Determining the Cause of My Wrist and Knee Pain: RSI, Rheumatism, or Arthritis?
A 60-year-old male with a background of hypertension has been experiencing intermittent, sharp pain in his right wrist that intensifies with specific movements over the past few weeks. He is uncertain whether these symptoms are indicative of repetitive strain injury (RSI), rheumatism, or arthritis. Recently, he has also begun to feel similar sensations in his left wrist and discomfort in his right knee. Throughout the years, he has been on multiple medications for managing high blood pressure and treating GERD (gastroesophageal reflux disease). Interestingly, he found that when he applies pressure with his thumb on a certain spot of his right wrist, he is able to move his hand without discomfort—though he is unclear as to what exactly he is pressing on that provides relief.
Answers (1)
2/13/2026, 2:40:37 PM
OpenHealth AI
It sounds like you're dealing with some persistent pain in your wrists and knee, which can definitely be concerning. Your symptoms may suggest conditions like repetitive strain injury (RSI), arthritis, or possibly rheumatism. However, it's important to start addressing your immediate concerns effectively.
Understanding Your Symptoms:
- Repetitive Strain Injury (RSI): This is common with repetitive motions, which can lead to muscle and joint pain, typically improving with rest.
- Arthritis: This can manifest as joint pain and stiffness, often worsening with activity. It can affect multiple joints, as you've noticed.
- Rheumatism: This is a broader term that can refer to various conditions affecting the joints and may also involve systemic symptoms.
Next Steps to Consider:
-
Monitor Your Symptoms: Keep a journal of when you experience the pain, its intensity, and any activities that seem to worsen or alleviate it. Note any patterns that emerge, such as whether the pain is more severe in the morning or after particular activities.
-
Modify Activity: Avoid activities that exacerbate your pain, particularly those involving repetitive wrist motions. Incorporating breaks can help reduce strain.
-
Apply Ice or Heat: To manage inflammation or discomfort, try applying ice wrapped in a towel to your wrists and knee for 15-20 minutes several times a day. Heat can also be beneficial for muscle relaxation and pain relief.
-
Gentle Stretching and Strengthening: Engage in gentle stretching exercises for your wrists and knee, focusing on improving flexibility. If comfortable, light strengthening exercises may also help in the long run.
-
Use Supportive Gear: Consider wrist braces or supports during activities that trigger pain. This can provide stability and alleviation of discomfort.
Since you found that applying pressure with your thumb provides relief, it's possible you are affecting a muscle or tendon that is relieved by that pressure. Continue to explore that but do it carefully.
If your symptoms worsen or do not improve with these self-care measures, it's advisable to seek further evaluation from a healthcare provider, especially considering your age and current medications. They can help assess and accurately identify the underlying cause of your symptoms.
Take care, and please feel free to reach out if you have any more questions or need further clarification!
Related Questions
Struggling with Chronic Illness: A 21-Year-Old's Desperate Search for Answers
At just 21 years old, I find myself in a challenging predicament. Standing around 5'6" and weighing 102 pounds, I understand that I appear quite slender for my age, but I assure you, I do not have an eating disorder. I am reaching out in hopes of finding some clarity regarding my ongoing health issues. I frequently endure severe illness, experiencing relentless vomiting even on an empty stomach—my body somehow manages to expel its contents no matter what. Unfortunately, medication has been ineffective; I vomit even those pills, leaving me feeling hopeless. My body often prefaces these episodes with intense pain, particularly in my chest, and I frequently become lightheaded due to the discomfort. There have been instances where I fainted, prompting visits to the hospital. They performed scans on my stomach, which resulted in normal findings, but when I requested further examinations, the doctors refused, opting instead to prescribe medication that only exacerbated my symptoms. After stopping that treatment, I faced another emergency situation characterized by relentless vomiting, chest pain, and numbness. The medical team deemed it minor, advised against blood tests, and sent me home with prescriptions that I chose not to fill. My boyfriend suggested that I document my vomiting episodes by taking photos to illustrate the severity of my condition, but in those moments of distress, I'm too disoriented to consider reaching for a camera. I feel lost and overwhelmed as no solutions seem effective. This ongoing illness hampers my ability to work or engage in any physical or mental activities, forcing me to confront the reality that I’ve lost jobs due to these debilitating conditions. I'm at a loss—what steps should I take next?”
