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Q. Is my joint soreness because of arthritis or alcoholic neuropathy?

Answered by
Dr. Florilyn Joyce Chulsi Bentrez
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 24, 2021 and last reviewed on: Sep 25, 2021

Hi doctor,

I have been suffering from psoriatic arthritis for a few years, nothing serious, but I do experience bouts of soreness in my finger joints, especially overnight.

Lately, I have been experiencing a lot of pain in my hands overnight that resemble a burning sensation, enough to keep me awake.

This seems to be worse after drinking alcohol. This is only overnight with no symptoms during the day, even when drinking alcohol.

I have been to a neurologist who performed a nerve function test, and it was perfectly normal. He sent me back to the doctor who treats my arthritis, saying that it is unlikely to be related to that.

Reading into this, I wondered if this could be an alcohol-related neuropathy, given that I have been a regular drinker for a few years?

Kindly help.

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#

Hello,

Welcome to icliniq.com.

Kindly answer the following questions to help you better;

1) Is there a discoloration of the hands?

2) Do you have redness?

3) Do you have pain when you touch the skin?

4) Do you have diabetes, renal problem, or exposure to pesticides or chemicals?

5) What is your job?

Electrophysiologic tests may be normal or may have minor changes despite the symptoms. If you are bothered that it is alcohol-related neuropathy, you can repeat nerve function studies after six months to check for progression. You have to trim down your alcohol intake too.

Regards.


The Probable causes:

Alcohol intake, nutritional deficiency, renal failure, bilateral carpal tunnel.

Investigations to be done:

Serum creatinine, uric acid, HbA1c (Hemoglobin A1c), erythrocyte sedimentation rate,
Thiamine.

Differential diagnosis:

Sensory neuropathy, small fiber neuropathy,
bilateral carpal tunnel syndrome.

Treatment plan:

Initial treatment of vitamin B complex and
Gabapentin.

Preventive measures:

Alcohol cessation.

Regarding follow up:

Follow up with results.

Hi doctor,

Thanks for the reply.

I do not have symptoms at other times of the day; it is only overnight.

I have had a full blood test, and all results are normal except slightly high cholesterol levels.

The nerve function test is perfectly fine.

Thanks.

#

Hello,

Welcome back to icliniq.com.

Thank you for answering the questions. If that is the case, you might have small fiber neuropathy. The small fibers are affected, giving you a burning sensation. Small fibers are not detected by EMG (electromyography) and NCV (nerve conduction velocity). You can consult your neurophysiologist regarding the investigation procedure. For now, you may take the medications prescribed a while ago. If not treated with Gabapentin, I might increase your dose or add another drug like TCA (tricyclic antidepressant) or SNRI (serotonin-norepinephrine reuptake inhibitor). Thanks.


The Probable causes:

Alcoholic or nutritional.

Investigations to be done:

Skin biopsy.

Probable diagnosis:

Small fiber neuropathy.

Treatment plan:

Vitamin B complex and
Gabapentin.

Preventive measures:

Alcohol cessation.

Regarding follow up:

Follow up after a week of medications.


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