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Joint Pain???

Discussion in 'Diabetes Complications' started by Sunamd, Aug 1, 2013.

  1. Sunamd

    Sunamd · Member

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    Hi All,

    Getting straight to the point, I have been having pain and swelling in my left middle finger (middle joint) and right thumb (middle joint) for the last 3 months. They seemed to start about a week after I recovered from a viral infection nearly 3 months ago. I went to my GP and he put me on difene which helped but did not eliminate the pain. I have been for an xray and nothing has shown up but it is obvious that there is a problem due to swelling and discoloration.

    While visiting the GP again yesterday things seem to be drawing to a close with no diagnosis. He feels I should be referred to a specialist but it's not apparent what type of specialist. Now I am noticing similar pain beginning to start in my left hip.

    I'm getting quite worried about it. I have also been for blood tests which have shown my rheumatoid factor is negative (thankfully).

    Has anyone experienced anything similar? If so, what was the condition and how was it treated?

    In case it makes any difference, I'm on NovoRapid and Lantus and my most recent hba1c was 6.3 in July.

    Any help would be great,

    Thanks,
    Sunamd
     
  2. catherinecherub

    catherinecherub · Guest

    I'll bump your post up so that someone may see it and answer.
     
  3. BobCornelius

    BobCornelius · Well-Known Member

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    Hi Sunamd,

    Sounds like you need referral to an orthopaedic surgeon or hand clinic/plastic surgeon! Are you on statins, as these can cause joint pain.

    :)

    Bob
     
  4. Sunamd

    Sunamd · Member

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    Thanks for the bump cc.

    Bob I don't know what statins are, so I guess that's a no lol.
    My doc is referring me to an orthopedic doc but god only knows how long that might take but at least the ball is rolling.
    Thanks
     
  5. Luna21

    Luna21 · Guest

    It could possibly be osteoarthritis or an inflammatory type arthritis. I have psoriatic arthritis which particularly affects the small joints of my hands and feet and hips/spine. This can't be diagnosed via blood tests, and you can get this condition without ever having psoriasis, though it's more uncommon.

    A Rheumatologist might be the best specialist to see, as they deal more with inflammatory conditions.

    Whatever it is, I wish you well and hope that your doctors get to the bottom of it.
     
  6. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    Hi I have some joint muscular problems, and after quite a few months, my GP referred me to a Muscularskeletal unit. The outcome was that it seems to be nerve problems in my foot and ankle, but possible joint problem in my left knee, I also have pain to the touch on both hips. I went to a Neurologist and he confirmed nerve problems.

    Unfortunately it's a process of elimination, but keep on at your GP, you know something is obviously wrong with your fingers and it must be investigated thoroughly. My Neurologist asked for lots of bloods to be taken, as not all inflammatory conditions show up on xrays, and there are a few of them. Also you could be lacking in certain vitamins, that's another possibility.

    wish you good luck and I hope you and your GP can get to the bottom of it, but it may take a little while for a correct diagnosis.

    Take care

    RRB
     
  7. Sunamd

    Sunamd · Member

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    Luna and RRB, thanks for the replies. I've mentioned both to my GP but I'm still waiting for my referral letter.

    RRB, kinda wierd you should mention the vitamins. I seemed to be coming down with bugs, colds and flus nearly on a monthly basis for the first half of this year. After the most recent flu I went to the chemist and picked up some Centrum (as advised by the chemist) to try and bolster the immune system. Shortly after starting to take them this ailment kicked off. Probably just a wierd coincidence, as I don't remember to take them everyday.
     
  8. Sunamd

    Sunamd · Member

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    Hi all,

    Just thought I'd give a further update on this as I was in the Diabetic Clinic for a check up yesterday.
    I'll start with the good news. I got my best ever Hba1c... 5.5
    I explained to the endo the problems I was having with the pain in the finger and thumb and how I have been on difene for the past 3 months. He had a look at the blood test results that have been done for me over the past year and told me that he felt my thyroid levels were a bit low (I think). He told me they were 6.7. I've looked into this and I think that figure is high but I was having a low at the time of the appointment (heat and missed lunch) so was still a little hazy while he was explaining all this to me.
    Long and short of it, I have managed to get an appointment to see a Rheumatologist towards the end of this month and the Endo is happier for the Rheumatologist to handle it, although he did say that he thinks it is RA :(

    Does anyone else have T1 and thyroid issues? Can you let me know what I might have to look forward to please?

    Thanks,

    Sunamd
     
  9. Luna21

    Luna21 · Guest

    I have T2, not T1, but thyroid problems, high BP, high Cholesterol (significantly decreased lately though) and I also have Psoriatic Arthritis which is also an auto-immune condition similar to Rheumatoid Arthritis.

    In many cases the diagnosis between the two, or indeed other inflammatory arthritis, can be difficult as the blood test checks to see if a specific antibody, known as the rheumatoid factor, is present in your blood. This antibody is present in eight out of 10 people with rheumatoid arthritis. However, it cannot always be detected in the early stages of the condition. The antibody is also found in one in 20 people who do not have rheumatoid arthritis, so this test cannot confirm rheumatoid arthritis.

    It took me many, many months to get a definitive diagnosis, so if that happens, don't despair, but hopefully your Rheumatologist can diagnose you pretty quickly and get treatment started if necessary.

    Apparently doctors do link autoimmune conditions with thyroid, especially for those with Type 1 diabetes, but not Type 2 that I have....seems strange as I am continually adding other conditions linked to the autoimmune system! :?:

    Taking the meds for underactive thyroid is no problem, if you are found to need it. You will probably get Levothroxine, which doesn't seem to have any side effects for the vast majority of patients, but you will need to take them for the rest of your life.

    I hope you get things sorted as soon as possible. I found that it was much better once I was actually diagnosed as then I was put on appropriate drugs to help cope with all the pain.

    I'm toddling off tomorrow to see my yearly appointment with my Rheumy.....cue list of questions to ask...always a good idea to write things down, by the way!

    Good Luck.
     
  10. Sunamd

    Sunamd · Member

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    Great post Luna21. Thanks for that.
    If my problem is some sort of auto immune arthritic problem, from your post it seems that the pain is only managed as opposed to eliminated. Is that the case?

    Do you find that this impacts greatly on your everyday life, work and choice of activities?
     
  11. Luna21

    Luna21 · Guest

    Hi, glad that some of the info helped. :wink:

    To be honest, yes that old mantra, everyone is different and it all comes down to the individual. What is true is that there is no cure, but symptoms can wax and wane, and it all depends on the severity of the disease.

    Some people cope well on just nsaid's alone (non steroidal anti-inflammatory drug eg, naproxen) whereas others need to go on stronger drugs. This is a good place to learn more as each person can be given different treatment depending on their diagnosis. http://www.arthritisresearchuk.org/

    I didn't get diagnosed for a very long time, a locum doctor even had me diagnosed as having gout, and it wasn't until I saw the Rheumatologist the second time that she could confirm my diagnosis, so sometimes it's not easy even for a specialist in the field of arthritis.

    I was pretty poorly by then, with barely being able to get out of bed, get out of a chair, even roll over, and I needed help to get into the bath, and I even needed to walk with a stick! This at under 50 years of age - to say I was scared was an understatement. :cry:
    I was put on methotrexate, which is often used for psoriatic and rheumatoid arthritis and it has been a godsend. Yes, reading about the side-effects is very scary indeed, but so long as the proper safeguards are in place, ie frequent blood tests, and you are monitored closely , it can be a wonder drug for many of us.

    Of course there are many other options, and if you are diagnosed with an auto-immune arthritis your Rheumatologist will explain all the options open to you.

    I am currently in a bit of a flare-up of my condition but since I lost some weight through being diagnosed with diabetes, I have really been pretty good up until lately. I can walk for miles, cycle on my static bike and generally do most normal things, although running is out as I have permanent joint damage now in my feet, knees and hip, due to the length of time it took to get onto the proper medication. Getting the right treatment quickly is vital to save any damage to your joints, and GP's are supposed to be clued-up to this, which isn't always the case unfortunately.
    Exercise, even gentle exercise, and eating well is very important in staying fit and healthy.

    Having an auto-immune arthritis means that you tire very easily though, and fatigue is probably one of the most common symptoms which you often just have to learn to cope with; taking time out when you feel the need and not pushing yourself over your limits if possible.
    There are good days and bad days, but please don't think that you will inevitably get worse, everyone is different, and there are lots of good drugs out there to help you cope.

    I don't currently work, only because I had no option but to give up my job when I was so poorly as it was a fairly strenuous physical job, and I just couldn't do it, but I do feel that I could do some kind of limited work now, although I'm very lucky in that my husband supports me, and I don't have to try and claim for any monetary help. My Rheumatologist suggested that I should claim for help a few years ago, which I didn't, so that shows how much I have improved, and there is plenty hope out there :D

    Stay positive, and that helps a lot, I assure you! When I was diagnosed with diabetes it was less of a shock to me than many it seems, as to be honest, as I have so much going on already with my decrepit body!!

    I hope you get your diagnosis soon, and remember to ask plenty of questions, and write them down as often you don't get to see a specialist Rheumatologist as often as you might like.

    Best of luck and please let me know how you get on. :wave:
     
  12. Sunamd

    Sunamd · Member

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    Another update

    Luna21 you were on the money. It turns out that I've got Inflammatory arthritis (most likely seronegative psoriatic arthritis). I've been put on methotrexate, folic acid and more difene.
    Even though I was expecting a diagnosis that would be hard to swallow this has kinda knocked me for six. Luna21 can you let me know how it affects you and how you cope?
    The pain in my fingers has subsided slightly but seems to have spread to my wrist and my ankle??!? I'm back to the Rheumy next week for an injection into my thumb to try and get me back to some normal level of use.

    Anyway, I'll post again with more updates in the future

    Thanks again everyone for the very helpful posts :clap:
     
  13. Luna21

    Luna21 · Guest

    Hi again Sunamd.

    I wish your news were better, but at least now you have a diagnosis, and you know where you stand, so to speak.

    Firstly, and this is the hardest part, be patient. Methotrexate takes a long time to start working - sometimes even up to 3 months, so don't despair if you don't feel much better for a while. Do remember to take your folic acid too, and if you get any nausea or sickness, there are tablets you can get to alleviate those horrible symptoms. I take my meth at night, and I find I get less nausea if I have eaten well, but it's all down to how the individual copes with it.

    Secondly, and this is doubly as hard in lots of ways, listen to your body, and don't overdo things. Fatigue is one of the known symptoms of PA, so you must rest before you start feeling tired, whether its housework, work or whatever. If you push yourself to the limit, the pain will feel 10 times worse, as I know from refusing to, as I put it once...'give in'. I learned the hard way.... I'm a very stubborn person and don't like the thought of mollycoddling myself in any way, but you really have to learn to know when enough is enough.

    Hopefully once the meth kicks in, you will find a huge difference in the swelling and the pain.

    If your wrist is swollen, you can get a flexible wrist support, either from your occupational health/nurse or you can buy them. They can really ease the pain a lot.

    I take it you are getting a steroid jab? They can work either work wonders or do nothing.....I have been lucky with them, so it's certainly something worth trying. Remember to rest the thumb/hand afterwards to give the injection the best chance of working.

    I have intermittent flare-ups with my psoriatic arthritis, I'm currently suffering one, so my rheumatologist has upped my methotrexate, so here's hoping it does the trick. I'm back on painkillers and lots of lovely little pills again! :crazy:

    Don't think that this, now, is as good as it gets.....many people often can live a perfectly ordinary lifestyle with work and play, for others it's more difficult - it all depends on how your condition reacts to the medications, and if the arthritis is kept in remission.

    There are lots of other options other than meth, so don't worry too much if it isn't the poison of choice, there are others! :mrgreen:
    Also you will be offered a flu jab; it's well worth taking as our immune systems are drastically lowered with the DMARD's we have to take.

    Chin up, it's definitely not the end of the world, it just makes life a little more difficult, and you have to take care in making sure that you are as healthy as you possibly can be, a good diet, as much exercise as you can cope with (difficult I know) to ward off any other complications.

    Good luck, and I hope to hear how you are getting on in a future post.
     
  14. Sunamd

    Sunamd · Member

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    Luna21,

    Thanks again for your reply. That sounds like very valuable info.

    If you don't mind can you tell me a little more about the supports. Are they necessary to wear? I don't likepeople knowing things about me and the thoughts off having to wear obvious things like splints or supports really gets to me.

    I hear you about the exercise but does that mean that endurance sports are out?

    Thanks again Luna21, you're a star
     
  15. Westie2

    Westie2 Type 2 · Well-Known Member

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    Sunamd
    I am sorry to hear of your problems, but it is now felt the earlier you start DMARDs the better the response is seen, because then any effects on your joints can be managed. Methotrexate is a safe well tolerated drug so long as you follow any instructions you have been given. Have you been given a purple monitoring book? You need to keep a record of your blood results since the GP and pharmacist need to check you have had the relevant blood tests before issuing any prescriptions.

