Dr. Ankush Dhaniram Gupta
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 30-year-old female. I do not have any medical issues that could associate with my problem. About a month ago I woke up to pain and stiffness in my neck and shoulders. I figured I just slept wrong or something little like that. But every single night since then, I have been woken up by the pain during nights. I cannot lay in any position where I put pressure on them and it only happens at night or while resting or laying down for more than an hour. It started with just my neck and shoulders. But gradually it has turned into pain and stiffness in my neck, shoulders, elbows, hands (which includes swelling in my fingers), hips and now my knees. It only happens when I lay down for long periods and gradually disappears during the day with movement and activities. It is also disrupting my sleep every night in which I barely get for three to four hours altogether. I have tried taking Naproxen before laying down for the night and using a heating pad at night to avoid these issues, but it is not helping. My question is, what is wrong with me and how can I reduce or stop the pain and stiffness?
Hello,
Welcome to icliniq.com.
The symptoms you have explained points towards arthritis. It can be osteoarthritis or rheumatoid arthritis depending on the joints involved and the duration of morning stiffness. Usually, in rheumatoid arthritis, morning stiffness remains for more than 45 minutes and joints of the hands involved are middle joint and the joint which connects your finger with hand. Osteoarthritis morning stiffness relieves in less than 30 minutes in the morning and the joint involved are the distal joints of your fingers.
The tests which you can go for to confirm are a rheumatoid factor, CRP (C-reactive protein), x-ray of the joints. The medications which can be used to relieve the symptoms are NSAIDs (non-steroidal antiinflammatory drugs), steroids to relieve the inflammation and DMARDs (disease-modifying antirheumatic drugs) like Methotrexate, Sulphasalazine, etc. Surgery is another option here which you can talk to your doctor after confirmation of the diagnosis.
I hope this helps.
Investigations to be done
Differential diagnosis
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Diabetology
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