Dr. Mishal Abdullah

Good evening,

Unfortunately this seems to be a question out of the scope of a Rheumatology practice since there are several potential explanations for your symptoms. I would advise you to contact your treating physician to discuss your concerns and decide on further measures that may be appropriate.

Have a great day.

Mishal Abdullah.

Good evening,

PMR, also known as Polymyalgia Rheumatica, is an inflammatory condition that is typically diagnosed and treated by Rheumatologists. It is characterized by relatively sudden onset stiffness in the shoulders and hip and is typically seen in individuals older than 50 years of age; it is not common in younger individuals. It is also characterized by abnormal levels of
inflammation in the blood. So, although it is not a specific kind of arthritis, it is an inflammatory disease that can present with joint pain.
I hope the above answers your question.

Yours sincerely,

Mishal Abdullah, M.D.

Good morning,

There are several different causes for knee swelling ranging for regular wear and tear arthritis to inflammatory conditions such as rheumatoid or psoriatic arthritis. Meniscus injuries and trauma can also be associated with knee swelling as can infections such as Lymes disease. In addition conditions such as gout and pseudo gout are also common causes for knee swelling. Unfortunately based on the information provided it is difficult to narrow it down further but considering the severity of symptoms I would strongly recommend reaching out to your PCP as a first step to getting a clearer diagnosis and if appropriate and possible then evaluation by Rheumatology or Orthopedics may also be needed.

I hope the above information is useful to you.

Mishal Abdullah.

Good afternoon,

Heel pain can be from various causes including degenerative arthritis, bone spurs, plantar fasciitis in addition to various other possible processes. If it does recur then it would certainly be useful to evaluate further to identify the cause. Treatment is based on the diagnosis and sometimes for benign causes treatment is symptomatic whereas for more serious causes there may be the need to pursue more aggressive treatments. With limited information I would be unable to comment further but would suggest starting a discussion with your primary physician who can then proceed with some work up and may also proceed with a referral to a specialist such as Orthopedics or Rheumatology. I would not want you to worry based on the information provided but would certainly advise some further work up to assess the underlying cause.

I hope the above information is useful for you.

Mishal Abdullah.

Good evening,

I hope you are well.

Rheumatoid arthritis is an autoimmune disease characterized by big red swollen inflamed joints. It is treated with immunosuppressive medications to quiet down the inflammation and other modalities that may provide symptomatic relief. Unfortunately, chiropractic care typically would not be expected to provide significant benefit for rheumatoid arthritis as a treatment modality. It may provide some benefit in other forms of arthritis such as osteoarthritis however.
I hope the above helps you.

Mishal Abdullah, M.D.

Good morning,

Yes, spine issues can cause neuropathy. The entire body has millions of nerves and all nerves in our limbs converge in the spine before going up to the brain; this is how sensations travel from our limbs to our brain. Therefore, if someone has problems with the spine this can affect the nerves entering and leaving the spine. This can cause neuropathic features and
neuropathy in the distribution of the affected nerves and can be characterized by pain, numbness and tingling, weakness, and other such symptoms which would be expected in neuropathy. It is generally important to assess the cause of neuropathy, and treatment is then aimed at the cause. If this is felt to be related to problems in the spine, then addressing that
problem could help with symptoms related to this. I would recommend you discuss ongoing problems with your primary care physician and based on what the findings are they may be able to implement relevant treatments and/or refer you to the right specialist.
I hope the above information helps.

Good evening,

In general there are a few medications that are used to treat nerve pain. These are prescription medications such as Gabapentin which can be associated with side effects. The important question though is why your son is having nerve pain. It would be very important to evaluate further for causes for the nerve pain so that relevant treatment can be implemented to treat the cause of the problem rather than just mask the symptoms. With limited information provided it is difficult to provide further advice but I would strongly advise discussing the ongoing symptoms with your son’s physician to delineate the cause of the nerve pain, and to pursue relevant diagnostic and therapeutic measures.

I hope the above information is helpful. I wish your son the best of health.

Mishal Abdullah.

