<s>[INST] pain started in a day--right wrist,went to hand md,had cortisone injection,,lasted 3 days , then went to reumatoligist,had carpul tunnel test,blood work, doplar sonogram --all neg. its 4 months now and im no better ,both hands swell .no one has a diagnoses. im on naproxin now. not working well. [/INST] Get a RA factor and ESR blood tests done. If positive, very likely, start treatment accordingly through your rheumatologist </s>