My stiff fingers are looking so knobbly and getting rings off is a nightmare

QSeveral of my finger joints have got larger and my hands now look a bit ugly. They are sometimes a bit stiff in the mornings too and getting my rings on and off is a real problem.

My doctor says it is arthritis and there is nothing that can be done about it, but is this just because of non-urgent work being stopped because of Covid?

This sounds like osteoarthritis (OA), where the cartilage cushions that protect the ends of the bones are worn away. This stimulates the growth of new bone, which is what makes the joint look enlarged and often knobbly.

Finger joints affected by OA may not be painful but as the condition progresses the joints can become stiff. It’s a condition that’s more common in women, tends to start in middle age and can run in families . So if your mother has knobbly finger joints you are likely to have them too.

As you have discovered, it can make it very difficult to get rings on and off. The answer to this is to have the ring enlarged, then have a small spring band or two small sizing balls inserted inside the bottom of the ring to stop it swinging round once it is on your finger. This is something a good jeweller can do.

Unfortunately your doctor is correct that there is nothing that can be done about OA of the fingers, and this is nothing to do with restrictions on hospital services due to Covid. However, some find that taking glucosamine and/or chondroitin food supplements can be beneficial.

AQI am writing to you about a colleague. She doesn’t know that I have contacted you but I am sure she will be all right with it.

For a while now, this friend has had lumps on her head. She saw a consultant two years ago, but no one since. The consultant suggested they may be caused by stress but he dare not take a biopsy to see whether there was any sort of tumour in case he caused bleeding – or something like that. These lumps have since got bigger and increased in number.

She finds it painful to sleep if she lies on the side where the lumps are more prominent. She is also experiencing light-headedness and pains in other parts of her body. I have expressed concern that this may all be related and she should see a doctor but it is difficult at the moment and she doesn’t want to waste their time or be off work.

A

There are a couple of things in this story that don’t sound quite right to me. Though stress can make some skin conditions worse, such as eczema or psoriasis, it is highly unlikely to cause lumps anywhere on the skin. Secondly, taking a biopsy only involves removing a very small piece of tissue and rarely causes bleeding. The fact the consultant didn’t take a biopsy suggests to me she didn’t think it was necessary and she was not concerned about them.

Without seeing the lumps it is impossible for me to guess what they are, but I doubt they are linked to her light-headedness or pains elsewhere in her body.

It does, however, sound as if they are causing her considerable distress and discomfort and because of this she should contact her doctor – this would certainly not be considered time wasting.

I suggest your friend emails her surgery and attaches pictures of the lumps. Her doctor will then be able to phone her back and arrange to see her in the surgery to examine the lumps if it is necessary.

But you need to be aware that getting involved in other people’s health problems can be a bit of a minefield and though you mean well, in the end it has to be your friend’s decision whether she contacts her doctor or not.

QI am a man in my early 70s. About seven years ago, I was diagnosed with proctitis. This responded well to mesalazine tablets and all symptoms disappeared after a few weeks and I remain asymptomatic. I still take the medication, at a slightly reduced dose, as advised by my GP. At the time of diagnosis I was told by a nurse at the hospital not to eat onions.

Can I safely return to eating them as I miss cooked onion and leeks? Proctitis is inflammation of the rectum, the lowest part of the large bowel. It can cause pain, diarrhoea, bleeding and also a discharge from the back passage.

It most commonly occurs in people who have ulcerative colitis, where the body’s own immune system attacks the lining of the large bowel, causing inflammation.

It may only affect the rectum, but in some, more extensive inflammation occurs, affecting the whole of the large bowel.

It is treated with drugs that reduce inflammation, such as mesalazine, or in more severe cases, with steroids or with powerful biological anti-inflammatory agents.

There is no evidence that specific foods cause ulcerative colitis, but some people do find that making small changes to their diet can help them control the condition, especially when a flare-up of inflammation occurs.

Though fibre is important in the diet, and for most people can help avoid constipation, those with colitis can be more sensitive to it and eating a lot of it can make symptoms worse. Foods in the onion family contain a lot of fibre that can, in some people, not only cause diarrhoea but also a lot of gas as well.

While it may be wise to avoid onions, especially raw, during a flare-up, once your gut has settled it should be possible to eat them without too much trouble.

I suggest you test it out with a small quantity and see how you go. You can get more information from Crohns and Colitis UK (0300 222 5700, crohnsandcolitis.org.uk).

A● If you have a health question for Dr Leonard, email her in confidence at yourhealth@express.co.uk. Dr Leonard regrets she cannot enter into personal correspondence or reply to everyone.