Q. I have pain in the bones and joints of hand and feet every morning. Why?

Answered by
Dr. Naval Mendiratta
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 05, 2020

Hello doctor,

I have pain in the bones, joints of hands and feet especially in the morning upon waking up. It has been consistent for the past couple of months. Please help.

Dr. Naval Mendiratta



Welcome to icliniq.com.

I have gone through the reports (attachment removed to protect patient identity). There is a high RA factor and low vitamin D. I would like to take a few more details on the history part. But it would be better if someone can examine the joints as it is a long treatment which patient will need. So she should be examined properly before commencing the drugs for it.

Does she have early morning stiffness? If yes, then for how long? Any dry eyes or dry mouth? Any oral ulcers? Any hair fall? Any recent changes in mood with irritability? Any history of tending to forget things early?

Was this answer helpful?


Thank you doctor,

No morning stiffness but she has pain in her hands and feet that is stronger in the morning and lighter afterward. She has dry eyes and a little bit of dry mouth and no oral ulcers.

She has inherited hair fall for a long time but under control now. She has a change in her mood recently and is irritated easily with any problems or issues. And yes she tends to forget things a little bit recently.

Dr. Naval Mendiratta



Welcome back to icliniq.com.

Well, as of the history and the blood reports I have drawn a conclusion. But you can once read on it and see if her symptoms correlate, because exact diagnosis does lie in the examination part, but at least we can start her on medications and see if it helps.

Blood reports say her RA (rheumatoid arthritis) factor is high, but it is a known fact that it can be positive in 10 percent of the people without any symptoms. As ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) are quite normal, so the scope of inflammation seems low. But one must get the feel of joints to be sure it is not inflammation.

With dry eyes, dry mouth and joint pains there seems to be more like a predominance of Sjogren's syndrome than rheumatoid arthritis. RF can be positive in both conditions, but again since ESR is normal, it goes a little against it as well.

My main diagnosis does go in favor of a condition called fibromyalgia which has pains, fatigue, forgetfulness, irritability. You can read about this condition and see if it fits in her symptoms. There is no diagnostic test for this, but we normally conclude it if there are no other problems found.

So start her on Vitamin D. For fibromyalgia, she can start on Pregabalin M 75 mg at night. But once you read, you can revert to me if it fits in her symptoms. But it is definitely not rheumatoid arthritis.

Was this answer helpful?


Ask a QueryAsk a Query Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

What causes memory loss and forgetfulness?

Query: Hi doctor, I am a 22-year-old and have had memory problems for the last five years. It started back in high school and I would wake up and not remember what was going on in my life, but not just for a few seconds, it would stay like that. I would know the friends I have, but I was not able to remem...  Read Full »

I forget names and have confidence problem. Why?

Query: Hello doctor, I am 30 years old, male. I am suffering from two problems mainly which I often noticed. One is I forget always names of person, place, etc., while talking with someone. However, I have remembered a lot of things of pasts but while talking about it, I often forget the names especially....  Read Full »

Prevention of Joint Pain in Old Age

Article Overview: Joint pain in old age is a major concern that should not be ignored. Most of us suffer from knee pain or back pain after an age. If we follow simple measures in daily routine then most of these conditions can be prevented. Read Article

Dr. Tiwari
Orthopaedician And Traumatologist

Knee joint pain and backache especially in the lumbar region is a very common problem. Almost every one suffers from these problems in life either because of unhealthy lifestyle or some disease. In most cases, these are preventable and treatable, but due to lack of knowledge most people suffer from ...  Read Article



Ask your health query to a doctor online?

Ask a Rheumatologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.



Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.