Sunday, October 5, 2008

Chronic severe Joint pain of Chikungunya

The rainy season due to the South West Monsoon over the Indian sub continent is over.Epidemic of acute severe joint pain and swellings associated with fever due to Chikungunya infection has also subsided.Now I am seeing more and more patients with Chronic severe joint pain of varying duration, a sequel of Chikungunya infection.

Let me tell you a little more about this virus and the illness it causes in humans.

Chikungunya is a re-emerging, mosquito-borne viral infection causing fever, rash and acute or sudden severe joint pains of several joints.Chikungunya (Chick’-en-GUN-yah) in Swahili an African language meaning “that which contorts or bends up” refers to the contorted (stooped) posture of patients who are afflicted with severe joint pains (arthralgia) the most common feature of the disease.
Chikungunya virus is a single-stranded RNA Alphavirus, from the family Togaviridae. Other Alphaviruses also causing fever, rash and arthralgia, include O’nyong-nyong, Mayaro,Barmah Forest, Ross River and Sindbis viruses. Chikungunya virus is most closely related to O’nyong-nyong, but remains genetically distinct.

The disease was first described by Marion Robinson and W.H.R. Lumsden, following an outbreak along the border between Tanzania(erstwhile Tanganyika) and Mozambique, in1952. Since 1953, the virus has caused outbreaks in Africa and South Eastern Asia, including India, Sri Lanka, Myanmar, Thailand, Indonesia, the Philippines and Malaysia, which are well documented. There is historical evidence that Chikungunya virus originated in Africa and subsequently spread to Asia. Phylogenetic studies support this theory, with Chikungunya virus strains falling into three distinct genotypes based on origin from West Africa, Central/East Africa or Asia.

Chikungunya is transmitted by the bite of the infected Aedes mosquito from an infected person to a healthy person. The disease does not get transmitted directly from human to human (i.e. it is not a contagious disease). In a pregnant woman with Chikungunya there is risk of transmitting the disease to her foetus.
The fever starts usually about 2 to 3 days after the entry of virus into the human body. There will be severe chills and shaking of the body at the onset of fever.At the same time the joint pain and swelling starts.The patient will not be able to move with in minutes of onset of illness.The joints of hands mainly the metacarpo phalangeal and proximal inter phalangeal joints become warm swollen and very painful.Wrist and elbow are also affected to a lesser extend.The joints of ankle,feet and to a lesser extend hip are all affected.
Itchy reddish raised rash is typically seen[70%] when the fever subsides, which in most of my patients was by 3 days.Many patients and Physicians confuse it with drug rash due to allergy to the medicines the patient took for fever and joint pain.
Rash is typically seen on the cheeks, nose and outer part of ears.The ear lobe is typically painful to touch. The rash is also seen over the trunk and limbs with severe itching which lasts for only 2 days. There will be painful swelling of ankle and shin with dark red discoloration. Painful oral ulcers are also seen during this time.Last year I had few patients with enlarged cervical lymph nodes, which disappeared in few days.

Although rare, the infection can result in meningo-encephalitis, especially in newborns and those with pre-existing medical conditions. Pregnant women can pass the infection to their foetus. Severe cases of Chikungunya can occur in the elderly, in very young ones (newborns) and in those who are immuno-compromised.

Chikungunya outbreaks typically result in several hundreds or thousands of cases but deaths are rarely encountered.
Differential diagnosis of Chikungunya includes Dengue and Dengue Haemorrhagic Fever,
O’nyong-nyong virus infection and Sindbis virus infection.
It has been reported that attack rates in susceptible populations may be as high as 40-85 per cent and the ratio of symptomatic to asymptomatic patients is about 1.2:1.

Children are less likely to experience joint pain, but may have other features such as febrile fits, vomiting, abdominal pain and constipation.

The discoloration of the nose usually lasts for months.I call it the seal of Chikugunya as I can identify a person who had Chikungunya in the recent past seeing that seal.
Some patients may remain feverish for some more days. The joint pain become less in few days. In about 60 percent of the patients the ilness including the joint pains last only about a week.They become completly all right with only a little bit of tiredness remaining.
But in about 40% of patients joint pain increases or persists.The chronic joint pain of Chikungunya resembles that of Rheumatoid arthritis. The joints commonly involved are the wrists and the knees.The ankle and smaller joints of feet and hands are also involved.Stiffness of these joints in the morning lasting more than 30 mts is typical. The patient feels better as he/she continues to move the joints.
The joint stiffness and pain lasts for about 3 months in about 30% of patients in my practise. But in an unfortunate 10% it may last indefinitely.

Lab Diagnosis of Chikungunya fever

Virus isolation and PCR techniques are costly and is available in very few centres. Serological diagnosis is possible only after a week of onset by detecting antibodies. As the treatment is mostly symptom specefic diagnosis will not alter patient management much. So the typical triad of fever, acute onset joint pains and rash along with a low white cell count in blood sample is sufficient enough to diagnose Chikungunya fever

Treatment of Chikungunya fever

Paracetamol 10 to 15mg per kg body weight given 3 to 4 times a day reduces the fever.It is needed only in the first 2 to 3 days of illness.

Non Steroidal anti inflammatory agents have to be given liberally to reduce the pain and swelling. This may have to be continued for few weeks in some patients with persistent joint pain. Renal and Gastric safety have to ensured while taking such medicines.
Short course of steroids like Prednisolone also helps in resistant cases.
Other analgesics like Tramadol are also useful.
Disease modifying anti rheumatic agents like Chloroquine have been found useful in some studies.Personally I feel Chloroquine is not of much help as it is a slow acting drug taking almost 3 months to be fully effective.

Most of the patients who turned to alternative systems of medicine for relief came back to me saying there is no relief to pain.Many had to take NSAIDs along with their Ayurvedic and Homeopathic medicines which proved that other systems have nothing much to offer.

In short Chikungunya fever is easy to diagnose but not that easy to treat, but to those who suffer it is pure hell.

153 comments:

Madhawa said...

Hi Doc, I'm a software eng from Sri Lanka and my wife had Chikungunya about an year ago. She had severe joint pain (wrist, fingers, knees) ever since. We have started consulting a specialist abt 6 months ago and still doing. He is treating my wife for rheumatoid arthritis. About 2 weeks ago (last time we channel him) he removed water from a knee. He told us that we have to continue the medication for another 6 months and have to start again if it arises.

Please give your ideas over this. Thanks in advance.

Charakan said...

Welcome to the blog,
I need more information about your wife's condition.I want to know how the illness started,how did it evolve,were there any symptoms other than joint pain, any skin changes,details about blood tests,detaisl about treatment taken etc.
You can mail me with details at doc6568@gmail.com

Anonymous said...

Dear Doctor,

I am writing for my wife she is affected Chickenguniya. Fever is over after three days but the swelling and pain on the akle is very painfull. Is there any alternative medicine for joint pain. Please advice me
mohamedalicp@gmail.com

Charakan said...

Mohammed Ali, do as your doctor says. Most of the anti-inflammatory medicines will help. Do not worry

sabitha said...

hi doc, i m a doc victim of chik,practically in hell.i put myself on a 1 wk trialof chloroquine.

Charakan said...

