[45F] With chronic hand and finger pain, swelling, and numbness

What might be happening

Based on the symptoms you've described, here are some possible explanations:

1. Carpal Tunnel Syndrome (CTS)

• Rationale: CTS is a common condition that can cause swelling, numbness, and pain in the hand and fingers, particularly the middle fingers. It often worsens at night and can be exacerbated by repetitive hand movements, such as cooking.
• Typical Treatments/Testing: Diagnosis is often confirmed through physical examination and nerve conduction studies. Treatment may include wrist splints, anti-inflammatory medications, corticosteroid injections, and in severe cases, surgery.

2. Arthritis

• Rationale: Given your history of arthritis and family history, it's possible that arthritis is contributing to the pain and swelling in your hand and fingers. Arthritis can cause joint inflammation, leading to pain, swelling, and difficulty with fine motor tasks.
• Typical Treatments/Testing: Diagnosis is usually made through physical examination and imaging studies like X-rays. Treatment may include anti-inflammatory medications, physical therapy, and lifestyle modifications.

3. Peripheral Neuropathy

• Rationale: Your history of IV drug use and the symptoms of numbness and tingling suggest that peripheral neuropathy could be a contributing factor. This condition involves damage to the peripheral nerves and can cause pain, numbness, and weakness.
• Typical Treatments/Testing: Diagnosis is often made through nerve conduction studies and blood tests. Treatment focuses on managing symptoms and addressing the underlying cause, which may include medications, physical therapy, and lifestyle changes.

What you can do

Carpal Tunnel Syndrome (CTS)

• Immediate Steps:
  • Consider wearing a wrist splint, especially at night, to keep your wrist in a neutral position.
  • Avoid repetitive hand movements that exacerbate your symptoms.
• Long-term Management:
  • Consult a healthcare provider for a formal diagnosis and treatment plan.
  • Physical therapy exercises can help strengthen and stretch the muscles in your hand and wrist.

Arthritis

• Immediate Steps:
  • Continue taking ibuprofen as needed, but be mindful of the maximum daily dosage.
  • Apply ice packs to reduce swelling and heat packs to relieve pain.
• Long-term Management:
  • Consult a healthcare provider for a comprehensive treatment plan, which may include medications, physical therapy, and lifestyle changes.
  • Maintain a healthy diet and exercise regularly to manage arthritis symptoms.

Peripheral Neuropathy

• Immediate Steps:
  • Avoid activities that worsen your symptoms.
  • Ensure you are getting adequate nutrition, as deficiencies can exacerbate neuropathy.
• Long-term Management:
  • Consult a healthcare provider for a thorough evaluation and treatment plan.
  • Physical therapy and medications may help manage symptoms.

General Tips

• Sleep Hygiene: Since your pain affects your sleep, try to maintain a regular sleep schedule and create a comfortable sleep environment.
• Symptom Tracking: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Given the severity of your symptoms and the potential for underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Worsening Symptoms: If your pain, swelling, or numbness worsens or becomes unbearable.
• New Symptoms: If you experience new symptoms such as changes in skin color, temperature, or severe weakness.
• Infection Signs: If you notice signs of infection, such as redness, warmth, or pus.

Remember, while I can provide information and suggestions, it's essential to consult a healthcare provider for a formal diagnosis and treatment plan.