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Online clinic on arthritis & pain management - Oct 2018

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is it osteoarthritis?

Postby redmaggie on Mon Oct 08, 2018 8:36 pm

I'm 61 and for the last few years have had aching and burning pains in my all fingers, knuckles and now toes. Also there are 2 or 3 joints particularly sore and a bit swollen. It can vary in intensity, but I'm always sore in the evening especially if I've been using my hands a lot. It's hard to make a tight fist. A couple of fingers and a thumb are starting to bend somewhat :( I can't find anything to relieve the burning.... Naproxen makes me depressed, Indometacin made me dizzy! what other treatment can help?
Does it sound like osteoarthritis? Rheumatoid factor blood test was negative. Thank you!
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Re: is it osteoarthritis?

Postby Dr Sandeep Bawa on Tue Oct 09, 2018 5:35 am


pain swelling and stiffness are hallmarks for inflammatory disease. I would certainly ask your GP to have a look. Blood tests including ESR and CRP, as well as a Hand x-ray would be helpful.

With regards to the Rheumatoid Factor test - one can still have RA even if blood test is negative.

I would suggest you have a review from your GP.


Dr Sandeep Bawa
Consultant Rheumatologist - MBChB, MRCP, MSc (Sports Exercise Medicine)
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Re: is it osteoarthritis?

Postby Matthew Rogers on Tue Oct 09, 2018 12:08 pm

The National Institute for Health and Care Excellence guidelines for osteoarthritis suggest that a diagnosis of osteoarthritis can be made without other imaging investigation (such as x-ray) if the person is over 45 years of age, if their joint pain is related to activity and movement of those joints and if they have less than 30 minutes of stiffness in those joints in the morning.

However, if the stiffness in the joints is prolonged beyond 30 minutes, if the symptoms are rapidly worsening or if the joints are hot and swollen, this may indicate an alternative diagnosis and I certainly agree that it would be worth consulting your GP again to get their opinion as there is much that can be done once you have a diagnosis.

You can also find out more at: www.iosteopathy.org/osteopathy-for-heal ... arthritis/
or by contacting the charity Arthritis Action or Arthritis Research UK
Matthew Rogers
Head of Professional Development, the Institute of Osteopathy

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Re: is it osteoarthritis?

Postby Arthritis Action on Tue Oct 09, 2018 4:55 pm

Dr Bawa and Mr Rogers have made some good points there. When you mentioned ‘I’m always sore in the evening especially if I’ve been using my hands a lot’ may indicate OA. However I would urge you to seek advice from your GP. He or she will be able to make a diagnosis. Key sign to look out for: Does your joint-related morning stiffness (or gelling) last less than 30 minutes?

In terms of the management, the updated European League Against Rheumatism (EULAR) guideline for hands osteoarthritis recommends topical anti-inflammatory over its oral counterpart. Exercises to strength and to reduce pain should be part of the management plan too. This means a referral to the Occupational Therapists or hand therapists. You will need to discuss these two with your GP.

Many thanks and hope you find the above helpful.

Martin Lau, Services Development Manager and Dietitian
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