Joint deformity a sign of arthritis
Q. About 15 years ago, I developed a small bump on the outside of my knuckle immediately below the fingertip of my little finger. It stayed consistent until about two years ago, when all my knuckles began to develop similar bumps. Some of them are painful at times.
I began taking 1,500 milligrams of calcium per day when I was told I had osteopenia, but this is the only adjustment I can identify in my lifestyle. Do you know why these bumps occur? Is there a way to prevent or reverse them?
A. Your knuckle bumps are most likely a sign of arthritis, but without further examination and testing, I can't be sure. Visit your primary-care physician, who can examine your hands and the extent of the joint deformities. He or she should also order X-rays of your joints. Arthritis is a common ailment, but if it is not diagnosed properly and treated with lifestyle changes and over-the-counter or prescription medications for inflammation and pain, it can lead to permanent joint damage and disability.
Q. My 78-year-old wife has focal dystonia of the hand. She was diagnosed 25 years ago, and at that time it was called writer's cramp. Her hand would only shake while in the writing position. Over the years, it has gotten much worse, and now it is difficult for her drink from a cup. Is there anything that could help her?
A. Focal dystonia of the hand or limb usually appears as a painless loss of muscular control during certain movements, such as writing or playing an instrument.
Symptoms include curling of the fingers, involuntary flexing, lack of precision and more. Some patients may experience tremor. Most cases are present only during specific activities.
Treatment can be challenging and depends greatly on the cause of the condition. There are two general treatment options available. The first includes medication that affects the transmission of messages from the brain to the affected muscle or muscles. Another option is Botox injections into the affected area. This may block nerve impulses to the contracting muscles, which temporarily weakens the muscle, reducing or eliminating symptoms for a period of time.
I suggest your wife be re-examined by a neurologist or other medical professional familiar with dystonia. If her condition has worsened, the specialist can offer some suggestions about ways to treat and relieve the symptoms. There may also be new treatments or techniques available with which I am unfamiliar.
In the meantime, your wife may wish to try drinking through a straw or a lidded cup to prevent spilling. Finding alternative ways to accomplish the tasks she is currently having difficulty with may be all that is needed.
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