Sabitha,

Sorry to hear about your illness. Chloroquine takes many weeks to act. Only in those 5% of patients whose joint swellings and pain are not relieved by 3 months I try Chloroquin,that too for a period of atleast 6 weeks.

Take NSAIDs liberally if you do not have a Gastro intestinal or Renal problem.Your illness will subside on its own in about 3 months time.

jimmyz said...

i have had it for four months. painful hips, hands, shoulders. there is a trial starting next year by australian researchers using drug currently used for (I think) pancreatic cancer and which works on the proteins caused by chikungunya also.

Praveen said...

Hi Doc,

I am very impressed with this website and information available. My mother had got chikungunya, almost 3 months backs. She was on anti-inflamtory tabs along with other pain relievers. We are quite consicous of the fact that these have side effects and even the doctors have advised not to take continously. It also keeps resurfacing back. Firstly it was one ankle and now both the ankles and one wrist that hurts her.

Can you please advise as to how long the pain remains post a patient contracting chikungunya.

You guidance will be greatly appreciated.

Charakan said...

Praveen,
As I said in the post the pain and swelling usually lasts for aboout 3 months.But in say abt 10% of patients it may last longer. If it is persisting it is better to rule out other causes of arthritis like rheumatoid arthritis. If the kidney functions are monitored properly you can continue taking anti-inflammatory medicines.

Anonymous said...

hi i am male 30 from karnataka-mysore.from last week 4-5 days back i had fever shoulder pain slight joint pains,cunsulted doctor he said this is viral arthritis not chikungunya. gave some medicines after taking medicine for 2 days the real problem started first my ears(outer area) with itching became red and got like small small wounds and became rough.secondly got badly infected by funges( fungal infection) not even to walk not because of viral arthritis but by fungal infection.after this i stopped all the medicines i am slowly alright. hell because of rash/itching/fungal infection(after taking medicines).
my questions r
1.what is the difference between viral arthritis and chickungunya.
2.does this infection increases skin related nfections like fungul infection etc.
3.entire body with small small wounds not seen by naked eye feeled when using soap.is this prob medcl reaction or speciality of this infection??????pls answr

Charakan said...

Anonymous, most probably your problem is also related to chikungunya infection. As such arthritis due to other viruses are very very rare. What do you mean by fungal infection? Describe in simple terms. After the fever subsides in chikungunya infection such skin changes are usually seen and is probably not drug allergy

Anonymous said...

thanks mr/ms charakan for reply(about viral arthritis).fungal infection i don know the medical term but itchy,ulcer type arround the private part of our body. and also i met the doc he said as u replyed in this blog.for fungal infection he gave clotrimazole ointment if problem persists he said i will prescribe tablets..pls give me more information on this fungal infection. thank u very much bye

Anonymous said...

Dear Doc,

Its been 45 days with chikungunya..I still don't feel good. I have a knee swelling and piercing pain there as well as on my feet. What best medicine can I take? I am really feeling depressed with these pains :( The pigmentation on my nose is gone and the allergies are gone but these joint pains persist...Kindly advise

Charakan said...

Anon, the pain usually last for abt 3 months.Any NSAID [anti-inflammatory medicine] will do if given in correct doses after ruling out renal and liver dysfunctions. Cheer up, you will be fine in 2 months time.

Anonymous said...

Your website is very informative. It is good to know that the join pain goes away in 3 months. I am counting...still 20 more days for completing 3 months.

Charakan said...

Anon, Thank you for visiting this blog.In a large majority of patients the pain subsides in about 3 months.Some may have persistent pain for few more days. Hope yours will subside soon.

lavanya said...

Hi Doctor,
My dad is suffering from chikungunea for the past one week. He is already very weak and thin and he has reduced even more since he got affected. He is not able to bear pain in his ankles which get swollen esp in early mornings. Is there any medicine I can ask him to take as he is not willing to take any pain killers as they are bound to have side effects. He is more ready to undergo the pain. Is there any auyurvedic or homeopathic medicine which does not have side effects and can reduce pain?
Please help!!
Thank you so much

Charakan said...

Lavanya, welcome to this blog. Acute pain of arthritits due to chikungunya needs anti inflammatory medicines which are not mere pain killers. Which medicine your father can use with out any adverse effects can be determined only by the doctor treating him considering his general condition and status of kidneys and GI tract. Do not be afraid of medicines but take them judiciously under close supervision of your doctor.

jerrin said...

Hi Doctor,

I had chikungunya a month back and have also developed scrotal ulcers with the fever. These ulcers are healing very slowly. Is this normal with chikungunya ? Is there anything that needs to be done for these of will they heal with time?

JJT

Anonymous said...

Hi Doctor, My wife and myself got chi.gunya fever for 3 days and swelling with joint pain started in the area of ankle, it is for the past 20 days. My question is, Is there any diat control to be observed and is there any remedy without consuming the tablets. Whether having B12 injection will give some relief??? or need to have pain killers regularly, please advice.

Charakan said...

Jerin,
Welcome to this blog.
I have seen scrotal ulcers only in very few patients. It should heal with time unless it is secondarily infected by bacteria.

Charakan said...

Anon,
Welcome to this blog.Diet control do not seems to have much effect in recovery from arthritis of chikungunya. Non steroidal anti inflammatory medicines [which are not mere pain killers] have to be used continuously under guidance from your Physician.B 12 injectins do not have any role here.

Sai Kumar said...

Hello doctor,
Thanks for this Blog. i'm also chikungunya patient, for the past 45 days.I'm 36 years old female.I'm obese weighing around 90kgs.. My Doctor has prescribed ERINIC and IRON SUPPLEMENT.still my joint pains, and sleeplessness persists and unable to feel good at all. As i'm Obese, i need 2 workout, but cant think of it as my feet and joint pains kills me. i need to know from you doctor,when can i start my workouts, what kind of excercise i can do.

Charakan said...

Sai Kumar, welcome to this blog. Most of the pain and swelling in post chikungunya arthritis will disappear by abt 90 days. But the medicines should give you good relief now itself.I foyu are not feeling better approach your doc again and lake him change the medicine.
Usually pain of chikungunya arthritis is worst at the starting of joint movements and become better as movements continue. Exercises like walking can be started now itself as rest has not proved to improve the illness.

SaiKumar said...

thank you doctor.
yesterday, i met my doctor of Apollo hospitals again due to severe pain. he asked me to take one injection for pain relief and continue "ERINAC SR"-Aceclofenac 200 mg" daily once. as my haemoglobin count goes down to 10 mg, he advised me to take more dates, almond, fig, and iron supplement. chooooooo horrible chikungunya. wanna get rid of it imm.

Anonymous said...

dear doctor, i got infected wth chikungunya, a month back,and still have joint pains. i can describe my joint pains as starting from
1) my ankles subsided after persisting for two weeks
2)it proceeded on to my right wrist and one carpo phalangeal joint of jus index finger of left hand.
i have got two questions sir,
1) wat can i infer about my immune response to this fleeting arthritis. from d onset of symptoms till now i ha not taken any medications (even NSAIDS). I am jus enduring pain. to allow my immune systemto do its job. is that safe?
2) am diagnosed with physiological goiter. am given thyrox 100micro gram. o.d. for a month. blood tests n scan reports normal
i presently have no physical complaints. as few people told abt swelling like thing in my neck they suggested me to check for thyroid.
so is that safe to start my dosage for a month?

