How to manage joint pains that impact daily life?

Question

Hello doctor,

I am a 50-year-old woman, and my weight is 165 pounds. For the past year, I have had joint pain that has been progressively getting worse. Initially, it was just some discomfort in my wrists and ankles, but now the pain has spread to my shoulders and knees. The mornings are the hardest, and as the day goes on, the pain lessens a bit, but by evening, it is back, and I feel drained of energy. I have tried painkillers like Acetaminophen and topical creams, but they do not help anymore. My doctor started me on a low dose of Methotrexate three months ago, but I have not noticed any improvement. I have not had any tests yet, but my doctor thinks it could be rheumatoid arthritis. Your suggestions will be appreciated.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

As per the descriptive information you have given, it does indicate it to be diagnosed as rheumatoid arthritis. The following investigations confirm your diagnosis: High levels of rheumatoid factor, CRP (C-reactive protein), and erythrocyte sedimentation rate (ESR).

It is always best to start on the medication. Methotrexate (antimetabolite) is administered once the diagnosis is confirmed by doing the above-mentioned investigations. As the investigation reports also help us in deciding on the strength of Methotrexate.

1. The flared-up immune response in your system will take time to respond and eventually settle down.

2. I would suggest that, along with a rheumatologist, you consult an immunologist. They will do the necessary investigations as needed to rule out any other underlying causes of rheumatoid arthritis you are suffering from, other than genetic causes, if any.

3. In case you are having persistence in your joint swelling and pain, do bring it to the notice of your treating doctor or consult an experienced rheumatologist. They will prescribe additional medicines, as Methotrexate alone will not help you in relieving the pain you mention here.

4. Also, an immunologist might suggest additional medicines if they feel the need.

I hope this information helps you.

Thank you.