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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5053
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I had initially made appt w/ my FP Doctor for ankle and PIP

Customer Question

Hello Doctor,
I had initially made appt w/ my FP Doctor for ankle and PIP joint pain in both hands especially in the am. Was hard to walk down stairs for hour or so. No other RA sx (swelling, warmth, system sx), so I decided to observe a bit longer. This week I noted I was repeatedly awakening with my hands clenched and thumbs in palm-nail marks in palm--which could be why I am having pains for last 2 months.
No tingling, numbness, nor real weakness. I do have bruxism since a teen (supposedly due to crossbite), not particularly anxious or other sleep issues. Only rx HRT (50 yo F).
Submitted: 1 month ago.
Category: Neurology
Expert:  Dr. Bob replied 1 month ago.

Hi there. I read your post. What question can I help you with?

Customer: replied 1 month ago.
I wondering what you thoughts are re the etiology.
Expert:  Dr. Bob replied 1 month ago.

RA is a good thought given the PIP involvement. It is easy to test for this, though in rare cases the RF is normal even when the clinical picture is pretty clear. (i.e seronegative RA). If it is RA, it typically responds pretty well, or very well, to NSAIDs. You could try ibuprofen or naproxyn if you tolerate them. That said, the nail marks in the palm make me wonder if you might be having occult seizures. They can sometimes occur only at night, and might be partial in nature. Either way, a sleep EEG would help to uncover this, or perhaps rule it out for now.

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