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Suggest Treatment For Severe Joints Pain In The Feet And Wrists

Posted on Tue, 13 Dec 2016

Question: Hi, I had mild Typhoid fever in Sept'16 for which my doctor prescribed 3 weeks of medication. My fever subsided almost immediately. However after finished my medication in mid Oct'16 I developed severe joint pains mainly in feet and wrists and fingers. Its now over a month and I still have this pain everyday which is terrible in the mornings and subsides a little after I take a pain killer. Pl advice what is the reason of these pains which are hindering my walking and day to day activities and how I can over come them. Im very worried and hope it is not serious

Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello and Welcome

I appreciate your concern

The development of joint pains in this distribution should be investigated further. Taking pain killers/ NSAIDs alone would only mask the problem and address the symptoms, alone rather than the cause.

The joint needs to be examined. Complete blood count, ESR, CRP, RA factor , anti CCP antibody, wrist radiograph, and ANA profiling would be required to rule out joint disease or any autoimmune cause.

Treatment can be advised accordingly in the light of the clinical exam and lab results. I would advise an internal medicine doctor or a rheumatologist to examine you in this regard.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

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Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Thanks Doctor, For ref attaching report of last full medical test done in Sept'16. From the report is there anything that can be suggested or would additional tests need to be done. I'm healthy otherwise with ideal weight of 75 kgs with height of 175 cms. My concern is it related to Typhoid after effects and would it subside in due course. I'm currently overseas in Hungary and dont have access to any English speaking doctors so seeking advice. I have also doubt if the Typhoid was wrongly diagnosed and fever could have been chinkunguniya ( though test result at that time showed negative ...I had a fever panel test for Typhoid, Dengue, Chikunguniya and Malaria )
In case it was CG was thinking Joint pains could last for months. Pl advice

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

The labs you attached are within the normal range.

Chinkunguniya does have arthralgia as a long term complication. However, since there was no serological confirmation nor clinical diagnosis made at that very time, its very difficult to presume such a diagnosis without any evidence.
Joint pains are not usually associated with typhoid fever as a complication.

The above workup that I advised would be more pertinent in this regard.

Wishing you best of health

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (25 minutes later)

Hi Doctor, So you are suggesting again an examination despite normal range readings from a most recent full body health check. Just to seek comfort I hope it is nothing serious or after effect of the typhoid medicines. Any OTC drugs ypu would suggest.

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

The investigations you uploaded initially include basically renal function tests and uric acid. I just saw the other results. The ESR is normal so no need for doing that. Its a marker for inflammation which is not significantly elevated. So you can very well relax.

Just to be on the safe side RA factor, anti CCP and ANA profiling can be done after consulting your physician.

For the time being ibuprofen 400 thrice a day for 5 days would be required. Its available OTC. Most likely your symptoms would improve with it and you may not even require further testing as the rest of your blood work is completely normal. The typhoid medication are safe and don't lead to long term disability.

Hopefully the recovery period will end sooner rather than later.

Thanks

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar