DEAR DR. GOTT: I suddenly developed a very painful right wrist (I’m left handed) a few months ago. X-rays showed nothing unusual. I was given prescription strength ibuprofen and hydrocodone for pain (which didn’t help) and instructions to see my primary doctor in a few days. By the time I saw my doctor, the right wrist pain was gone but it had moved to my left hand. Over the next five weeks, the pain moved from one wrist to the other nine times. My primary doctor said I might be developing rheumatoid arthritis but the RA titer was normal.
To the best of my knowledge I have not been bitten by anything, not had any illness immediately prior, been scratched by anything, nor had I added any new vitamins or supplements.
In desperation, I consulted a physician (MD) who also works with acupuncture and homeopathic medicine. During the five weeks of pain I received four acupuncture treatments and some homeopathic anti-inflammatories. I think it helped. Early one morning, after a painful and sleepless night, I took regular aspirin and that helped. I had a two-week “reprieve” and then the pain returned with a vengeance. The following three weeks followed the same back and forth pattern. Then, the pain gradually diminished until it is hopefully gone. I continue to use aspirin. Another RA titer showed normal for rheumatoid arthritis, gout, etc.
I have an appointment with a rheumatoid specialist but hesitate keeping the appointment. Without symptoms, I feel like I am wasting my time and the doctor’s time. I’ve done extensive reading and wonder if I should ask to be tested for Lyme disease or West Nile virus as I live in the far west where both of these have been identified.
I would appreciate your thoughts on this mystery.
DEAR READER: Wrist pain can have many causes ranging from arthritis to injury. You appear to have run the gamut on standard testing with nothing to show for it. Therefore, in my opinion, Lyme testing may be appropriate. West Nile typically causes encephalitis (brain swelling) so it’s unlikely to blame.
I actually know of a case where a young woman complained of a single painful wrist and had no knowledge of being bitten by a tick, yet was diagnosed with Lyme following positive blood work.
It is also possible to have rheumatoid arthritis (RA), Lyme and other rheumatologic diseases that do not test positive, so this should be taken into account. Perhaps an appointment with a rheumatologist is in order.
Another thought is that you may have unknowingly injured your right wrist and over-compensated for the pain by using your left hand more and vice versa. This could explain why the pain appeared to move one wrist to the other. Unfortunately, I can’t offer any other insight that you don’t seem to have already been testing for.
If the aspirin is working, continue it, but be sure to take it with food and at the lowest dose possible to avoid potential stomach upset and to reduce the anti-coagulation effects. If you experience easy bruising, bleeding, stomach upset, bloody stools or vomiting, discontinue the aspirin immediately and see your doctor as these can be signs of a stomach ulcer which can be caused by aspirin use.
Readers who are interested in learning more can order my Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.
