Dr. Robin Locks, MD

Working at a computer, can increase your risk of developing tendinitis in the hand or carpal tunnel syndrome, but not an actual rheumatic disease. It is important that you have an ergonomic workstation even if you use a laptop it should be on a desk. And you want to make certain that there is a wrist rest.

There are over 120 different types of arthritis. Osteoarthritis in the past was called degenerative arthritis as the disease starts in the cartilage as it thins with age causing the bones of the joints to rub together and form bone spurs that cause pain and swelling and when this occurs in the spine, nerves can be pinched. Rheumatoid arthritis is due to inflammation in the synovium which is the lining of the joint that normally lubricates the joint but with inflammation the synovium produces large amounts of joint fluid that causes the joint to become warm, swollen and painful and can even be red at times. Osteoarthritis occurs as we get older or in a younger person who has injured a joint. Rheumatoid arthritis can occur at any age from a few months of age to the nineties; it can have a genetic component. Other than anti-inflammatory medications like ibuprofen and naproxen there are no therapies for osteoarthritis; often once the joint is severely damaged, surgery is required. In rheumatoid arthritis, there are many medications that can prevent further damage from occurring and put the disease in remission although we do not have a cure as of yet.

Obviously he needs to see a pediatric rheumatologist and be evaluated. I am certain that he will be started on hydroxychloroquine and then, depending on if he has any organ involvement, he might be started on prednisone, and or azathioprine. The prognosis for lupus, now is much better than in years past as there is biologic therapy that can put the disease into remission.

If a patient fails a trial of two different NSAIDs it is recommended to be started on biologic therapy or JAK inhibitor therapy. Dr. Dore

Hot compresses 3 times per day for 20 minutes each is what is recommended. Massage is usually performed on muscles not joints

Excessive weight contributes to osteoarthritis in weight bearing joints such as the knees, feet, hips and low back. Dr Dore

Rheumatoid arthritis runs in families and usually begins between the ages of 30-50. The diagnosis is made on the basis of a physical examination of the joints, laboratory studies for rheumatoid factor, CCP antibodies, sedimentation rate, quantitative C reactive protein and an ANA and hand x-rays or musculoskeletal ultrasound.

There is no such condition as fibromyalgia rheumatica. There is fibromyalgia and polymyalgia rheumatica which is treated with prednisone. If a person cant be tapered off prednisone, it is recommended to add Actemra that is a self injection or IV that allows the prednisone to be tapered off and is in place of the methotrexate. Dr. Dore

Yes this is normal and why many people with arthritis live in the desert or Florida where it is warmer year round.