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Q. I have rheumatoid arthritis with severe pain in joints. Kindly help.

Answered by
Dr. Rajiv Ranjan Kumar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 02, 2020 and last reviewed on: Sep 05, 2020

Hello doctor,

I am suffering from rheumatoid arthritis for the past four years and it was diagnosed six months ago. I feel excruciating pain in my lower and upper limb joints and I am not feeling relief even after taking NSAIDs. I was given steroids and penicillin, and it did not work properly. The pain is mostly in the knee, hip, elbow, and shoulder joint.

Dr. Rajiv Ranjan Kumar

General Medicine Internal Medicine Rheumatology
#

Hi,

Welcome to icliniq.com.

A diagnosed case of rheumatoid arthritis on biological agent, still having pain needs to evaluated in detail. Pain can originate from muscle, nerves, or joints. The odd point is diarrhea for a month and it needs to be evaluated. It can be due to drug-related or disease-related diarrhea.

As per your information, you are having RA for the past four years.

Your present complain is excruciating pain in the upper and lower limb (duration is not mentioned). You tried pain killers, steroids, and antibiotics (the reason is not clear). Joint pain if related to RA usually responds well with pain killers like Etoricoxib, Naproxen, etc. If not fully then partially. It seems like your pain may be related to muscle origin or nerve related which is very common in a patient with RA and hypothyroidism.

You may have fibromyalgia, or nerve-compression symptoms which needs to be evaluated by proper history and examination. It may be refractory RA.

For chronic neuropathic pain or fibromyalgia pain you can try Pregabalin and Duloxetine. And others after consultation and evaluation.

Check your

1. ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) for RA related pain.

2. LFT (liver function test), KFT (kidney function test), sugar (fasting), and thyroid profile for assessment of the origin of pain.

I hope this helps.


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Thank you doctor,

What dose should I take? And do I need any treatment for arthritis.

Dr. Rajiv Ranjan Kumar

General Medicine Internal Medicine Rheumatology
#

Hi,

Welcome back to icliniq.com.

You can try capsule Pregabalin 75 mg daily at bedtime. But the best thing for you is to meet a rheumatologist personally for detailed evaluation for its exact cause of it.

I hope this helps.


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