I am a 19-year-old girl (turning 20 in a month). I have pain in the joint of my right index and middle fingers. I used some heat pad and rumoxil and massaged it but it still hurts. I heard it’s the first symptom of rheumatoid arthritis and it cannot be examined. Is it really arthritis? And what do I do to get rid of the pain. It has been hurting for a couple of days. Do I need to visit a specialist? — Anonymous

There are several causes for the type of symptoms you have presented. Your statement means that you have joint pain of two fingers, namely both index and middle fingers. Would have been more informative if you had stated whether they are swollen or inflamed too. Yes, one of the prime causes could be rheumatoid arthritis which you have pointed out. I do not know why you have stated that it cannot be examined and obviously it is imperative that the specialist or doctor concerned examines you for proper diagnosis.

Among differential diagnosis, it could simply be case of trigger finger which is a type of tendinitis which develops in the tendons that bend the fingers. It is a common problem because of the way that the hand is made, which may be a little different than you would suspect. There are no muscles in the fingers. We actually move our fingers by remote control. Muscles in the forearm are connected to the finger bones by smooth, flexible strings, called tendons. The muscles pull on the tendons, which then bend the finger joints. When the tendons which bend the fingers (the flexor tendons) become irritated, they can cause pain, swelling, and stiffness. Tendon swelling (tendinitis) results from a person’s own tendency to collect fluid around their tendons and joints. This may be aggravated by repetitive or strenuous activities.

Treatment part consists of icing for five to fifteen minutes at a time on the area which is most swollen and tender, non-steroidal anti inflammatory medication (NSAID), such as aspirin, ibuprofen, naprosyn, or ketoprofen. Remember all these medications cause acidity which is a common disease entity in our population. Avoid activities which involve a sustained grip as these put stress on the irritated tendon. If fingers bend and lock during the night and are painful to straighten in the morning, it may be helpful to wear a splint to keep them straight while sleeping.

Well, it could also very well be rheumatoid arthritis where the cause is unknown except that there is a genetic element to it. If it is confirmed by blood tests and physical examination then there are factors like which food to avoid, physical therapy and supplements like omega 3 fatty acids and judicious intake of medication course which would surely alleviate your condition. There are so many preventive exercises that are useful. Surgery only comes into play if the joints are damaged.

Of course, there are other conditions like bursitis, osteoarthritis, osteoporosis, bursitis, cellulitis, Raynaud’s phenomenon (restricted blood supply), carpel tunnel syndrome, chilblains among others which has to be ruled out. Thus, my advice is not to jump into conclusions, let us first see an orthopedician who would rule out your cause of finger pain from the above stated entities and if it is indeed rheumatoid or arthritis of some sort then you could see a rheumatologist who would guide you to physical therapy, exercises, diet to be avoided, supplements to be taken and specific medicine course to be taken.

But foremost important is to come to the correct diagnosis as it could very well be just a case of trigger finger or otherwise.