Need advice on treating psoriatic arthritis

Hi all, this is my first post on here. Brief history is that I have had problems with joint pains over the past 10 years. Many times I have been tested for rheumatoid arthritis and the results always come back negative. I was referred to a rheumatologist 2 years ago and they just diagnosed me with fibromyalgia and discharged me. Over the past month my joint pain is the worst it has ever been and I have now been signed off sick from work. My GP is referring me back to the rheumatologist. I was desperate for answers so looked at the arthritis uk website and came across psoriatic arthritis. I have mild psoriasis on my scalp since I was a child and I have had two bouts of guttate psoriasis in the last 10 years. The rheumatologist never asked me about psoriasis and never thought to tell her?! Reading about it I am now starting to think this is what I might have as it matches my symptoms perfectly. Over the past week my joints in my fingers have become very swollen. I am presuming the referral to rheumatology is going to take several weeks so I would like some advice on how to treat the very painful swollen joints in the meantime. I am taking ibuprofen regularly at the moment but this is not taking the pain away or bringing the swelling down very much.

Sorry for the long post - if you have stuck with it thank you. All advice would be greatly received as I feel in limbo at the moment



9 Replies

  • Hello and welcome, we're a new site and still in our infancy but you will still receive good advice and friendliness. Sorry to hear that your in so much pain at the minute. Yes when you see your consultant do mention that you have Psoriasis and say is it Psoriatic Arthritis, at least then you've placed the seed and will feel better for having said it. I did this at my first visit and felt like punching the air when it was confirmed if it weren't for the pain in fingers and shoulders! Instead burst into tears and said someone listened, and was immediately put on medication to help with this disease. It took three visits and several blood tests and X-rays before we got there.

    In the meantime I would advise you to revisit your GP and request stronger painkillers there are a few that can be given. I have a three step painkiller medication, depending on the severity of pain. However I don't take Ibropen as I have IBS-d and it sets that off.

    When visiting both teams ensure you take a pad and pen making notes, especially on dosages and what painkillers you can mix with and what not, as some have a little bit of both in them, and we don't want overdose treatment! Also beforehand write down questions you'd like to ask or things you wish to tell them. You may find in the conversation much of your list has been answered or said but at least you have you notes to remind you if not all has been covered. You only have ten minutes so use it wisely and by taking your pad and pen you are doing that. Likewise take notes during the time as it will help to refresh afterwards.

    Just a little for you to be going on with, I hope it's helped, but most importantly see your GP for stronger pain killers.

  • I think you are wise to consider psoriatic arthritis and I hope you get some answers and appropriate treatment when you see the rheumatologist.

    Meanwhile, it does help to keep moving as much as possible. The 'common sense' approach to rest, rest, rest when joints hurt can be counter-productive and some movement may well actually help with pain. I wouldn't advise a marathon, but walking, swimming, gentle stretching will keep the all-important muscles and tendons that actually support the joints supple and strong. You may also want to try heat pads or ice (I just use good ol' frozen peas) to ease pain and swelling a little.

    If you do have PsA the swelling may continue for some time so don't let it get to you. The drugs available can bring it down and make you feel better overall but they also take a long while to kick in, so patience and self-help are the way to go. So sorry you've got all this to contend with but there is light at the end of the tunnel. If we can help at all or share your woes you know where we are!

  • Thank you both for your replies, they both sound really positive. I am going back to the GP on Monday so will ask for better pain relief. I am worried about how long I might have had this untreated when most things I read say the quicker it is treated the better the prognosis. Just want some answers really

    Kat x

  • Hi Katt just a thought, you say your joints are badly swollen at the moment. It may be prudent to take photoes to show your Rhymy as ten to one the swelling will have gone down before you get your appointment.

    Hope you get it sorted.

    Regards Mike

  • Thanks Mike for your advice. My fingers are very slender usually so even when swollen they don't look too bad but I know they are because they look more like sausages!! And I cannot get my rings off.


  • Sorry to hear you are suffering. The only thing we have here in Canada is Celebrex for swelling and pain, I will take that and an extra strength Tylenol for the pain. Definately try and get in right away to your doctor to appear start something, you do not want to leave interested for too long as you could cause damage it is also no fun and very painful. I was also diagnosed with Rheumatoid and about 10 years later a specialist said nope you have psoritic arthritis. Hope this helps in some way. Treatments are fairly similar for the joint pain and swelling

  • I have had OA for a long time mainly in my hands. But been getting pain in other joints. My GP referred me to rhumetolagy to see if it was just OA found out it was PsA too that was May of last year I also have mild psoriasis witch I thought was just dry skin on my elbows. I was put on sulfasalazine for the PsA went for follow up appointment last month and the consultant wants me to take Leflunomide too. And I take cocodamol for the pain

  • Hi - sausage fingers was the first sign that my rheumatologist noticed on me! Until you see your doctor, try soaking in warm water with Epsom salts. It helps mine. I also take Vit D, iron and magnesium supplements. But this was after my blood work came back stating I was deficient in these. Good luck - it's not easy. I also have to take Norco when my pain is too bad. Hopefully your GP will give you a stronger pain medicine.

  • Hi Katt, I would echo Mike's advice. Take photos. Of anything unusual - not just your fingers but also rashes. I have just been diagnosed (two days ago), like you after years of problems and being dismissed and discharged by various rheumatologists... 4 months ago, I finally succeeded in getting an ultrasound, which showed synovitis and got me a diagnosis of 'mild inflammatory arthritis', but what finally swung the PsA diagnosis was the fact that I took a photo of my belly button when it had a nasty rash last month. The rheumy took one look and said "With a rash like that, it's 99% certain you have PsA" and is putting me onto Methotrexate... And remember that if you take photos of your fingers while they are swollen, the rheumy will be able to compare that with your 'real' fingers in front of him/her at the appointment, so the difference might be more obvious. Good luck!

You may also like...