### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I have rhumotoid arthritis and goit and I am taking 300mg allopurinol,30mg lansoprazrazole,5mg lisinopril,250mg naproxen,40mg simvastatin,200mg hydroxychloroquine and 500mg paracetamol.My hands,elbow joints,neck and shoulders are still very painful,am I taking too many tablets or are they the wrong combination.I am male and 69 ,thank you. Peter

### output:

Hello, To comment first on the history with respect to medication, it is totally a physician decision based on the symptoms provided at the time of writing the prescription. So he will be the right person to give justification on why so many medications were prescribed.  Now coming to your pain part. The pain is due to inflammation of the joints. Which you might be aware of. RA is a moving pain and can lead to pain at small joints and big joints also at times. You have a take a bigger precaution and that is to keep yourself warm. Like staying in cold weather will aggravate the symptoms. So keeping yourself warm will be first line of action.  Next will be since how long you been facing this pain, and when was this RA diagnosed to you? This plays a key role in the overall guidance of the treatment plan. Regarding the medicine part please visit a rheumatologist as he will be the right person to take care of it.  Now treatment part. First thing is to keep the muscle and joint mobility to the maximum. So a physiotherapist will play a key role here. They might perform some passive or active exercise based on a physical assessment. Also, physical therapy pain reduction modalities like Ultrasound therapy and TENS therapy will be of benefit to reduce the pain.  Besides, please understand that this is only symptomatic for the pain. But to improve the metabolism and keep the body warm internally is only in your hand. The more the active you are the more, the better the outcome score. Usually, I see chronic RA cases in my clinical practice. They all respond well to exercise. Any kind of deformity present needs correction via physical therapy or with the help of splints. But most patients respond well to exercise in long term rehabilitation. Hope I have answered your query. Let me know if I can assist you further.  Jay In Chat Doctor. 