Navigating the Challenges of Kidney Stones
My history with kidney stones dates back a decade, but the specifics of my past experiences are a bit foggy. Recently, however, I have been dealing with some concerning abdominal issues. For the past few weeks, I've been experiencing pain on the right side of my abdomen. Almost two weeks ago, I saw significant blood in my urine, prompting me to believe I had passed a kidney stone. Following this incident, I sought immediate medical attention, where the blood tests returned normal results, and the analysis of my urine seemed to be fine as well. A CT scan revealed no presence of kidney stones. Shortly after, I began to notice persistent discomfort. A few days later, I woke up with severe pain in my flank and lower abdomen on the right side. I returned to the hospital, where the doctors suspected a urinary tract infection or a kidney infection, possibly related to the undetected stone. Consequently, they prescribed antibiotics, specifically nitrofurantoin, which I've been taking for the past three and a half days at a dosage of four 100mg tablets daily. While I find myself battling exhaustion and occasional nausea—common side effects of the medication—I am still managing some flank and lower abdominal pain. If I did indeed pass a stone as I suspected a week ago, it has now been several days since that event. If what I am experiencing is merely a post-stone discomfort, I'm prepared to handle it. However, I can't shake the concern that I might be developing another stone or some other condition. I have already scheduled a consultation with a urologist to explore this further. To give you a bit of background, I am 36 years old, female, reside in the UK, do not smoke, abstain from alcohol, and do not regularly take any medications.
Back Pain and Numbness Post-Surgery
I am a 38-year-old woman, standing at 5'5" and weighing 125 pounds. Currently, my medication includes ibuprofen and gabapentin, and I do not consume alcohol or use illicit substances. In October, I underwent surgery due to a herniated disc and Cauda Equina syndrome. The neurosurgeon successfully decompressed my nerves, which was a positive outcome. However, I’ve been experiencing persistent pain and numbness, which my doctors have indicated is to be expected following such an injury due to possible nerve damage. Generally, I’ve been coping relatively well with these symptoms. Last week, I visited my doctor for a scheduled appointment regarding steroid injections. During the examination, he expressed the need for nerve testing prior to proceeding with any injections. I am entirely agreeable to this approach. However, I awoke the following morning to intensified pain. My primary concern centers around the severe back pain and increasing numbness that seems to be worsening. Prior to my last appointment, I could only detect numbness in my vaginal area when touched, but now it appears to be expanding from my labia towards my anal region, inner thighs, and buttocks. Additionally, I have lost sensation while urinating. I still feel the urge due to pressure in my bladder, but I no longer have the sensation of actually voiding. What began as minor numbness, primarily localized towards the right side, has progressed considerably over the past week. Is it possible to experience Cauda Equina syndrome again? Should I be concerned about these developments? I would prefer not to visit the emergency room unless absolutely necessary, as I do not want to misuse anyone's time if these symptoms are typical following my injury. Thank you for any guidance you can provide. I have uploaded the MRI results of my initial injury, as well as a follow-up MRI conducted in December; I'm uncertain if sharing them here is permissible.
Mom's UTI: Improvement in Urine but Deterioration in Blood Tests After 5 Days of Antibiotic Treatment
**Patient Overview:** - Age: 56 years - Gender: Female - Height/Weight: 5 feet 6 inches, 71 kilograms - Ethnicity: Indian - Duration of Symptoms: Recurrent UTI for approximately 5 weeks - Location: India - Medical History: Prediabetes (HbA1c 5.8%), hypothyroidism, iron deficiency anemia - Current Medications: Nitrofurantoin 100 mg twice daily, Fosfomycin 3 g (completed), Metformin 500 mg twice daily, Thyroxine 62.5 mcg, iron supplements **Primary Concern:** My mother is currently facing a challenging recurrent urinary tract infection that has shown resistance to multiple antibiotics. Initially, she experienced a high fever (103°F) with her first infection in mid-January; however, she has not had a fever during subsequent occurrences, despite indicators suggesting the infection might be worsening. The confusion arises as her urine analysis appears to have improved while blood test results indicate a decline. **Timeline of Events:** **January 11, 2026:** - Diagnosis: E. coli UTI (100,000 CFU/mL) - Treatment initiated using antibiotics. - Symptoms recurred one week later with fever (103°F). **February 8, 2026 (New Infection):** - Urine