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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Pain In The Right Hand And Fingers Indicate?

The fingers in my right hand hurt, especially between the two knuckles, and including the knuckles ,down along the fingers. The tips of my fingers are numb. The fingers most affected are the tall-man, ring finger and pinky. There is some blue coloring in these areas. In the beginning, the pain was severe with swelling. The swelling moved up into the hand, then wrist, then lower arm (with pain in the elbow), and then the whole arm, accompanied by warmth. At that time, I also had swollen foot, ankle, and lower leg on the right side. I took Hydrochlorothiazide 25 mg to get rid of the swelling and it worked. But the fingers continue to hurt. Some relief is felt when I raise my hand above my head and hold it there. Ice and heat also help. But this has continued for three weeks now! I am on a lot of medication for chronic pain due to a lower back injury, with nerve damage in left lower leg and foot, and left rotary cuff injury. My meds include: Butran patch, 15 mcg/hour, 3 Hydrocodone-Act. 10-325 per day, 3 Gabapentin 600 mg per day, 3 Ibuprofen 800 mg per day, and Fluoxetine 20 mg a day. I can t imagine what the pain in my right hand might feel like without the pain medication I am already on for the other conditions! Question: Why might my right hand be hurting? What tests should I be asking for to find out why? It scares me that I might be losing the full use of a third limb!
Wed, 8 Aug 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

I suggest you to consult an orthopedician or a rheumatologist to find out if you are having rheumatoid arthritis. Rheumatoid arthritis (RA) is an autoimmune disease that can cause joint pain and damage throughout your body. The joint damage that RA causes usually happens on both sides of your body. So if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will probably be affected, too. This is one way that doctors distinguish RA from other forms of arthritis, such as osteoarthritis (OA). Treatments work best when RA is diagnosed early, so it’s important to learn the signs. Read on to learn everything you want to know about RA, from types and symptoms, to home remedies, diets, and other treatments. First your doctor will ask about your symptoms and medical history. They’ll also perform a physical exam of your joints. This will include looking for swelling and redness, and testing your reflexes and muscle strength. Your doctor will also touch the affected joints to check for warmth and tenderness. If they suspect RA, they’ll most likely refer you to a specialist called a rheumatologist. Since no single test can confirm a diagnosis of RA, your doctor or rheumatologist may use several different types of tests. They may test your blood for certain substances like antibodies, or check the level of certain substances like acute phase reactants that are elevated during inflammatory conditions. These can be a sign of RA and help support the diagnosis. Diagnosing RA can take time and may require multiple lab tests to confirm clinical examination findings. Your doctor will use several tools to diagnose RA. They may also request certain imaging tests. Tests such as ultrasonography, X-ray exams, and magnetic resonance imaging (MRI) not only show if damage from RA has been done to your joints but also how severe the damage is. A complete evaluation and monitoring of other organ systems might be in order for some people with RA, too. There are several types of blood tests that help your doctor or rheumatologist determine whether you have RA. These tests include: 1. Rheumatoid factor test: This blood test checks for a protein called rheumatoid factor. High levels of rheumatoid factor are associated with autoimmune diseases, especially RA. 2. Anticitrullinated protein antibody test (anti-CCP): This test looks for an antibody that’s associated with RA. People who have this antibody usually have the disease. However, not everyone with RA tests positive for this antibody. 3. Antinuclear antibody test: This tests your immune system to see if it’s producing antibodies. Your body may make antibodies as a response to many different types of conditions, including RA. 4. Erythrocyte sedimentation rate: This test helps determine the degree of inflammation in your body. The result tells your doctor whether inflammation is present. However, it doesn’t indicate the cause of the inflammation. 5. C-reactive protein test: A severe infection or significant inflammation anywhere in your body can trigger your liver to make C-reactive protein. High levels of this inflammatory marker are associated with RA. Treatment: There’s no cure for RA, but there are treatments that can help you to manage it. Treatments for RA help to manage the pain and control the inflammatory response which can in many cases result in remission. Decreasing the inflammation can also help to prevent further joint and organ damage. Treatments may include: 1. medications; 2. alternative or home remedies; 3. dietary changes; 4. specific types of exercise. There are many types of medication for RA. Some of these medications help to reduce the pain and inflammation of RA. Some help to reduce flares and limit the damage that RA does to your joints. The following medications help reduce the pain and inflammation during RA flares: 1. nonsteroidal anti-inflammatory drugs (NSAIDs); 2. corticosteroids; 3. acetaminophen. The following drugs work to slow the damage that RA can cause to your body: 1. Disease-modifying antirheumatic drugs (DMARDs): DMARDs work by blocking your body’s immune system response. This helps to slow down RA’s progression. 2. Biologics: These new generation DMARDs provide a targeted response to inflammation rather than blocking your body’s entire immune system response. They may be an effective treatment for people who don’t respond to treatment with more traditional DMARDs. 3. Janus kinase (JAK) inhibitors: These are a new subcategory of DMARDs that block certain immune responses. These are drugs that your doctor may use to help prevent inflammation and stop damage to your joints when DMARDs and biologics don’t work for you.

Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr Sanjay Kini
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What Does Pain In The Right Hand And Fingers Indicate?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I suggest you to consult an orthopedician or a rheumatologist to find out if you are having rheumatoid arthritis. Rheumatoid arthritis (RA) is an autoimmune disease that can cause joint pain and damage throughout your body. The joint damage that RA causes usually happens on both sides of your body. So if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will probably be affected, too. This is one way that doctors distinguish RA from other forms of arthritis, such as osteoarthritis (OA). Treatments work best when RA is diagnosed early, so it’s important to learn the signs. Read on to learn everything you want to know about RA, from types and symptoms, to home remedies, diets, and other treatments. First your doctor will ask about your symptoms and medical history. They’ll also perform a physical exam of your joints. This will include looking for swelling and redness, and testing your reflexes and muscle strength. Your doctor will also touch the affected joints to check for warmth and tenderness. If they suspect RA, they’ll most likely refer you to a specialist called a rheumatologist. Since no single test can confirm a diagnosis of RA, your doctor or rheumatologist may use several different types of tests. They may test your blood for certain substances like antibodies, or check the level of certain substances like acute phase reactants that are elevated during inflammatory conditions. These can be a sign of RA and help support the diagnosis. Diagnosing RA can take time and may require multiple lab tests to confirm clinical examination findings. Your doctor will use several tools to diagnose RA. They may also request certain imaging tests. Tests such as ultrasonography, X-ray exams, and magnetic resonance imaging (MRI) not only show if damage from RA has been done to your joints but also how severe the damage is. A complete evaluation and monitoring of other organ systems might be in order for some people with RA, too. There are several types of blood tests that help your doctor or rheumatologist determine whether you have RA. These tests include: 1. Rheumatoid factor test: This blood test checks for a protein called rheumatoid factor. High levels of rheumatoid factor are associated with autoimmune diseases, especially RA. 2. Anticitrullinated protein antibody test (anti-CCP): This test looks for an antibody that’s associated with RA. People who have this antibody usually have the disease. However, not everyone with RA tests positive for this antibody. 3. Antinuclear antibody test: This tests your immune system to see if it’s producing antibodies. Your body may make antibodies as a response to many different types of conditions, including RA. 4. Erythrocyte sedimentation rate: This test helps determine the degree of inflammation in your body. The result tells your doctor whether inflammation is present. However, it doesn’t indicate the cause of the inflammation. 5. C-reactive protein test: A severe infection or significant inflammation anywhere in your body can trigger your liver to make C-reactive protein. High levels of this inflammatory marker are associated with RA. Treatment: There’s no cure for RA, but there are treatments that can help you to manage it. Treatments for RA help to manage the pain and control the inflammatory response which can in many cases result in remission. Decreasing the inflammation can also help to prevent further joint and organ damage. Treatments may include: 1. medications; 2. alternative or home remedies; 3. dietary changes; 4. specific types of exercise. There are many types of medication for RA. Some of these medications help to reduce the pain and inflammation of RA. Some help to reduce flares and limit the damage that RA does to your joints. The following medications help reduce the pain and inflammation during RA flares: 1. nonsteroidal anti-inflammatory drugs (NSAIDs); 2. corticosteroids; 3. acetaminophen. The following drugs work to slow the damage that RA can cause to your body: 1. Disease-modifying antirheumatic drugs (DMARDs): DMARDs work by blocking your body’s immune system response. This helps to slow down RA’s progression. 2. Biologics: These new generation DMARDs provide a targeted response to inflammation rather than blocking your body’s entire immune system response. They may be an effective treatment for people who don’t respond to treatment with more traditional DMARDs. 3. Janus kinase (JAK) inhibitors: These are a new subcategory of DMARDs that block certain immune responses. These are drugs that your doctor may use to help prevent inflammation and stop damage to your joints when DMARDs and biologics don’t work for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Sanjay Kini