Charakan said...

Anonymous,
Your decision to endure pain may not increase your immunity. Anti-inflammatory medicines may cause side effects if used unjudiciously,but if used carefully they can help a great deal.
About your goitre,it depends on a variety of factors including your age,size of the goitre, the problem if any psychologically or physically it is causing etc etc. Only you and your Physician can come to a conclusion on the best method of treatment after considering all the above factors.

Peter said...

Hi Doc Charakan, I contracted Chickungunya in early November while visiting India. I have since returned to Malaysia. Thanks for this blog, and the symtoms described in your blog matches those of mine. I still have swelling in the legs and I wonder if this is Chickungunya related. Prior to this I suffered from Plantar Faciitis in my feet. Pains from Chickungunya are still there on the feet, knees and wrists. I have stopped exercising for quite a while due to the pains. I can endure the pains and I am wondering whether I can carry on with my exercises like jogging, badminton etc. while enduring the pains? will it cause more harm if I do that? thanks.

Charakan said...

Peter,welcome to this blog.
I am sure that your pains will slowly disappear with in few weeks. Instead starting jogging and Badminton straight away, I will suggest brisk walking for a week and slowly increase the level of exercise if you feel ok.

Anonymous said...

thanks for ur suggestions doc

Anonymous said...

I visited Uganda, Africa this past summer and after returning I began having symptoms of fever, chills, severe muscle and joint pain, severe headaches, sensitivity to light, and at times red/blotchy marks on my nose and cheeks. It has now been almost five months with only a small improvement. Could this be Chikungunya? I live in an area in the US where doctors know very little about tropical illnesses. They are saying they symptoms have occurred too long to be Chikungunya. What should I do?
- Alyson

Charakan said...

Alyson, welcome to my blog. Sorry to hear abt your illness. From the brief description you gave it is unlikely to be chikungunya May be if you can give me more details by email I may try to help doc6568@gmail.com

Sunil said...

Hi doc this is sunil from mumbai, a fantastic enlightening site...kudos to u..my dad had got fever a month back which lasted for 3 days.now he is suffering with severe joint pains as well as swelling. has got itching on fingers..is it chikungunya as doctors could not recognise it. also my dad did not have any kind of joint pain 2 months back! Also please prescribe some medicines (names) to reduce joint pains...thanks a lot

Charakan said...

Sunil,welcome to this blog and thank you for your words of encouragement. Your father most probably is suffering from arthritis due to recent chikungunya infection. He will do well with non steroidal anti inflammatory agents but such drugs should only be taken for a long time under strict medical supervision especially as he is elderly. Please take him to a good General Physician or a specialist in Internal medicine to get the treatment

Romeo J Fernandes said...

Greetings Doc. Nice info on the disease. I am from Tamilnadu. Here there r a number of cases (virtually an epidemic)of high grade fever followed by joint pains. especially of the feet and knees. Most of the cases are being treated by the local docs with steroids like dexamethasone, analgesics like paracetamol, aceclofenac, nimesulide etc. the fever subsides soon enough in most but the joint pains and especially the feet and soles are extremely sore for weeks afterwards. Many people also have rash all over the body, some days after the fever subsides. Is this chikungunya or something else? Are steroids helpful? I heard that steroids should be used sparingly...
Please let us know your valuable opinions.

Charakan said...

Fernandez, welcome to this blog. Tamilnadu is facing a bad epidemic of Chikungunya .Rash at the end of 3 to 5 days fever is also very common in chikungunya. Non steroidal anti inflammatory drugs are the best medicines for pain and swelling. Small dose of diuretics may be needed for taking care of edema during the first few days. Steroids may be used as a last resort very cautiously at the minimum effective dose and that too for short period of time like a week.

Sunil said...

hi doc this is Sunil again.. a visited a M.D and he has started a treatment with Flexon tablet(ibuprofen & paracetamol tablets)..so do u think its chikungunya or arthritis).his pain is residing after starting thIS TABLET...waiting for ur reply

Charakan said...

Sunil, What I meant was your father is suffering from arthritis (which means inflammation of joints ) due to a recent chikungunya infection. Please continue as per your doctor's advice .

Pavithra said...

DOC, i am pavithra from chennai. i am a student. i am currently suffering from chikungunya. i had all the symptoms you said. I got the fever on 4th jan and i still have joint pain (severe) in my legs alone. MY DOUBT IS: i have presently developed rashes for the second time in my face and all over too.but it is not reddish but spread like grains of sand. Does rashes come for the second time? I was prescribed tramadol. I have become sick of medicines. I was unable to move till a few days back. wat kindda food should i eat to cure these rashes and joint pain?? i cannot bear it anymore.
please advice

regards,
pavithra

Charakan said...

Pavithra, welcome to this blog.

Tramadol is not the best medicine as its anti inflammatory effect is negligible. Rashes can re appear in Chikungunya but a doctor should see it and rule out rash due to medicines.
You should take normal diet. Diet do not have that much role in post Chikungunya arthritis. You will be all right by April end.

Misfit medico said...

hi...i am a doc from kottiyoor,kannur...doing CRS..First of all congrats for this fantastic blog..really enjoy ur posts..thanks for all these information..one thing i want to ask you is how i should approach this post chikungunya arthralgia...this area was affected badly last year and a majority of the pts are c/c pain sufferrers some even taking nsaids for the last 1yr...can you give some sort of algorithm?

Anonymous said...

Hello doctor,

I am 30 years old female, I got chikungunya on November 1 when I visited Chennai. I had fever for 3 days and till now I am having severe joints pain especially in the knees, ankle and feet. There is no swelling now. I consulted a doctor(MD Medicine) and she asked advised me to take Naprosyn and Rantac till the pain decreases. I took Prednisolone and Chloroquine for 2 months but my doc asked me to stop as steroids shouln't be taken for a prolonged time.

Earlier I had been doing yoga but after i got infected I stopped yoga as it is more painful.

I am scared whether I will become all right and will I be able to do my normal exercise and yoga. In the blog, you have mentioned for 10% of the people the disease persists indefinitely.

Since I am young, will this disease continues till my end of life. Please let me know. Can I continue the tablets Naprosyn for a prolonged time ? Please advise me.

Thanks.

Charakan said...

Misfit medico, welcome to this blog. Yes some people suffer from chronic joint pain for months to years. It is always better to rule out other form of chronic arthritis like Rheumatoid arthritis, Reactive arthritis, osteo arthritis etc. If nothing else can be the diagnosis treat with least toxic but effective NSAID and Hydroxy chloroquine can be given for a long time. Short course of steroids may be used judiciously. Investigations to rule out drug toxicity should be frequently done.

Charakan said...

Hi Anon, Sorry to hear that joint pains are persisting even after 3 months. You can refer to my comments above as a guidance to the management. Less difficult steps of Yoga can be tried. I am sure with in weeks your joint pains will become less and less.Pain lasting life long do not happen in Chikungunya arthritis.

hoPe said...

Hi, doc. Thanks for the info... I could not imagine how painful it'll be to be attacked by Chikungunya but i'd rather not know the experience. I couldn't find a better way to put the experience than yours [to those who suffer it is pure hell] I've suffered from the pain for abt a month d, on & off, though, and what you'd written really enlightens me as I din expect that the pain could be up to 3 months or longer~that means it's normal for my joints to be still painful till now...:-p
Thanks again, doc!

