Will pain on my wrists last forever?

 Prof. Useh: Yes … but lifestyle modifications, physiotherapy could help

Dear Prof,

I hope this email meets you well. I am a 28-year old female entrepreneur with pains in my right and left wrists. This has been on for three years. I occasionally feel feverish, tired, and weak with the pains.  So far, I have consulted many doctors and tried several herbal remedies. Reading your column, I’m beginning to think maybe physiotherapy could be the solution. I really don’t know much about this aspect of medicine but I will be grateful if you could throw some light on this condition and recommend a way out for me. Just wondering, will I live with this pain forever? I pray not.

Jane

Uyo

Dear Jane,

A physiotherapist will evaluate you and your condition to ascertain whether or not you will benefit from physiotherapy. However, there are a few questions and tests that will confirm your diagnosis. Your symptoms are those of Rheumatoid Arthritis (RA). This is a chronic inflammatory disease that primarily affects the joints. The condition can affect people of all ages but older adults are more likely to be diagnosed because the risk of developing RA increases with age. However, a special form of RA, juvenile rheumatoid arthritis, also affects children under 16.

The most often affected joints are those of the knuckles, wrists, and feet. As the disease progresses, however, larger joints such as the elbows, knees, and ankles can stiffen as well. Rheumatoid arthritis is caused by the immune system attacking the lining of the joints. You mentioned that you’ve had this for over three years. It is possible that over time, the synovium (the connective tissue that lines the inside of the joint capsule) reacts by becoming thicker, damaging the tendons and bones. In addition to joint symptoms, in some people, RA advances to affect tissues and organs, like the skin, heart, lungs, and kidneys, as well.

In addition to these common presentations which are usually bilaterally i.e. the same symptoms on both sides of the body (such as in both hands and both knees), there will be weight loss, fever, general fatigue or tiredness and weakness. You may also experience:

• Pain or ache in more than one joint. That is your wrist and your knees, or wrists and ankle joints.
• The feeling of stiffness in more than one joint as mentioned above. Usually, this might even be common in the morning as soon as you wake up.
• The painful parts are usually tender when they are touched. It is also not unusual to experience swelling in more than one joint. In your case, in addition to the wrist, you might also experience swelling of both knee and ankle joints.

Physiotherapy goals will include rest and a few lifestyles modification.

Jane, you asked if you would have to live with this forever. The simple and quick answer is yes. However, lifestyle modifications will assist in relieving your pain and improving the functions of your activities of daily living. Most times your physiotherapist will work with the occupational therapists to achieve these goals.

The treatment that is commonly used includes electrotherapy for pain management, with exercises that are carefully planned to improve and maintain movements of the joint and improve your functional capacity, thereby reducing or eliminating fatigue. Active rest is prescribed when joints are painful and sore.

Best Wishes