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pain in heel and joints

Q: I often feel pain in the joint of my right hand and middle finger of my right hand. When I fold the middle finger of my right hand I feel severe pain. I also feel pain in the heel portion of my right leg and whenever I stand and walk I feel moderate and sometime severe pain in the heel portion . This pain starts the moment when I get up from bed and put my legs on the floor. Can I know whether any check up is required and can you suggest any medicine. Please let me know SASTRY

A:You have two categories of symptoms; one relating to your finger and the other relating to the heel. Both can occur in some patients particularly those who have some arthritis like rheumatoid arthritis. However, both these may occur without any underlying disease. As you are a hypertensive your serum uric acid must be done and if it is high you should have diet modifications to reduce that.Coming to your specific symptoms, your finger pain could be because of a condition called trigger wherein a tendon that moves the finger gets trapped in the tight sheath of police in the palm and finger. This sheath gets tight because of inflammation or swelling in them. Taking a pain killer like Diclofenac or Ibuprofane may reduce the swelling and help reduce pain and improve movements. Some patients may need surgery to release the tight sheath.Heel pain, some times you may need injection of local steroid to reduce pain. This should not be done without consulting an Orthopaedic surgeon and because there is a high risk of infection, it should be attempted only in an operation theatre under thestrict aseptic condition.Your heel pain seems to be plantar-fascitis. This also should settle with the anti-inflamatory drugs or with steroid injection. Again this should not be done without consulting an Orthopaedic surgeon and because there is a high risk of infection, it should be attempted only in an operation theatre under the strict aseptic condition.

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