Q: I am a 20 years old male suffering from high ASO levels for the past 10 years. The titre value remains always around 400. For the last 10 years, I am suffering from continuous pain in both the wrists, which sometimes surges to a great pain. In my childhood, I once suffered from sore throat which may have led to this complication. I had taken Penicillin G potassium for two years, but after taking it I suffered from severe gastritis and vomiting. So I had to discontinue the medicine. After homeopathic treatment for two years, my ASO level got down to below 200. But recently I had severe wrist pain, severe headache and chest pain. Now, I am having headache everyday, which goes away with paracetamol but recurs after 10 hours. There is also constant wrist pain. How can my persistent wrist pain be managed?

A:You need to be evaluated for your joint pains whether high ASO is responsible for your joint symptoms or not. Investigations like haemogram including ESR, CRP, ANA-IF, Rheumatoid factor quantitative, X-ray of the wrist and hands, echocardiography should be done and a physician consult is required. If there is any inflammation then CRP should be high. For persistent headache a CT scan / MRI brain maybe done after the physical examination if required. ASO titres can fluctuate due to episodic sore throats and will not cause heart/brain damage.