Q. Even after taking medicines, there is no improvement in pain radiating from hip to toe. Why?

Answered by
Dr. Rishav Bansal
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jun 18, 2020 and last reviewed on: May 07, 2021

Hi doctor,

My mother is 43 years old and she was diagnosed with rheumatoid arthritis three months back. She has a serum uric acid level of 4.3 mg/dl and an RF IgM antibody of 132.1 units/ml. Her treatment was started by taking Defcort 6 mg for a week, Methotrexate 15 mg for three months, HCQS 200 daily after dinner for three months, vitamin B12 shots weekly for a month followed by B12 shots every month. Even after taking medications, she does not have an improvement in her knee pain, ankle pain, and pain radiating from hip to toe. She took a pain killer Setolac ER 300 mg. But there is no improvement. Kindly suggest.



Welcome to

Pain radiating from hip to toe occurs due to sciatica and it does not occur due to rheumatoid arthritis. Your mother needs to take nerve suppressing painkillers and physiotherapy. Regarding other joint pains, we need to rule out the cause after having a detailed history. It is necessary to increase your mother's arthritis medications. Your mother needs to take Folate with Methotrexate to avoid its side effects in long term. Your mother needs to do CBC (complete blood count), RFT (renal function test), and LFT (liver function test) every three months as arthritis medications can cause side effects.

The Probable causes:

Your mother has rheumatoid arthritis or sciatica.

Investigations to be done:

She needs to do an X-ray LS (lumbosacral spine) spine in anteroposterior view and lateral view, CBC (complete blood count), RFT (renal function test), LFT (liver function test), and ESR (erythrocyte sedimentation rate).

Regarding follow up:

Have a follow-up with your reports.

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