Ex World Explorer said...

Hello Doctor!

I contracted Chikungunya 2 years ago in Africa. I had joint pains for about 2 months, after which all was good.

But a few months ago I started having strong pains in my toe. Then the whole foot started to hurt. Now also the hands hurt a bit, and they remind me of the Chikungunya kind of pain.

Is it possible that my body still has some residual symptoms? I will do blood tests to exlude rheumatoid arthritis. Is rheumatoid arthritis more common in people who had Chikungunya?

Thanks,
Stefania

sudha said...

Hello Doctor,
Congrats for such a nice blog..My mother got chikungunya by last week of Jan.She is 48 years old and working in school as a clerk.She got recovered from fever but she is having pains in her joints still.As she has lot of writing work,her right shoulder,and fingers are paining more..
1.Should she lessen her writing work and household chores?
2.When can she be perfectly alright?
3.How can she improve her immune system by diet?

Charakan said...

hope, i am sure you will be all right in few weeks time

Charakan said...

hope welcome to this blog and thank you for the kind words too

Charakan said...

Stephania, welcome to this blog. Rarely post chikungunya arthritis can persist in a waxing and waning fashion.There is no strong evidence to say that there is more chance for Rheumatoid arthritits in patients who had chikungunya though some reports have suggested such a link. Pain in toe and foot are not characterestic of RA. Only a through physical exam and more lab tests can help in arriving at a diagnosis.

Charakan said...

Sudha, welcome to this blog and thank you for the nice words. If she is having considerable pain it is better to avoid strenous activities.In 3-4 months time she should all right. Healthy diet including fruits ,vegetables, enough calories and avoiding excesive eating etc may help.

Anonymous said...

Hello doctor,

I had posted earlier on Feb 15 about my illness. Now I have completed 4 months. I am feeling slightly better now. My morning stiffness has reduced much, however I have pain in my knees. The pain is more especially while claiming staircase and getting up from the floor. I did walking everyday for 30 mins and I found that if I do it continuously for 1 week, my knee pain increases, so I have stopped. I am still continuing pain killer Naprosyn.

For patients who are feeling better, how much time does the disease will take to completely get cured ?

Please advise me.

Charakan said...

Anon, Good to hear that you are better. I expect that with in few more weeks you will be near normal,though we cannot exactly predict the date. Continue Naprosyn if needed and try to reduce the dose as much as possible.

ashokha said...

I have fever in february 2010 first week. the fever gone after 4 days. but the pain is still there. it is acute. i am taking ayurvedic medicines from 16.3.2010. it will be cured in fifteen days. is 31.3 2010. i am waiting....

jayceysl said...

hi, doctor..i got a chinkungunya virus.. what should i do to reduce the swelling on my feet for two months already. is there any remedy anf what causes the swelling.. hope to hear from u soon. thanks.

jayceysl said...

hi doctor .What should i do to reduce the swelling on my feet for two months already. Is there any remedy for the swelling and what causes the swelling.

Charakan said...

Ashoka. Hope you will be better soon

Charakan said...

Jayces, The swelling in the ankles after chikungunya fever is due to inflammation of ankle joint .Usually there will be pain also. It subsides in most patients by 3 months. Anti inflammatory medicines and diuretics may help

Amar Deep said...

Hi, Thanks for the information. This is very useful. I had chikungunya 3 years back. I had major swelling in my knee. For 6 months i was on pain killers. However after that the swelling is gone. I do have discomfort in my knee though. It continuously bothers me and usually throughout the day. I have played some sports in past few months. The pain is not much and i can bear it but its just that its not back to normal. Is there a way out of this problem? Also should i stop playing sports for sometime till it completely stops?

Charakan said...

Amar Deep, welcome here. Sry to hear you have mild joint symptoms 3 years after the fever. I cannot be sure why you are still having pain. Better to see an Orthopedic Consultant and get an expert opinion

Fonz said...
This comment has been removed by the author.
Charakan said...

Fonz, Welcome to this blog and thank you for nice words.Sorry for the long delay in replying. Sorry to hear about your pain. 11 months of severe pain may happen in a very small percentage of post chikungunya arthritis.But deformed joints are very rare and have never come across such a thing.You should rule out all other causes of arthrits and a judicious course of systemic cortico steroids with chloroquin may be tried for few weeks.Hope you will recover fast.

Anisha P said...

Hello Doctor,

I must say, you are doing great work with the blog.I am a 28 year old female having the same symptoms of chikungunya, though my doctor has not identified it yet as the same.Its from reading through a lot of stuff on the internet that I am convinced it is chikungunya.

It started with 102 deg fever day before yday and severe ankle pain after which I developed red unraised rashes on my face,chest,hands,legs and back.The fever has come down today but i still have severe ankle,knee and wrist pain.The red patches under the skin seem to have spread out now making my skin look flushed(they are nt raised) and they have begun icthing today.My doctor had prescribed Sumo for the pain,Dolo for the fever and and vocet(levocetrizine tablets) for the itching.But I would like to know if there is better medication for my present condition.

I am really worried as I am gettin married in 2months from now and want to be fine by then.Pls help.

Thank you.

Charakan said...

Anisha,
Welcome here. Your symptoms are suggestive chikungunya. Hope you are much better now. Main stay is anti inflammatory drugs. Other drugs can be considered only by your treating Physician. Hope you will be fine by the time of your marriage.

Charakan said...

Somanath,Pune
Welcome here. Sorry your comment was lost somehow. Sorry to hear about your painful joints.10 months means other causes have to be ruled out. Please find a good Physician trained in Rheumatology to help you.

Anonymous said...

Hi doc, I am 29 year old and had got chikungunya about a month back. Still I have very severe pain in my right knee, left ankle and fingers of both the hands. Please suggest a remedy for this as I have always been a very fit and active person but post chikungunya I have been down many times with fever, cough and cold.

Charakan said...

Anon , welcome here You need to take only some anti inflammatory medications for few more weeks You will all right soon

Anonymous said...

Hello Doc,

Your site is really informative. I too contracted chikungunya 2 weeks back. Though fever has subsided i still suffer from stiffness, pain & swelling of the feet. However what i am extremely worried about is the appearance of dark spots 2 days back on my nose. Is this also a symptom of chikungunya? Will these spots disappear? How long does it take to go? Is there any cream which can be applied to lighten the spots? Can i continue to use soap on the face during this time? Eagerly look forward to your reply

Charakan said...

Anon.welcome here and thank you. I call the spots on the nose seal of chikungunya. It may take about 8 weeks to disappear. You can continue to use soap.To my knowledge no cream is proven to be useful. Wishing you a speedy recovery

Anonymous said...

Thank you very much for the speedy response Doc. You are doing a great service by responding to queries of all us folks struck down by chikungunya by dispelling our fears & creating awareness about the disease.

May your tribe increase!

Anonymous said...

Hi Doctor

I have gone through most of the comments here and so I guess I kind of know what I'm going through. In Dec 2010, I had what I think was Chikungunya with joint pains etc. The pain subsided but post March, pains have steadily increased and now it's almost crippling, can't even open normal lids or open a tap. I only want to go for Ayurvedic treatment - so do you think this is rheumatoid arthritis then? what do you think I can start taking - be it Kashayam or arishtam or ayurvedic massage

Anonymous said...

