential diagnoses based on the symptoms you've provided. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some general suggestions that may help alleviate your symptoms:

Rest: Try to rest the affected joints as much as possible. Avoid activities that cause or worsen your pain.
Ice and Heat: Apply an ice pack to the affected joints for 15 minutes at a time to reduce inflammation. You can also try a warm bath or heating pad to help relax the muscles and increase joint mobility.
Over-the-Counter Pain Relievers: Non-prescription medications like ibuprofen or naproxen can help reduce pain and inflammation. Always follow the package instructions.
Gentle Exercise: Regular physical activity can help strengthen the muscles around your joints and improve your range of motion. Consider low-impact activities like swimming or cycling.
Physical Therapy: A physical therapist can show you exercises to help strengthen the muscles around your joints, increase your range of motion, and reduce pain.