Q: My wife is 27 yrs old and we have 2 childern. Since the last two months my wife is having pain in the finger joints. This gets severe in the nights and then she can't even fold her hands. This is happening in the toes also. But in the hands it is more severe. In the morning as she starts working this pain disappears. Kindly suggest a treatment for this. Is it some type of serious disease? Your suggestion will be highly appreciated.

A:I have read the symptoms that you have described. I would like to give a short description of disease classified as 'arthritis'. There are hundreds of different types of arthritis. But, they can be easily classified into 2 categories: 1.'Green Flag' arthritis - This is nothing serious; mostly related to the aging process of the joints, occurs in people over 50 years of age and causes knee pains. This is not a serious internal, life-threatening disease but more a 'mechanical failure' of the joint due to wear-and-tear. We rheumatologists do not consider it as anything very serious; simple exercises, reduction of weight, aerobic exercises and some simple medicines is all that is needed in most cases. In exceptional cases the worn off surface coating of the knee joint may have to be changed (like they did in the knee of the Prime Minister!). 2. 'Red Flag' arthritis'- This category includes several serious internal diseases that usually occur in young persons below the age of 50 years, 4-5 times more often in young ladies, and affects small joints of hands and feet with a lot of morning stiffness that improves slowly as they start using the joints. This is a serious group of internal disease. The most common disease in this group is called 'RHEUMATOID ARTHRITIS' (not to be confused with a rare type of arthritis in children - called 'rheumatic arthritis'). Its cause is now known but, rather complicated to be explained here in a short write-up. Suffice it would be if I tell you that there is a strong genetic background to this disease. If left untreated, it may become serious, crippling disease and it can even threaten life. One must strongly avoid taking the 'wrong track' of scientifically unproven 'alternative systems of medicine' for the treatment of this disease. That could be disastrous in the long-run! The most important thing in this disease is EARLY TREATMENT. If modern medical treatment is delayed even by a few months, permanent damage may result. Considering the symptoms in your wife my guess is that she is an early case with rheumatoid arthritis (or with one of its many variants). She needs to be seen urgently by a trained and qualified rheumatologist . All-India Institute of Medical Sciences, Apollo Hospital and Indian Spinal Injuries Centre (Vasant Kunj) are 3 well-know centres for rheumatological diseases and rheumatoid arthritis. It is strongly advised that she consults at any one of these hospitals without any further delay.