Hi Doctor

This is a not a query related to Chikungunya. My father is under medication for heart failure and is a diabetic. Due to intake of diuretics, his movement has been gradually restricted due to loss of fluids. As a side effect he has hyponatremia too. a recent development is severe itching sensation in all joints particularly in the nights. There is no skin rash, nothing on the surface, which seems to indicate there is possibly some drug induced toxicity? I consulted his physicians but they they don't seem to have any idea as to why this is happening.. Please advise.

Charakan said...

To Anon with jt pains. Only detail physical exam and blood tests can tell you if it is Rheumatoid arthrits. Modern medicine is better than Ayurveda for Rheumatoid arthritis

Charakan said...

To Anon with his father's problem. Sorry,Wont be able to tell you the reason with out a detailed examination

Anonymous said...

Hello Doctor

Thank you for your advice. I will get this examined. Thank you.

Anonymous said...

As regards my father's problem - how do we get to meet you?

Thanks

Neeraj said...

Dear Doc

Thank you for this blog and responding to queries, its very reassuring.

I live in Delhi and my wife has chickengunya(not tested so far, but symptoms are all the same, we have also showed to a doctor in our area). My question is that can we take some pain killers to alleviate the pain, apart from Paracetamol 650mg that she is taking every 5-6 hours. Since this is her 3rd day of the appearence of symptoms, she is having acute headache. Is it like that or does it have any side/after effect. Why I am asking this question is that our doctor here tells me that pain killers need to be avoided. But yesterday night, after taking advice from another doctor I gave her SUMO (nimuselide/paracetamol) and that seems to have helped her.

Thanks much
Neeraj

Charakan said...

Neeraj,
Welcome here. You may have to give her non steroidal anti inflammatory agents. I prefer Diclofenac,Aceclofenac or Ibuprofen and not Nimuslide.Give it judiciously if there are no contra indications

Anonymous said...

I was browsing the net to figure out my ankle swelling & joint pains when I came upon your blog- I am so shocked to read this and have to say I have experienced all you mentioned including the burning ears,rash on face ,fever, swelling,pain etc - it all started suddenly on 22nd Sept 2010 for me I'm off all medication now - learning to bear the pain and pray this will end soon enough for me ! Have to say this is so painful, its like having a sneak peak into old age with arthritis !
Thank you Doc for explaining the signs & symptons with so much detail & for the tips.

swarna said...

hello sir i m DR SWARNA,POSTGRADUATE RADIODIAGNOSIS i would like to know is temporomandibular joint also involved in this fever.i had fever typical for 3 day as described by u with sever joint pain in wrist and knee with small joints of hand,thinking of denge i didt go for serology.i m having pain in tm joint not able to open my mouth.pain is not dental origin.plz reply

Charakan said...

Swarna, Welcome here. Sorry to know about your illness. TM joint pain is very rare in Chikungunya related arthritis but can occur Kindly rule out any local sepsis. Antibody tests sometimes give false negative results Use NSAIDS liberally A short course of oral steroids can by tried as a last resort.

Neeraj said...

Thanks Doc. We only gave her in total 3 sumo tablets(in last 15 days). Her symptoms are less now, but still present. She has backache and knee joint pains. Will give the medicines as suggested. Thanks much and KEEP UP THE GOOD WORK! HUMANITY NEEDS A LOT OF THAT.

Meenakshi said...

Hi,

I am 13 weeks pregnant. I had viral fever which started on 8 Oct,2010 in Delhi and lasted for 3-4 days with fever touching 102 F followed by chills,headache and joint pains. The fever subsided after 3-4 days and was followed by rashes and sever joint pain. The test for Chikungunya was negative. Since this week, I am having pain in my left foot and due to this, I am not able to walk .It becomes very difficult to put my foot down after getting up in the morning. Doctor has advised me to take Calpol for pain relief. Please suggest how I can get relief from this pain. Also is there a possibility of passing the virus to the fetus.

Anonymous said...

hello doc ,my mother had 100 f fever and chills then the next day couldnt get up from bed and was unable to do her daily routine after medication she was fine for some days but again after 2months she has a lot of swelling on hands and knees ankles and severe unbearable pain we checked for rheumatoid arthritis which is not there our doc says that the viral infection has affected her sympathetic nervous system so has prescribed drugs like folitrax hydroquin repace allegra pregabaline and a steroid injection which is again to be taken next week and our doc said that my mom will take 3weeks to recover i need your guidance and suggestions on this please help

pranaw said...

excellent blog!
can you throw some light on your experience with use of corticosteroids...when do you start and how long do u give it..and how do you taper it...how are the results?

dr.pranaw

Charakan said...

Meenakshi, welcome to this blog Sorry to hear about your illness. Better to avoid most medicines especially anti inflammatory medicines in early pregnancy. You can continue with Paracetamol (calpol) Other drugs can be used only with extreme caution under strict medical supervision. You will be all right with in few weeks. This infection will not affect your fetus.

Charakan said...

Anonymous, welcome here You should get a second opinion about your mother's illness from a Rheumatologist or a General Physician experienced in treating Rheumatic conditions

Charakan said...

Dr Pranaw, welcome here Contact me through my email @doc6568@gmail.com

Anonymous said...

thanx i will consult another rheumatologist and get back to you

Jasmine said...

Hello,
I work in API Manufacturing, just came across your blog.
You have been answering comments and queries since January for this post!
:)
Keep up the good work. I also can't help but notice how often people have gone to an OPD despite your review and come back with the same advice as you offered!
:)

Anonymous said...

Hello Doc.
I have been reading your blogs for quiet sometime now.Very informative.Thank you.
I am 39(female) and I was down with Chikungunya in feb 2010.But even now I have pain in my finger joints.Is pain in small joints also related to Rheumatoid arthrits? There is no pain in the other joints(My toes hurt as soon as I get up early in the morning for a couple of mins)Do I need to get any tests?I would be grateful for your guidance .Thank you

sabharwalentp said...

dear Dr.
I am anil from Delhi aged 55 years.
first of all i thank you for taking so much of pain by replying to the quarries of people who are in pain.
i pray to god to give you lot of happiness best of health and prosperity.

on 28th Oct. i woke up in the morning with very stiff joints particularly my wrist, right knee and left toe. by the evening i had 102 fever which went upto 104 by the night. i took paracitamol. next day also fever was 104 on third day it came down to 102 and forth day came to normal. fifth day i had rashes all over it was like measles and very ichy.

now its over one month but i have acute pain in my wrist and right knee. i took zinase D for aweek but developed acute gastric problem.
pain is really bad and specially in the morning. i am quite worried about it.

kindly adv what do i do?

thanks

Charakan said...

Anon39f, Welcome here You do not seems to have swelling of joints but only pain It may not be anything serious If very disabling you can consult a doctor and get investigated

Charakan said...

saberwalentep, welcome here Your symptoms are suggestive of chikungunya The joint pains may last for around 3 months You can use NSAIDS under supervision of a local doctor for pain and swelling

Pavee Raheja said...