Good afternoon,

Nelo Ivan is an anti inflammatory medication which can affect the kidneys and the lining of the stomach although there are several other potential side effects which are less common. It does not affect the liver as much as a lot of other medications so the combination of Meloxicam and beer would not be as bad as some other medications such as Tylenol. However, there would be a slightly higher risk of gastrointestinal problems. If you avoid having beer within 24 hours of Meloxicam that would be perfectly fine although if you were to develop any new or worsening symptoms / side effects particularly additional pain or other signs of damage to the stomach lining you would be best advised to stop the medication and contact your treating provider. In addition, the amount of alcohol intake also probably would make a difference so best advice is to always practice moderation.

I hope the information above is helpful.

Mishal Abdullah.

Good afternoon,

Osteoarthritis is the most common form of arthritis and is also commonly known as degenerative arthritis. Typically this starts later in life around the 40s onwards but certainly could occur earlier related to strenuous activities that cause early onset of degenerative change. Sometimes osteoarthritis can also start early due to joint laxity or ligament or meniscus injuries. Therefore it certainly is possible to have early onset osteoarthritis but it would also be important to consider other forms of arthritis which are more likely to present early in life such as rheumatoid arthritis or psoriatic arthritis. Without any further information it is difficult to comment further on the likelihood of this but it would be useful to consider a consultation with a rheumatologist or orthopedist to assess further and to rule out other forms of arthritis.

I hope the above information is helpful.

Mishal Abdullah.

Good afternoon,

Pain in the hands can be related to a variety of different diagnoses and intact diabetes can be associated with nerve pain in the hands and feet. Other causes of hand pain could also include various different forms of arthritis or tendon problems as well as nerve problems. Generally conditions such as rheumatoid arthritis are characterized by red hot swollen joints particularly with periods of inactivity whereas regular wear and tear arthritis typically worsens with activity. Unfortunately based on the information provided I cannot provide any further insight but would recommend discussing with and seeing your primary physician who can then determine whether treatment and testing is needed or evaluation by a specialist such as rheumatologist or orthopedics may be beneficial.

I hope the above information is helpful to you.

Mishal Abdullah.

Good evening,

Gout is an extremely painful condition which causes recurrent "attacks" or "flares" of painful and swollen joints; this typically affects one joint at a time, but can affect several as well. This is brought about by deposition of uric acid crystals within joints of genetically susceptible individuals which is why there is often a family history. Treatment of primarily gout is in 2 parts;

1. Treatment of the acute attack which involves the use of medications including anti-inflammatory medications such as Indomethicin, steroids or a medication called Colchicine. All of these are aimed at stopping the gout attack. Sometimes the joint involved is injected with steroids to calm it down.
2. Treatment of elevated uric acid levels which involves the use of medications such as Allopurinol to decrease the uric acid levels in the blood which thereby decreases the severity and frequency of gout flares; decreasing intake of certain foods such as shellfish, red meat, and large amounts of alcohol also provide benefit, but this approach typically is not enough by itself.

The above is brief overview which I hope is helpful. I would strongly advise you to have your daughter see her PCP or a rheumatologist so that relevant treatments can be implemented.
I hope the above information is helpful. Have a nice day.

Good afternoon,

Lupus is an extremely complex condition which can present in many different ways. It can affect several organs and varies in severity from mild disease to life-threatening disease. Treatments used for lupus largely depends on which organs are involved and how severe the disease is. There are several different medications used based on the presentation and the
disease status. I would strongly advise you to seek Rheumatology expertise with a local physician if there is concern for lupus to 1st clarify and confirm the diagnosis and then to discuss specific treatments.
I hope the above information helps.

Yours sincerely,

Mishal Abdullah

Good afternoon,

Gout is a condition caused by elevated uric acid levels in the body that have a tendency to deposit in joints of individuals thereafter setting up significant inflammatory response. This causes severe pain, redness and swelling in the affected joint and is often described as the MOST painful joint process known to man. Typically, the base of the big toe is the most common joint affected but other joints such as the knees could be affected. It can also be associated with certain triggers such as beer, shellfish and red meat. It is important to note that just having elevated uric acid levels in the blood is not diagnostic of gout as in a lot of people joint inflammation does not occur or develop. It is only when there is elevated uric acid level in the blood and inflammation within the joint due to uric acid crystals is the diagnosis gout. There are treatments for gout and in case of suspicion or concern I would urge you to discuss further with your primary care physician or rheumatologist.