    Best Wishes


    Sent from the Diabetes Forum App
     
  16. Luna21

    Luna21 · Guest

    They are just neoprene, and something like this. Loads on the market, but you must get the right size to support your wrist properly. Mine is a lovely (not) bright orange but you can get all colours which are more discreet.

    http://www.precisiontraining.uk.com/tra ... -wrap.html

    I really couldn't say about endurance sport - as if it's something that really pushes you to your limit, it might be worth speaking to your doctor/physio about the best way to go, as you don't want to damage already inflamed tendons,ligaments etc. Physiotherapists are really brilliant, and it's well worth a visit to one if you can, especially if you are keen to keep up with your sport. Get your Dr to refer you to a NHS one if possible as they can be expensive privately.

    Perhaps you may have to give yourself time to get the full benefit of the methotrexate into your system, but it's well worth asking medical advice. I found doctors very willing to try and help you to lead as normal a life as possible, and sport is definitely not ruled out, but again it's all very subjective to how your arthritis responds.

    Never be afraid to ask for advice from the Rheumatologist or the specialist nurses; they are there to answer questions and help.

    Good luck.
     
  17. katielee80

    katielee80 · Newbie

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    Hi yes I've type 1 (diagosed 2002)to which I take novorapid and glargine plus I have an under-active thyroid gland diagnosed 1995 then I had a thyroid ectomy 2005.my thyroid gland was always playing up under-active over-active until I had 2/3 removed. My diabetes has never been well controlled, I never fully came to terms with it always fighting it, 11 years down the line and still struggling. Hopefully I will some day get full control.I find this website helpful. PS I also get a lot of joint pain especially in my legs and knees.
     
  18. Tracey69

    Tracey69 · Well-Known Member

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    Hi
    I am a T1 diabetic with thyroid problems. Previously i had an over active thyroid ( you lose weight) and i now have underactive thyroid (makes you gain weight) both are treated with drugs. for the underactive it's called Levothyroxine, i think the other drug is thyroxine. If your diabetic doctor saw these levels he should of been the one to start the drugs, but he may want to see what happens next time. Keep an eye on your weight (lose or gain) record it if necessary.
    He should send you a copy of what he found and discussed then you can go over it in your own time.
    Hope all goes well and you feel better soon.
    Take care
    Tracey
     
  19. rogerinfrance

    rogerinfrance · Member

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    Oh not this AGAIN. You need to take vitamin B12. Its so easy for Brits, take 2 teaspoons of Marmite with every meal. However, for those in Holland, suffer, in most other countries you can get either tablets or liquid. Here in Europe many doctors are sort of not accepting but not rejecting the theory, however, our diabetic doctor sent someone she thought I did not know after I told her about it for a test, and lo and behold he was very low on B12. She put him on this and also his "alzheimers" improved- dramatically.
    If I do not have my B12 for a few days then I get clicky middle finger, and locked up left shoulder.
    An aquaintance that also went coincidentally to the same diabetic doctor, had had stiff shoulder for 12 years and walked like a cripple. I gave him a jar of Marmite on the Friday, and on the Monday went to his company, I got dragged in and given a large brandy. He showed me he could lift his arms.
    So go away and try it, you need about 1000ug to start it off and then about 500ug liquid or 1000ug tablet a day or as stated the Marmite. Due to the totally innocuous stuff there is no adverse problems as the body just dumps that which is not needed.
    PLEASE LET PEOPLE KNOW IF IT WORKS FOR YOU
     
  20. Luna21

    Luna21 · Guest

    rogerinfrance....Very unhelpful, and possibly dangerous, information for those who have actually been diagnosed with an inflammatory arthritis.

    Yes, B12 can be helpful for those with a deficiency, and trials have shown it may (not proven) to be of some benefit to those with osteoarthritis, a completely different type altogether, but won't help inflammatory arthritis sufferers who if not treated quickly enough with drugs may go on to have severely malformed joints, of which I myself have some.

    The important thing is to be seen and diagnosed quickly by a Rheumatologist, who usually only deals with inflammatory arthritis conditions, ie Psoriatic, Lupus, Rheumatoid etc.

    Marmite nor B12 tablets would not have helped me in any way, as I, and the thread opener have joint pain and swelling due to an inflammatory, ie auto-immune arthritis.

    I don't know if you honestly believe in what you are saying, or just think its funny to post such odd 'advice'.
     
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