Dear doctor,
i am a 21 yr old boy currently residing in delhi. i recently contacted a high fever and had symptoms indicating Chikungunya including mouth ulcers & severe joint pain and i did not get a clinical test as dengue test came -ve and there was no fever. My doctor advised me to take a 10 day course of PREDMET4 and etoshiine for the pain. I being reluctant to take steroids or a pain killer only consumed them for 2 days to provide temporary relief from pain. would you advise to take them??? Would they provide permanent relief or not?? i am willing to bare the pain if these medicines only subside the pain temporarily and not cure it.
regards

Charakan said...

Pavee Raheja,welcome to this blog.
The illness should subside by itself in few weeks. But if your pain is incapacitating you may take Etoshine. Predmet is reserved for special cases only.

Anonymous said...

Hi Doctor, I traveled to Delhi and have come home to London. Since returning I've had 3 days of high fever (max 102.5f), joint pain and now although the fever has gone, I have rashes on my hands on thighs and lots of itching.

Is there an over the counter medicine I can take to overcome the itching? Also what can I expect next with the disease?

Thanks in advance.
Tim

pavee said...

thank you doctor

Charakan said...

Tim. Welcome here and sorry for the delay in replying. By now I am sure your itching must have disappeared. If not you can take any anti histamine tablets like Chlorpheniramine maleate. Unfortunately I do not know the brand name. You can expect joint pains and morning stiffness. All the joint pains will subside soon Hope you will recover fast.

Anonymous said...

hello dr... i too had fever and joint pains about a month ago... my dr told me its chikunguniya... had rashes and mouth ulcers too... but still having joint pains... its very difficult to walk in the morning after waking up... there is swelling in hand and foot joints... there is pain in finger joints too...its difficult to sleep at night due to these pains... what to do???

Jansi said...

Hi Doctor,
I'm 24 year old girl. I got recovered from chickenguniya fever 3 weeks back. I was not sure if it was chickenguniya, as my doctor just told it could just be a viral infection or dengu and treated me and am cured now.
But the joint pains are really worse. It gets stiffed when i sit and work infront of my computer for a long time such that am not able to walk normally the moment when i get up.
As am obese for my age and height, i practise yoga for weight reduction. Now, after this fever am afraid to practise and it really pains more when i try to practise.
Please help me to get rid of this pain and advice me in what way i can continue my physical exercise for weight reduction? Can i continue yoga with the joint pains?

Nitin said...

I just wanted to take some time to say thank you very much ! for the effort you have taken to inform the common man. My mom is suffering for this and knowing more about the disease helps you to understand and cope up. Thanks again !

Anonymous said...

Hi dr... I am a 48 year old female who contracted chickungunya while travelling in India. Fortunately I came down with the condition on the flight back to Australia. After about 4 weeks I had started to feel better but after attending a function which at which I had to stand all evening my joints have flared up worse than ever. I am now nervous as to what I can do as I don't want it to become worse. I have worked out that I feel the most normal with lots of feet up rest and fluids (this is difficult in daily life). I normally do not get sick and thought chickungunya was worse with people who have a low immune system. Does the virus normally worsen after an activity such as standing for prolonged time?

Charakan said...

Anon 1, if you have persistent joint pain and swelling consult a doctor. You may need to take non steroidal anti inflammatory agents.

Charakan said...

Jansi , welcome here You may need some pain relieving medicines. Better to consult a doctor for that. Light Yoga exercises can be done. I am sure you will fine in 2 to 3 months

Charakan said...

Thank you Nithin for those kind words

Charakan said...

Anon frm Australia, Chikungunya related arthritis is considered as an immune reaction and need a fairly efficient immune system for it to happen.So this does not mean your immune system is weak.You may have to take some more rest if you are having pain. Anti inflammatory drugs like Ibuprofen may help but consult a doctor before taking it

Anonymous said...

Hi Doc.... My Name is Deepak and I am 26 years old.I had chikungunya fever last month and it was cured within a week with no joint pain etc. But the pain has come after a month since then it is increasing. Please suggest what medication should be followed.

Charakan said...

Deepak, welcome to this blog.Sorry to hear about your illness. My advice is same as for others who asked this same question in this post.

sudhi said...

Hi Doc... I am 29yrs old and had Chikungunya kind of fever an year back. After that my ankle has become weak and it pains a lot when I try to do any exercise. A month ago I twisted my ankle and pain has not gone. The doctors did X-RAY and told that the cartilage had some damage and they need to do MRI Scan. Please let me know if there is any other natural remedy to it. Thank you...

Rinny said...

Hi doc, how long after infection with chikungunya virus are you still prone to passing it on to another person through a mosquito bite?
Cheers

Anonymous said...

dear doc...23/1/11
I read all your blog, when my wife[62] & myself [66] had CG on last diwali day, two and half months ago.
We are inching to normal ..almost. The sporadic after-symptoms are as usual..pain etc.
Couple of points:

1. Painkiller
During the painful weeks after CG fever, many painkillers/ayurvedic oil massage etc are being tried."Powergesic tab" contains

diclofenac etc seemed to have effect. One tab seems to give relief for 2-3 days.

Hope 1 or 2 tabs in a week is not bad.

2.Does CG have some GOOD SIDE EFFECTS ! ?
One thing we suspect is : Our digestive systems has changed for the better !
We both had Acidity / hot or spicy-food-sensitivity problems for years.
And they are significantly reduced !
My wife used to totally avoid 'teekha' or take Aciloc immediately etc.
I used to, feel "petme garam' after hot food; burning sensation after urination within hours and burning after next morning visit.

Used Kailasjeevan etc for relief. And ate very little 'teekha'.
This was thought to be uncurable !
and now, things are better. We can eat close to normal food.

Also I had 'gas' problems, daily evening , after 5 pm, every few minutes.
To avoid , I took a spoon of 'Ajwain' in the afternoon which was very effective.
Now, I dont need to !

Hope these positive side efffect last !

Anybody has any such experience?

Charakan said...

Sudhi,
Your pain is highly unlikely to be an aftermath of chikungunya.Get advise from your doctor.

Charakan said...

Rinny,
The infectious period is only during the fever period and 2-3 days after.

Charakan said...

Anon,
Welcome here
I am not sure there is any real good effects for chikungunya infection

Anonymous said...

i am writing this for my dad.He suffered severe pain in knee joints ,neck, fingers ,the symptoms were of chickenguinya but was not detected .He had a high fever also. but then he was alright in 30 days but now he again is incured with the same pain in joints .wat is the reason behind this ? are traces of chickengunya still showing ?

Charakan said...

Anon,
The joint pains following chikungunya infection can last for few weeks to month.Your father may have to consult a doctor and get treated

Mangal said...

I am writing this to get your valuable information about my illness. I am a 30-yr-old female mother of 2-1/2 boy and 9-months female baby. I am a very active, in good health for over 13 years not even had fever or anything. Last December 13, 2010 I had fever of 100 which lasted only for 2-3 days, oral rash, and skin rash over trunk and redness of the eyes with severe joint pain all over esp felt in the wrist and fingers, which made me to feel hell even to carry my 9-month old baby. I tested for Malaria, Dengue, Jaundice and it all came negative. I was okay after a week then later 2 weeks I started to have same kind of joint pain which is unmanageable.

It is almost 50 days now...finger joints, wrist and ankle joints hurt the most with morning stiffness.

