Joint Pain

Name: Jane Down

Age: 45 years old

Date of Birth: 30th August 1979

Location: Bluewood Surgery

Occupation: Professional Tailor

"My wrist has been painful for the last month or so, I think I've just been using it too much at work and it'll go away."

• Site: In the joints of the fingers of your right hand.

  (if specifically asked: yes, you find it strange how its the joints closer to your hand that are more painful)

• Onset: Started about 4 months ago

• Character: Not sure how to describe it but it's a constant pain. Joints feel a bit stiff as well.

• Radiation: No

• Assoc Sx: Knee was a bit stiff last weekend but that was after 2 hours of gardening so you doubt it's related

• Timing: You think it's worse at the start of the day and eases off as you get moving

• Exacerbating Factors: Nothing really, but it's worse first thing in the morning

• Relieving Factors: Weirdly enough it goes away when you start working

• Pain Scale: Maybe a 6/10 in the morning but the stiff ness is worse

• First realised one morning when I was going to work. I thought that I had just been overworking myself lately and that it would go away, but it never did.

• Recent illness: None.

• Recent trauma: None. 

• Recent travel: None.

• Previous episodes: Never experienced this before.

• Ideas: "I think I've just been using my hands too much"

• Expectations: “Can I get some painkillers to help with work?"

• Concerns: “It's been affecting my work slightly as my hands are not as good as they used to be"

• Bowel habits: Nil

• Urinary habits: Nil

• Appetite: Same as usual.

• Sleep: Same as usual

• Weight: No change 

• Pain in the chest/abdomen: None

• Headaches: None

• Fever: None

• Cardiology: Normal

• Respiratory: Normal

• Upper limb neurology: Normal, no numbness or tingling. No particular movements worsens the pain.

• No pain in lower limbs

Previous hospital admissions: None

Previous surgeries: None

Medical conditions:

• I've always been very fit and healthy, with the occasional cold. Never really needed to come to the doctor's before this.

Medications:

• Over the counter vitamins and paracetamol

Allergies:

• None.

My dad always had bad joints but he worked in a job which was very physically demanding.

• Smoking: You used to smoke about 5 a day but have stopped for almost 10 years now!

• Alcohol: Occasional glass of wine at parties

• Recreational drugs: Never

• Diet: I usually cook at home

• Exercise: I do a lot of gardning and I walk my dog

• Ill contacts: No one around me was recently ill

• Home: Lives with husband and 10 year old son in 2 storey house

• Active Daily Living: Indenpendent with all ADLs

• Occupation: I have my own clothing shop