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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35472
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have Rheumatoid and Osteoarthritis and am having treatment

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I have Rheumatoid and Osteoarthritis and am having treatment (since 1997). Recently I have been having trembling fingers and involuntary shaking and occasional jerking spasms in the right arm. The right shoulder (for which I am waiting for surgery) is one of the Osteoarthritis sites, along with cervical spine. I take Methotrexate (along with Folic acid), Prednisolone, Tramadol Hydrochloride, Calcium D3 Forte tablets, Simvastin, Fluoxetine Hydrochloride, Lanzoprasole, and Myocrisin Injection (every 3 weeks). Over the past few months I have experienced a sense of general weakness and also occasional loss of balance. I would be grateful for any advice/comments you could offer.


Were any blood work or medical imaging done for these symptoms?

Did you mention about these to your rheumatologist?

Dr. Arun

Customer: replied 6 years ago.

I hve not spoken to my Rheumatologist about these symptoms. I just assumed they were part of the Arthritis 'package'. The only blood tests I have had are the regular ones every 3 weeks, before the Mycrosin injection. These are recorded in a booklet and are consistently within the same (presumably) acceptable range.

The blood tests are for HB, MCV, WBC, Platelets, Neurophils, Lymphocytes, ALT,Creatinine, CRP. There is another category which has recently appeared on the list but it is handwritten and may be GFR (reading for this is 80). Cheers

Hello and welcome.

Thanks for the detailed information. Your symptoms can be due to Rheumatoid arthritis (it may affect the nerves). Though the more likely cause is side effects of the medicine (methotrexate or prednisone can be responsible) or peripheral neuropathy due to other causes. Your physician may need to get the following investigations done;

1) Electromyography/nerve conduction studies (EMG/NCS)

2) MRI of the spine and brain

3) blood glucose, glucose tolerance test and glycosylated hemoglobin

4) serum B12 level with methylmalonic acid (with or without homocysteine),

5) serum protein electrophoresis

This should give the diagnosis and guidelines for the management.

Please feel free for your follow up questions.

Dr. Arun

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