Meanwhile Out of my spl interest on 26/1/2011 I again did some investigations to rule out: RA factor, ASO titre, CRP and CBC. My report:
RBC: 4 millions
HB: 11.4
PCV: 34.9
WBC: 7600; N-61%,L-34%,E-3.8%,M1.2,B-0.1%
Platelets: 2.57 lakhs/cmm
MCV: 87.5
MCH: 28.6
MCHC: 32.7%
ESR: 1hr:6mm
ASO: 14.2Iu/ml
CRP: 2.4 mg/dl
RF: 88 IU/ml.

Almost all parameters within normal except the RF which should be below 15. Hence I wanted to know whether RA factor is elevated in chikungunya infection or false positive can also occur with severe joint pain. Have u tested any chikungunya patients for RA factor? what is your opinion in my case. Should I have RA?
Awaiting your earnest response to further decide my treatment course.

Charakan said...

Mangal, welcome here.
Your illness is most likely to be arthritis seen after chikungunya infection. Rheumatoid factor can be falsely positive. You can expect the pain to last for 2 more months and slowly subside. You can take non steroidal anti inflammatory medications as per the advice of your doctor.

sandeep said...

dear friends
I sandeep kumar from meerut had chikungunya fever in the month of october 2010. now it is february 2011, it has been 4 month still i am not able to move, my legs dont have strength to walk a 100 meter.
how could i get my legs strength back can anybody tell me please.
i will be very greatfull of him/her.

Charakan said...

Sandeep, sry to hear abt your condition.In some ppl it may take more time recover. See your doctor and to get advice

juhi chaudhary said...

Hello Doc,

I was feeling quite low and frustrated till I found your blog. During Sep-Oct last year, i got chikangunya/dengue type of fever. It started with acute body/joint aches so much that I couldnt move an inch.. followed by 103 fever. And when the fever came down, i got bad pain in jaws/mouth and pink small spots/rashes (itchy ones on face only), arms and thighs. At the same time, I got acute pain in my right ankle and its persisting since then (almost 5 months!) My other ankle, sometimes my knee and palm also hurts. my dengue serology report wa negative. Doc gave me anti-inflammatory meds but due to running around n dancing, pain kept on flaring back. I got my blood tests done alongwith MRI of my right ankle - report is normal except mild joint effusion. Blood reports are all normal. Today only I consulted a rheumatologist ( as my blood relative is suffering from spondyloarthritis). After exmaination he said i dont seem to be suffering from arthritis as of now but an aftermath of chikangunya and taking rest wont cure it. Many a times i limp and i cant do brisk walking at all. Rheumatologist has advised me calcium, vit d supplemts with SOS anti-imflammaory pills. Pls pls tell me will my foot get ok? I want to run and dance like before. ALso, should i go for walks even if it pains? Thanks

Charakan said...

Juhi Chaudary, Welcome to this blog.
Hearing your description I am sure your problem is arthritis following Chikungunya infection. In a very small percentage of patients this may last for a long time. I will advice you to take anti inflammatorry tablets liberally and do moderate amount of excercise under a Doctor's supervision. Your ankle will be all right soon

Anonymous said...

Hello Doc. I am a 40 year old female. I have been reading your blogs regularly.I had Chikungunya infection nearly a year ago.I have been observing severe hair loss in the past 4-5 months. Is it because of my earlier infection? Also the pain in my finger & toe joints persist.In the mornings it is worse.
Pl advice esp regarding hair loss.Loosing hair over this problem.Thank you for providing a platform to ask our medical queries.

juhi chaudhary said...

Thank you doc...i just hope the ordeal gets over soon..also i am trying out a paste of ginger, pepper n garlic..if i see any improvement in a month, will post about it. thanks

Charakan said...

Anon,
Welcome here.
Hair loss can be due to various reasons or without any reason at all.Hypothyroidism,Anemia,Vitamin deficiencies are all possible causes.If Chikungunya infection is the reason I think it is time now for regeneration of hair.So better to consult a doctor.

Charakan said...

Juhi,
All the best for your experiment.Keep me posted about the result

Avnesh said...

Hello Doctor, First of all hat's off to your sincere efforts of helping poeople for such a long period, your blog is like ray of hope for people suffering from CG. My father got CG in Oct 10 & still he has acute pain in one knee (in X ray agap has also been identified in this knee), ankle & fingers of another leg, the pain is sometimes so acute that it becomes tough for him to walk, if you permit can I email you the reprts & prescription in detail.

Hope to hear soon

Regards,

Avnesh Sharma
Jaipur

Anonymous said...

Anon40f:Thank You for the immediate response.Will consult a Doc as advised.Do pain in finger & toe joints persist till after a year?

Charakan said...

Avnesh,
Welcome here and thank u for the nice words. Yes you can email me at doc6568@gmail.com

Charakan said...

Friends,
I wish to know the final outcome of all patients whose details were discussed in the comments section of this blog post. If possible kindly email me the details of the clinical outcome of all patients to doc6568@gmail.com

Anonymous said...

Hi Doctor,

I posted on February 16, 2010. It has been almost 2 years since I got chikangunya now I am completely alight. Now I can do yoga, climbing stairs, walking, running I am back to normal.

I had severe pain for the first 3 months and then I had moderate pain for 5 months. After 8 months I slowly started getting back to normal.

Thanks for the information you shared. Your blog is very useful.

Chandan said...

Respected sir, ur article was very much informative.my mother 42f has been suffering from chickngunya for last 8 months I have tried various ayurvedic treatment and allopathy treatment as well but there is no relif .she is also suffering from hypothyroid nd high blood pressure.please advice it wud be very greatful of u.
Thanking you
chandan

Charakan said...

Chandan,
Thank u for visiting this blog.As i wrote before it is always better to confirm your mother's pain is not due to any other illnesses.So it is better to see a General Physician or Internist or a Rheumatologist to confirm the diagnosis.

Anonymous said...

Doc, thank you for the time you are taking to help out. I have just retunred back to Australia from Africa with my family. After 2weeks back my 14 year old was ill with fever. He has since developed severe hip and shoulder pain with knee soreness. It is so debilitating he can not walk more than a few meters nor use his left arm/ hand. The doctor has him on Naproxen - it does little but upset his stomach. Could this be Chicknugunya? How can we test him? Steve J.

Charakan said...

Steve,welcome here
How long did t fever last? Did it start from Africa or after ur return? Was there itchy rashes?

Abhilasha said...

Hi Doctor,
First of all, thanks a lot for such a useful and insightful article about this hellish menace. I'm diagnosed with Chikungunya. It started around a week back, now the fever has subsided but am left with swollen hands, esp fingers and swollen feet and they are itching like anything. Please help me, tell me some medicine or remedy asap as am really pissed with this excessive itching. Needless to mention, i've got some rashes also on my hand as well as legs but it is the severe itching that's taking my life :( PLEASE HELP

Abhilasha

Charakan said...

Abhilasha,
Welcome to this blog. U can take Levocetrizine 5mg at nite time and apply Calamine lotion for 2 to 3 days
U may develop joint pains later which may need NSAIDs

Anonymous said...

Doc, Steve here again. My son had a virus but no rash to speak of after we returned from Africa, about 2 weeks back. He had no symptoms in africa. He's now on Methatrexate. Feeling somewhat better but not back to normal. He can walk again, albeit with difficulty but his arms can't lift yet. It's hanging around so I guess it's not chickununga. Do you agree?

lakshay_soni said...

