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Will my joints ever be normal again?

I had my third consultation with the Rheumy department yesterday and although I have only been taking Mtx (15mg) for 5 weeks they are very pleased that all my indicators are down in the normal range. I know I am luckier than a lot of people and only have real problems with both wrists, one ankle and to a lesser degree hands. I have played league darts, snooker an pool for many years and enjoyed it very much. I now cannot play any of these game because of my wrists, I tried to throw a dart yesterday and had searing pain in my wrist. Besides this I can no longer do many other "normal daily activities". I cannot walk for more than about 100 yards before my ankle gives way. They seem to think that I have PsA because my Father suffered with Psoriasis but fortunately I have no skin problems. I am also becoming depressed which is very distressing. I am just hoping that the Mtx will start to work and I will be able to use my wrists and ankle again because I am starting to believe that I will be unable to use the joints normally ever again. Does anyone have any theories about using affected joints i.e. should you try and use them or rest them? I know there a lot of people out there who have far more problems and pain than I have, my heart goes out to them and I hope and pray that that things improve for them. xx

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Unfortunately there is no clear cut answer as we are all different. If your medication suits you and works there is every chance of a fairly normal life but this may involve many changes either of dose level or medicine and can take some time. It is a balancing act of do you use or rest - this is something that only you can work out over time although joints should be kept mobile. Some people like ice for their joints while for others it is heat that helps. Perhaps your rheumy can refer you to physio for relevant exercises or I think it is occupational health for wrist supports or splints which may help. Depression can be part and parcel of this disease so a trip to your GP may be relevant as there is a fine line between realising you are on the edge and falling off it. Farm



I have PsA too. PsA loves exercise as a rule ... but you need to take some care. So I think steady walking is something I'd do with a painful ankle and I might keep going despite pain, but I probably wouldn't run or do anything that might twist or jar it. And of course wrists are all too often subjected to repetitive movements, it's probably best to limit those. Ice or heat on affected joints can help as can wrist braces, I'm sure lots of us here could recommend our favourites. I've found them most useful at night to prevent the wrist flopping or twisting while I'm asleep. I think you have to keep moving ... that's the best way, but alternate light exercise and your daily tasks with rest as much as you can.

I hardly ever get depressed these days ... but from time to time I will sink. It happens. Where you're at you can most certainly expect, hope and demand to feel a whole lot better before too long. For me personally Mtx helped loosen up joints, dampen pain and improve fatigue. It didn't reduce swelling, but it made a difference. Many of us with moderate to severe PsA find that DMARDs do not cut it, ultimately, and that biologics are the way to go. So, slow as it is (it may be 3 months or so before Mtx shows its hand) don't get stuck on any one DMARD for years if they're not working well enough. Sometimes rheumys need a push in these cash-strapped times.

To answer your main question in a sentence: "perhaps not 'normal' but very likely loads better, enough to cheer you up, enough to make your life much easier and more enjoyable again".


By the time I was diagnosed I struggled to walk, to hold anything, to wash myself, to make food etc, etc. Just about all I could do was cry....

5 years later I'm fine. I walk the dog for miles every day, I can do most things normally, and life is mostly pain free. I have to take a bit of care not to overdo things, eat well & exercise but apart from that it's ok.

Believe that you'll get there, and keep moving. Exercise has made a huge difference to me, but you have to judge it carefully. When joints are inflamed don't push them too hard, but don't keep them immobile all the time either. When I was at your stage I concentrated on daily range of movement exercises, stretching and even tho' I couldn't walk far I did move around the house as much as I could. Rather than playing snooker right now, spend time rearranging your trophies and other more gentle activities. But it's very early days for you, and everything about this disease takes time.


Yes exercise is excellent. BUT start from where you are now, not where you used to be before the joints hurt. Plan your exercise to be little and often, warm up and cool down - that is start slow, get up to speed (with the dusting, the walking, the shopping) and slow down at the end. Exercise doesn't need to be in the gym or with an exercise bike, it can be just getting up in the adverts and walking up and down stairs.


Hi. You really need to make an appointment with the Occupational Therapist. There are some great splints available that will help you to continue with your activities without hurting your joints more. The OT will help you to get the correct splints. Don't suffer in silence. Make use of what is available to you. They really do help. Good luck.

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