DEAR DR. DONOHUE: I am 56 and have just been told I have arthritis. Aren’t I slightly young for arthritis? I saw the doctor because of tiny bumps that popped out on the top knuckles of some of my fingers and because my fingers had become stiff. Only my hands are affected. Everything else is fine. I’m having trouble accepting this as arthritis. What do you think? – R.K.
ANSWER: I go along with the arthritis diagnosis – osteoarthritis, the most common kind of arthritis. It used to be called “wear and tear” arthritis, but it doesn’t occur simply from wear and tear. We know many factors that are involved, and there are many factors we don’t know. Aging, genes, previous injury and hormones are some of the known factors.
You’re not too old for osteoarthritis. It’s infrequent before age 40, and it’s most often diagnosed in the late to mid 50s. You’re at the right age.
What happens is that the cartilage that covers the ends of two bones splits, fissures and crumbles. The result is a stiff, painful joint. Pain increases with activity. Osteoarthritis most often affects the hands, fingers, knees, hips and the spine in the lower back and neck.
One form of osteoarthritis is more common in women, and it appears you have that kind. It happens in the fingers and hands. Small bumps appear on the knuckles closest to the fingertips. They’re called Heberden’s nodes and are indicators of osteoarthritis. The bumps are bony growths.
For most, osteoarthritis is a slowly progressive illness. Your kind might remain limited to the hands and fingers.
The arthritis booklet discusses rheumatoid arthritis, osteoarthritis and lupus. Readers can obtain a copy by writing: Dr. Donohue – No. 301W, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: What is referred pain? I have had pain in my right shoulder blade, off and on, for about six months. I thought I had strained a muscle. My doctor believes it comes from my gallbladder, and I am scheduled to have an ultrasound of it. Can the gallbladder cause shoulder-blade pain? How? – M.M.
ANSWER: Referred pain is pain felt in a place distant from the actual source of the pain.
Gallbladder pain is a good example. The gallbladder is beneath the liver on the upper right side of the abdomen. However, a gallbladder attack can be felt in the right shoulder blade or in the area between the shoulder blades.
The explanation has to do with where organs are located during fetal life. Organs and tissues far removed from each other in a mature baby are close to each other in a fetus. As maturation progresses, the organs migrate from their fetal position to their full-term maturity position. But they carry with them the same nerve connections they had from the beginning. So nerves adjacent to the fetal site of organs can become activated after that organ has relocated to its normal, fully developed position.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475.
©2007 North America Synd.