<s>[INST] My son 9 years old had a fever for the last 1 month with joint pain his esr test is 90 . We did all the tests from bone marrow ......all are negative. Now the fever gone no pain in joint but still the esr 90.  Is it about time to be lowered. Or we need to give him medicine. [/INST] Hi,ESR is elevated in  inflammatory conditions. Was your son suffering from any rheumatic fever. The ESR will come down, now that the inflammation is controlled. Was any antibody workup done. If more details are provided, I would be able to help you more.You need not give any medicine to reduce ESR. Once the cause is identified and treated, it reduces on its own.Take care.Hope this helps.Any further queries, do not hesitate to ask again.Dr. Jyothi BL </s>