Health

Swollen wrists and feet, can’t sleep – VnExpress


Wrist pain, pain in the thumb, and a crackling sound when flexing the fingers are often associated with tendinitis.

I have had dermatitis (eczema) for several years now. A few months before I had not had an AstraZeneca vaccine, I often had pain, swelling in the ankle joint and left instep (daytime), from night to morning when I woke up, it collapsed almost normal. This cycle is repeated often.

After I had my first AstraZeneca vaccination more than 5 weeks, the swelling and pain on the left foot was gone, now it is painful and slightly swollen left carpal tunnel and big toe. The flexed thumb is painful and has a crackling sound. At night, I have difficulty sleeping (only about 4-5 hours), during the day, I feel sleepy. I use functional foods to help reduce joint pain and improve sleep regularly. Ask your doctor for advice, what disease do you have? Thank you to the doctor. (Vo Nguyen Dung)

Reply:

His current condition is swelling and pain in the wrist area, with pain in the thumb and a crackling sound when flexing, which is often related to inflammation of the thumb tendons, especially the thumb flexor tendon. In the early stages of the disease, patients may only appear pain when performing finger flexion movements, but if not treated promptly and properly, the disease can progress to more severe, leading to difficulty in flexing the fingers. hand, resulting in having to use the other hand to help. Eventually, the finger can lose its ability to flex and get stuck in a position known as trigger finger or spring finger.

Tendonitis is common in patients who use their fingers a lot, perform repetitive finger flexion, pinching, and grasping movements; can be related to occupations such as teachers, craftspeople, barbers, surgeons, office workers who use a computer mouse a lot… The disease can also be encountered after trauma or inflammatory diseases systemic diseases such as polyarthritis, spondyloarthritis, psoriatic arthritis, gout… Currently, no symptoms of flexor tendonitis have been recorded after vaccination.

Musculoskeletal pain is a symptom of many diseases. Photo: Unsplash

In his particular case, he had a history of painful swelling in the instep before the injection, and later developed inflammation of the flexor tendon of the finger. Therefore, in patients, doctors have not ruled out systemic inflammatory diseases and have little thought about vaccination. To definitively diagnose the cause, doctors need to perform a soft tissue joint ultrasound, which checks for systemic inflammation by testing for erythrocytes, CRP, and other autoimmune factors.

To treat flexor tendonitis, the patient first needs to limit the movement and use of the inflamed finger, which can be combined with cold compresses and fixed splints. At the same time, the patient will be prescribed appropriate anti-inflammatory drugs such as NSAIDs (Meloxicam, Etoricoxib, Celecoxib…); Local corticosteroid injection if not responding to oral medications. In case the fingers are stuck in the trigger position, the patient must undergo surgical intervention to release the fibrous inflammation to restore the motor function of the tendon.

If this situation of tendinitis is related to systemic inflammatory diseases, depending on the specific diagnosis, the patient will be treated and have a long-term follow-up plan. So it’s best to go to the hospital.

MSc.BS.CKI Tran Thi Thanh Tu
Orthopedic Trauma Center, Tam Anh General Hospital, Ho Chi Minh City

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