Q: I get stiffness in my hands while getting up in morning and it last for 15-20 minutes. This started nearly a year ago and I started taking pain killers. Recently I was advised for a blood test and the report is as follows: Rheumatoid Factor: 119 IU/mL.(+ve); Rheumatoid Factor, IgA (ELISA)= 9.80 U/mL (-ve); Anti-ds DNA Antibody (double stranded)= 34.00 IU/mL (-ve); ANA/ANF (-ve); HLA-B27: (-ve). Presently I am taking following medicines - Neotrexate 2.5mg - 3 tab. once a week, Folinal (folic acid tab. 5mg)- 2 Tab. twice a week, Orthobid - 2 tab. daily and vitamin E Cap.- 1 Cap. daily. I don't feel any improvement so far even after taking medicines for two months. Please advise.

A:You are suffering from rheumatoid arthritis. May I suggest that you take treatment under the care of a rheumatologist rather than a general physician or an orthopedic surgeon. The approach to treatment of this disease has undergone considerable change in recent years! If you do not receive adequate treatment at this stage, joints can get deformed leading to physical disability. Your present treatment is probably inadequate for the severity of the disease and it is not surprising that there has not been much improvement! If you are already under the care of a rheumatologist, please see him/her again for a review.