culture revealed Citrobacter koseri (>100,000 CFU/mL) – indicating a different pathogen. - Urine pus cells: 60/HPF (elevated level). - Presence of blood in urine. - CRP level: 8.81 mg/L. - eGFR: 89 mL/min/1.73 m². **February 9, 2026:** - Medical advice included: - Nitrofurantoin 100 mg twice daily for 14 days. - Fosfomycin 3 g pouch for 3 days. - Clinical notes suggested possible pyelonephritis. - Blood Pressure: 146/80. **February 13, 2026 (Following 5 Days of Antibiotics):** - Urine examination showed positive trends: - Pus cells: Decreased to 6/HPF (from 60). - Bacteria: Not observed under microscopy. - Blood: Absent. - Leucocyte esterase: Still detectable. Despite improvements in urine analysis, blood results showed a concerning turn: - CRP: Increased to 17.47 mg/L (previously 8.81) - signifying a doubling of inflammation. - ESR: 60 mm/hr (normal range <30) - a new test result indicating inflammation. - eGFR: Dropped to 84 (from 89), suggesting declining kidney performance. - Hemoglobin: 11.4 g/dL (down from 11.9). - Sodium level: 134.6 (mildly decreased). **Key Questions:** 1. What could explain the significant reduction in urine pus cells (from 60 to 6) while the CRP levels have doubled (from 8.81 to 17.47)? Does this indicate a potential progression of the infection from the bladder to the kidneys? 2. Is the absence of fever a notable factor? With the first infection accompanied by a fever exceeding 103°F, her current lack of fever alongside rising blood markers is perplexing. Could her prediabetic state be concealing symptoms? 3. Are the prescribed antibiotics sufficient? While I acknowledge that Nitrofurantoin is effective in targeting the urinary tract, it may not adequately penetrate kidney tissues. Should alternative antibiotics be considered? 4. Does this clinical pattern suggest confirmed pyelonephritis? Considering: - Improvement in local urine parameters - Deterioration of systemic blood markers - Decreasing kidney function - Absence of fever amidst elevated CRP/ESR. 5. How immediate is the need for intervention? Should we consult the doctor without delay, or is it acceptable to wait until she completes the current antibiotic regimen? 6. Is hospitalization necessary? Given the concerning increase in CRP and declining renal function, would intravenous antibiotic treatment be warranted? **My Concerns:** Initially, the doctor raised the possibility of pyelonephritis, and the observed improvement in urine combined with the decline in blood tests seem to strengthen that suspicion. The absence of fever raises doubts about her true health status, especially with kidney function decreasing from 89 to 84 within just 5 days—this development is quite alarming. I appreciate any insights or advice on how to proceed further.
Exploring MMIHS vs Hirschsprung: Understanding Congenital Megacystis and Abdominal Distension in an Infant
**Patient Information** - **Age:** 13 months - **Gender:** Male - **Height:** 80 cm - **Weight:** 8.9 kg (notably lost 1.5 kg post-norovirus infection this month) - **Location:** Berlin, Germany **Current Medications:** - Prophylactic antibiotics since infancy - Laxbene **Medical Background:** The infant has been diagnosed with congenital megacystis and underwent surgery for posterior urethral valves (PUV). Urodynamic studies indicate a hypoactive bladder, and there is no evidence of vesicoureteral reflux. The bladder can hold approximately 300–320 ml but does not fully discharge; residual urine levels are between 20-100+ ml. The patient does not urinate during sleep and is currently catheterized 3 to 4 times a day. As for bowel health, a diagnosis has not yet been established. It appears that gas is becoming trapped in the upper abdomen, raising concerns about possible impaired intestinal motility. Recent imaging through MRI and CT scans revealed: - No indications of spinal or neurological issues - Dilated bowel loops The infant experienced a significant norovirus infection in January, necessitating a 14-day hospitalization. A motility disorder has been suspected since that time. Meconium was passed within the first 24 hours after birth, and constipation was observed starting at three months, characterized by hard, dry stools and straining. The infant was switched to a formula for cow's milk protein allergy (CMPA) combined with Laxbene. In the past three to four months, symptoms have intensified, causing: - Daily bloating leading to noticeable abdominal distension - Vomiting episodes when the abdomen becomes taut Occasionally, passing stool or gas will provide some relief, but this is not consistent. The distension tends to lessen overnight but reappears as the day progresses. **Inquiry Points:** 1. Which diagnostic evaluations should be conducted before we refer to a specialized motility clinic? 2. Is it advisable to proceed with a rectal biopsy now to exclude Hirschsprung disease? 3. For a referral in Germany, which specific specialty should we seek assistance from? Thank you for your help!