<s>[INST] I started having major swelling in both hands top & wrists as well as both knees along with severe pain. I have been tested for rumetoid arthrisit and lupus and all blood work has came back normal. My doctor thinks because of seeing the actual swelling with redness and heat that it is rumetoid but she is not sure. The flare ups are happening almost daily and she has started me on medication but it still is not seeming to help or releive the pain or the swelling any idea [/INST] Hi Dear, Welcome to Chat Doctor. Understanding your concern. As per your query you have swelling in hands and wrists along with pain. Well there can be many reasons for symptoms you mention in query like osteoarthritis, rheumatoid arthritis, gout, psoriasis arthritis or septic arthritis. I would suggest you to consult orthopedic surgeon again for proper diagnosis. Doctor may order blood tests or X-rays along with joint aspiration. Doctor may prescribe medicine like allopurinol, anti-inflammatory, methotrexate along with antibiotics and analgesic. For now continue your medicine, apply warm compresses and take ibuprofen or acetaminophen for pain. Hope your concern has been resolved. Get Well Soon. Best Wishes, </s>