So last week my thumbs were so swollen and sore I couldn't write for more than a few minutes cos it was too painful, my elbows hurt and my toes were agony, I gets my bloods done and my nurse gave me a steroid jab (with fab results), so why all the pain and swelling and a CRP of only 2? Don't get it!!

CRP is supposed to go up with swelling and inflammation isn't?

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Hi Casapp - there have been a few questions about CRPs on here lately and the general thought is that they don't mean much - they are supposed to be a snapshot of how inflamed we are but so many people come on here and say that the pain and swelling they are experiencing is not matched at all by the CRP tests that I feel inclined to discredit my recent on of 13. Especially since my ESR taken at the same time was up at 40. My GPs say that they think ESR is more reliable for RA but they don't take them for RA patients regularly because they say they are often misleading and cause distress. So I'm going with them on this one and i think you probably should too. Tilda


Thanks for that Tilda, i wondered as an orthopaedic nurse nurse I see some very high CRP's in my post op patients and extremely high ones in patients with ongoing infections. I have only had CRP done a few times and it has always been low. I must check my ESR results although I think it's only been done once and it was only up a little bit--really weird how when I am swollen and sore they don't go up--must investigate this more--can't think why I haven't actually unless it justdidn't fizz on me!! When I saw my results yesterday we only had baby doctors on duty and they didn't know the answer!


Ultrasound are thought to be more reliable ways of detecting inflammation I believe although I've never been given one for this. I think a lot of doctors and rheumies believe their eyes and what you say about the way you are feeling - at least mine seem to. RA is systemic so it doesn't always show up in the blood for some people my GP told me. I asked her whether it made a difference if larger joints are inflamed as opposed to small ones like fingers. She said she didn't know as "only a GP" but she wouldn't have thought it made much difference because it's systemic.

I asked her this because when I was first tested my ESR was up at 60 (didn't have a CRP taken then) which is reasonably high and this was when my knees and feet were both very painful, but there was no visibly swelling anywhere. Then when I had both tests taken after a flare and before going on Prednisolone my CRP was 19 and my ESR was 30 last October - which made no sense at all because by that time I had visible swelling and a lot more pain in my hands.

So I wouldn't read too much into blood results Casapp - although I can see it's interesting from a professional angle for you too.


I did have ultra sound in Spetember as part of the investigations and it showed I had some bone destruction at my finger and toe bases, that seamed to make sense to me as I had gone 2-3 years and mis0-diagnosed as so many are, I think I suspected it was RA a couple of years ago but it took some persuading to get refered to the rheumatologist, who said almost straight away that he thought I had RA. Sometimes its a struggle to get people to believe how much your pain is, especially if you no visible swelling or redness--although the bases of my fingers and my thumbs do swell I never get redness. I am lucky to have a really good rheumatologist who listened to what I was saying to him, made the diagnosis and started the treatment very promptly, I also have a brilliant RA nurse, really lucky compared to some whose stories have been on here and elsewhere


Hi again Casapp - I was looking to see if there were other exercises I could do to get my fingers fully clenching again as the stressball and other hand exercises really make such a huge difference if I do them everyday - but still not able to fully clench my hands again yet despite this. I came across this page and thought it might be useful to you and to others who maybe don't get physio. In fact I'll put it up on a blog in a moment I think. Same exercises my physio gave me to do daily.

Sorry that the delay in getting a diagnosis has meant that you've had to have joint destruction in your hands - but very glad that you are feel your consultant and RA nurse are so good now. I wish I had an RA nurse or someone I could get expert support from but at least my GPs are both good and my rheumy seems to know what he is doing - although I am kind of worried that he only gives me 10-15 mins every 4/5 months and is the only expert I get so he always rushes me through and seems quite old fashioned and cautious in his approach.

I have no access to his secretary and can only approach him through the GP so now I feel I really depend on the physio and OT to keep me right with exercises and gadgets. I did have a hand x-ray last year in June but my hands were fine then. Since then they have changed shape a bit in the way they lie when outstretched and are quite covered in lumps and bumps and swelling and stiffness. Like you I don't really get much by way of hot red swelling although occasionally a knee or my ulnar joint will go very hot and red at night. My knuckles go red when they are sore though but often the worse pain has been in my wrists which can feel broken and yet no visible sign of swelling or inflammation at all. Anyway hope the link helps. I'm off to write a blog now! TTx


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