I hope the above information helps.

Good afternoon,

Rheumatoid arthritis is a serious condition and can lead to significant joint damage and deformity; it can also lead to significant internal organ involvement. Treatment essentially entails the use of immunosuppressive medications and there are several different medications available for this purpose. I would strongly advise to establish care with a rheumatologist if not already done so and then proceed to work with them in terms of managing the condition. I would strongly advise against ignoring the condition as it can lead to significant joint problems and major complications including organs such as the lungs, kidneys, skin, nervous system and blood counts.
I hope the above helps.

Good evening,

Lymes disease can cause a variety of manifestations; typically a skin rash develops which then resolves and can be accompanied with fatigue and fevers and other such symptoms. Untreated Lymes disease can affect the nervous system, heart and can cause significant joint swelling and inflammation. I do feel evaluation by a physician and relevant testing for Lymes disease would be important. If she does have infection treatment is with simple antibiotics but if it remains untreated it can lead to significant problems and treatment then may not be as easy.

I hope the above information helps you.

Mishal Abdullah.

Good evening,

There are several kinds of arthritis; some are age related and develop late in life whilst others are not necessarily related to age and can be related to conditions such as RA. To answer the question, yes it certainly is possible for a 13 year old to have arthritis and would be important to discuss with your physician as sometimes evaluation by a rheumatologist could be very important in such situations.

I hope this helps.

Mishal Abdullah.

Good evening,

Most people will develop some degree of arthritis in some joints as they grow older; this is typically wear and tear arthritis also known as osteoarthritis. This type of arthritis typically affects joints such as the knees, hips or back but can affect other joints and is typically associated with pain with activity, improvement with some rest and anti-inflammatory medications, heat and other such measures. There can also be some swelling.

Rheumatoid arthritis is an autoimmune disease that affects the joints in a very different way to wear and tear arthritis; typically there is a lot of pain, redness, warmth and swelling in affected joints and typically there is also a lot of morning stiffness and with activity the symptoms and stiffness do improve a bit during the day. In addition, it typically RA affects multiple joints all at the same time on both sides of the body such as the knuckles of both hands, the wrists, ankles and feet. If you have red hot swollen joints typically every day in the mornings that take a long time (greater than an hour) to loosen up and that does not really improve with regular OTC medications such as Advil or Aleve, then it would be useful to be evaluated to ensure that you do not have RA or any other similar condition.

I hope this helps you.

Good evening,

Rheumatoid arthritis is the most common form of inflammatory (inflammation associated) arthritis. It is characterized by red hot swollen and inflamed joints; it is typically symmetric and affects the smaller joints such as the knuckles, wrists, ankles and feet although large joints can be involved. It is diagnosed based on relevant clinical findings on history and exam and there are some blood tests that are done to confirm the diagnosis although it is important to realize that blood tests can also be falsely abnormal so the blood tests themselves are not helpful just by themselves. The blood tests done for RA including two specific antibody tests called the Rheumatoid factor and the CCP antibody although other blood tests such as a routine CBC and ESR may also have clues to a diagnosis of inflammatory disease.

I hope the above information is helpful and if you do have concerns I would urge you discuss this with your primary physician to assess further and possibly refer you to a rheumatologist for relevant assessment as early diagnosis is an important factor in preventing permanent joint damage.

Mishal Abdullah.

Good morning,

A rheumatologist evaluated patients by taking a detailed history, performing a systematic physical exam, and pursuing blood test and imaging that may be appropriate to determine the cause of joint or muscle pain. Blood tests are certainly helpful but it is the clinical features that often provides important clues that leads to an accurate diagnosis. An accurate diagnosis is essential to determine the treatments that may or may not be useful in a certain clinical scenario. If there is suspicion for an underlying joint problem it is always useful to seek the opinion of a rheumatologist whom may be able to delineate the diagnosis and implement relevant treatments as needed.

I hope this helps.

Mishal Abdullah.

Good evening,

These are unrelated conditions. Degenerative disc disease is age related wear and tear damage. It is not inflammation related or autoimmune in nature. Sjögren’s syndrome is an autoimmune disease which sometimes can be associates with joint problems but these are different from degenerative disc disease

Mishal Abdullah.