Hi Doc, first of all thanks for this very informative and interactive blog,i must say its one of its kind on internet,now regarding my problem for which i need your suggestions,
Doc, my mother had gone to delhi to attend a marriage one month back,on 30th september 2011 she suffered fever for the first time and after that the usual symptoms of chikungunya started affecting her,she had rashes all over her body,she also vomited blood one day, plus had an eye infection with a bit of blurred vision continuing even till now,after recovering from fever she has severe joint pain and swelling in her hand,foot,wrist & other areas plus overall muscular pains also,she took rest and recently started with ayurvedic medicines plus massages and heat therapy with water bottle but the pain is subsiding at a very slow pace, also application of anti inflammatory gels like volini or moov are actually increasing her pains rather than subsiding it,she also started taking "Dan-P" a pain killer drug tablet once a day and that has helped her but the pain starts as soon as the effects of the daily dose ends, we all are very stressed out with what is happening with her, can you please suggest anything to cure her joint pains??? i will be very thankful to you for your guidance.

Anonymous said...

Hello Doctor,

I was affected with Chikungunya one month back and I still suffer from joint pains. Another family member caught it a couple of weeks ago. I have a two month old daughter(1 month preterm) whom I breastfeed. While I understand that the disease doesnt pass through breastfeeding, does she have any immunity from the disease because I am feeding her and I already had the disease? Would really appreciate your insight.

Thanks
Radhika

Charakan said...

Steve, probably it is not Chikungunya

Charakan said...

lakshay soni,
welcome here. Sorry to hear abt ur mom. She can take anti inflammatory medicines under advice of a dr after ruling out other possibilities and also after cheking out her kidney/liver status. Consult a MD Physician. It most ppl it will subside by itself by 3 months.

Charakan said...

Radhika,
welcome here.
Your child wont get any immunity. You can continue breast feeding.Be careful about what medicines you take for your pain. May be best in lactating period is Naprosyn but consult ur Dr first

Anonymous said...

Hi doctor Charakan,

First let me thank you having dedicated blog for chikungunya...My wife is suffering from confirmed chikungunya from last 5 weeks; current problem includes - joint pain and some time swelling on wrist and ankle joint. From last 4 weeks she is only taking homeopathy treatment and I am also doing massage on knee and ankle join by using "Till ka Oil" sesame oil in night, which according to her give some relief also she takes voveron 50 mg some time in sevear pain in five weeks she has taken about 6 tabs more of alternative days not continues.

One of my friend who is pharmacist advise me to have her injected by decaduroblin 25mg at least two time i would like to know from you is this injection is ok and advisable for treating female patient with three kids at home age about 32 and weight about 62 kg

regards
SAT

Charakan said...

Anon,
Welcome here. You should not give decadurobolin,which is an anabolic steroid and can create lot of side effects,with almost no effect.You should consult a modern medicine doctor,preferably a Consultant Physician[MD in Medicine] or a Rheumatologist and get advice.

Anonymous said...

sir, both my parents are suffering from chikungunya. Its for over 25 days. in my dad's case the pain subsided after 10days. But today suddenly he is saying he is feeling the same pain all over his body and his eyes are swelling like that of conjunctivitis. My question is that is there any chance that this is chikungunya again? Is there any chance for it to come back again that too in such a short gap?

Swati said...

Dear Doc,
Came across your blog while searching for the cure for my joint pain. Last month I went to my native place in Varanasi, after 2-3 days I started suffering from high fever 102-103 degrees, and severe joint pain. The fever subsided after 3 days but the joint pain still persists. My doctor prescribed only paracetamol and told that the symptoms matched to CG. After the fever subsided, I developed rashes all over the body which subsided within one day of taking the prescribed medicine. But,my index finer is swollen since then, and i also experinece severe joint pain , shifting in nature! Sometimes the pain is in shoulders, sometimes feet. The pain in palm and the fingers persists all the time. I consulted doctors here in guwahati, and they have advised me to go for blood test, ECG etc. The pain is unbearable and i am unable to even lift a glass of water with full strength. I cant get up quickly if i sit for while. Kindly, suggest what i need to do? Waiting for your reply

Swati
Guwahati

Pinnacle Lawsuit said...

Interesting blog you have about chronic severe joint pain of chikungunya. Thank you for the information. Keep this going!

Anonymous said...

Hi! I travelled to India in 2010 June and contracted Chikungunya, with the typical high fever, rash and arthralgia. After about a couple of months, the arthritis subsided, and I have been normal for more than a year now. I had consulted with a rheumatologist after 4-5 months of coming down with Chikungunya, and after doing some bloodwork and X-rays, he had pronounced that I was not at risk at that time for RA. I exercise on a regular basis and maintain an active lifestyle. However, in the last couple of weeks, we moved to a new home and I did a lot of bending, carrying, and going up and down stairs during the process of packing and unpacking. I am noticing that the arthritis is back, especially in the small joints, with more severe upper and lower back pain.
Can you give me some information on whether there are recurring episodes of arthritis 1.5 years after the illness? Should I get checked for RA again? What are the statistics and the prognosis for chronic arthritis as a result of Chikungunya? What is the treatment, should RA be negative again? I would like to limit the use of NSAIDs because I have a history of heartburn. Thanks for your time!

Mea said...

Dear doc,

I was affected with CG in 2006 November and I am still suffering from its after effects. I had also suffered from a medial meniscal tear in my left knee soon after the illness and i had a fall in 2008 where I got an annular tear btw C4-C5. Each morning I get up from bed I have severe joint pains and it takes time for me to regain my daily activities.I have pain un my hip joint. knee joint, elbows, wrist and my ankle. What should I do?? Should I treat myself for arthritis ?? Please help me.

Emilie said...

Dear Dr.,
I contracted chikungunya in Jan 2009. About 3 months later I developed a swollen wrist. About 6 months later I had pain in my knees. I went to my primary doctor who did a blood test that showed my inflammation factors were very high for someone of my age. The specific factors were those that indicate lupus. The wrist pain began to go away in December of 2009, and the knee pain in jan2010 and totally went away when i got pregnant the next month. Last fall (2011), the wrist pain came back and even seemed to travel to the other wrist and back again.) i also had knee and ankle pain, so the dr. tested me again and those inflammation factors were high again, and indication possible lupus. I the last few years I have developed Body aches, feverish feeling, swelling and joint pain when exposed to allergens, but have had allergies for years that previously only caused headaches and respiratory symptoms.
In march of 2010, My dr. Referred me to a specialist( rheumatology and immunology) who poked me a lot and did not know what to do with me. He looked on a website right in the examining room and then wanted to try antimalarials (even though it had been over a year since the acute chikungunya).
I guess my questions are these: 1. Have you ever seen chikungunya trigger the onset of lupus, or seen blood test results of a chikungunya patient with joint pain indications markers for lupus? 2. Do you think I should try to get a second opinion from another specialist? 3. Have you ever seen a patient's symptoms last 3 years?(my pain is not constant, but I have flare ups of joint pain, fatigue, and feverish feeling but no fever present; and my last one was march 2012.).
I appreciate any help you can give.

Arun.N.M. said...

I am not answering questions any more in this post. For any doubts or clarifications please email me at doc6568atgmaildotcom