Dr. Ashaq Hussain Parrey
Rheumatology
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 31 years old. I have had psoriasis since I was ten years old. Then recently I became worried about psoriatic arthritis. I did not have any symptoms. Then one day I woke up and my ring finger was hurting at the first joint not bad and only when I pressed on it but I started freaking out and having really bad anxiety. I went to urgent care and they did a normal x-ray and blood work, sedimentation rate, and c-protein, and all the standard blood work came back normal. I felt better. Then I got a rash on my neck which my doctor thought was an allergic reaction. Then I noticed my knees were a little tight and started panicking. I went to my doctor he did an ANA and an HLA-B27 antigen all came back negative. But then all my joints started popping and my legs felt weak and my muscles started hurting. I had this happen before when I had extreme anxiety. I started Talz and started to feel better but at the same time, my anxiety went down. I had my thyroid checked and it was normal. I had my gluten checked and it was normal. I had my cortisol levels checked and they were extremely high. I was in a place with lots of ticks and deer the month before as well. Is it possible that my symptoms are caused by anxiety? Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
Thank you for your query. I read your query and understood your concern.
I went through your post and investigated whether you have psoriasis but as of now, you do not seem to have psoriatic arthritis because your inflammatory markers erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are normal and there is no active swelling of any joint. It seems all anxiety-related. take a few days of analgesics and having a session with a counselor will help
I hope my advice will be helpful. Feel free to reach out if you have any further queries.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I have experienced left elbow pain and tightness in my forearm and wrist as well as some heel pain and some pins and needle feelings in my hands but the pain has not been that bad and this is after a long day also.It typically feels way better in the morning and worse at night.
Thank you.
Hi,
Welcome back to icliniq.com.
Aches and pains are normal occasionally especially after exertion as long as they are not associated with inflammation, swelling, redness, and tenderness. They are called arthralgias and everyone has them. The pain especially in the lower back is worse in the morning and improves with activity and is associated with stiffness in the morning is important in psoriasis. You do not have any such symptoms nor any joint swollen in addition your inflammatory markers are negative the only thing that you have not done is MRI SIjoint which would completely make sure that there is no evidence of psoriatic arthritis. For mild aches and pains that come in day-to-day life take a few days of analgesics and rest and do not worry about it.
Thank you.
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Rheumatology
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