[51F] With chronic hand pain, stiffness, and swelling

Patient Description

A 51-year-old female has been experiencing a throbbing ache in her hands that has gradually developed over the past few months. The pain is exacerbated by housework and does not improve with rest or specific treatments. Additionally, she reports stiffness in her hands, especially in the morning, along with swelling, deformities, and difficulty moving her fingers or hands. The patient has a family history of autoimmune diseases, specifically rheumatoid arthritis and lupus, affecting her grandmother and great aunts. She has had a CCP test but did not specify the results. The patient has a history of smoking but currently does not smoke. Her medical history includes GERD, osteopenia, and asthma diagnosed in March, and edema diagnosed in November. She is currently taking Lyrica (200 mg twice daily) and Omeprazole (40 mg twice daily) and has an allergy to NSAIDs.

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Arora's Assessment

What might be happening

Based on the information you have provided, a possible unifying diagnosis is:

  • Rheumatoid Arthritis (RA): Given your symptoms of throbbing pain, joint swelling, deformities, and difficulty moving your fingers, along with a family history of autoimmune diseases like rheumatoid arthritis and lupus, RA is a likely diagnosis. RA is a chronic inflammatory disorder that typically affects the small joints in your hands and feet. It can cause painful swelling that can eventually result in bone erosion and joint deformity.
    • Typical Treatments: Treatment for RA often involves medications to reduce inflammation and pain, such as disease-modifying antirheumatic drugs (DMARDs) and biologics. Physical therapy and lifestyle changes can also help manage symptoms. In some cases, surgery may be necessary to repair damaged joints.
    • Testing: Blood tests, including the CCP (cyclic citrullinated peptide) antibody test, can help diagnose RA. Imaging tests like X-rays, MRI, or ultrasound can assess the extent of joint damage.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Medication Adherence: Continue taking your prescribed medications, Lyrica and Omeprazole, as directed by your healthcare provider.
  2. Physical Activity: Engage in gentle exercises like stretching and low-impact activities to maintain joint flexibility and strength. Avoid activities that exacerbate your pain.
  3. Heat and Cold Therapy: Applying heat can help relax your muscles and alleviate pain, while cold packs can reduce inflammation and numb the affected area.
  4. Healthy Diet: Maintain a balanced diet rich in anti-inflammatory foods, such as fruits, vegetables, and omega-3 fatty acids. Avoid foods that can trigger inflammation.
  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and get insights. This can help you and your healthcare provider understand your condition better and adjust your treatment plan accordingly.

What you should look out for

Reasons to see a doctor more urgently include:

  • Increased Pain or Swelling: If you notice a significant increase in pain or swelling in your joints.
  • New Symptoms: If you develop new symptoms such as fever, unexplained weight loss, or severe fatigue.
  • Difficulty Performing Daily Activities: If your symptoms interfere with your ability to perform daily activities or if you experience a sudden loss of function in your hands.

Remember, while this information can help you understand your condition better, it is essential to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago

People Also Ask


What are the common symptoms of rheumatoid arthritis?

Common symptoms of rheumatoid arthritis include joint pain, swelling, stiffness (especially in the morning), and deformities. It often affects the small joints in the hands and feet and can lead to difficulty moving the affected joints.


How is rheumatoid arthritis diagnosed?

Rheumatoid arthritis is diagnosed through a combination of patient history, physical examination, and tests such as blood tests for rheumatoid factor and anti-CCP antibodies, as well as imaging tests like X-rays or MRIs to assess joint damage.


What are the treatment options for rheumatoid arthritis?

Treatment options for rheumatoid arthritis include medications like DMARDs and biologics to reduce inflammation and slow disease progression, physical therapy to maintain joint function, and sometimes surgery to repair damaged joints. Pain management and lifestyle modifications are also important.


Can lifestyle changes help manage rheumatoid arthritis symptoms?

Yes, lifestyle changes can help manage rheumatoid arthritis symptoms. Regular low-impact exercise, a healthy diet rich in anti-inflammatory foods, stress management, and avoiding smoking can all contribute to better symptom control and overall health.


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