I'm newly diagnosed with RA, I am on methotrexate, although I have missed a few doses due to having shingles and taking antibiotics, but I'm really struggling with the pain in my hands, fingers, arms and elbows.
Does anyone have any suggestions on what will help. I have tried supports but because I have carpal tunnel syndrome, it just sends my hands numb. I have tried hot and cold things and nothing makes a difference. I'm not due to see the consultant till end of feb. Do you think I should contact my rheumy nurse.
Hiya & welcome. Yes, please do contact your Rheumy nurses. Although you say you're newly diagnosed it's not clear if you'd been on MTX long enough to have been feeling better on it, was pain, inflammation etc reduced? Needing to halt it will allow RD symptoms to creep back in which would account for the Carpal Tunnel symptoms (inflammation) but it sounds as though your splints may not be adjusted correctly, is there an adjustable metal rib on the inside of the splint? This is intended to take pressure off the median nerve & ease the pins & needles caused by CT. I had this problem when I had CT the first time & bending the metal rib helped ease the symptoms until I had the CT release op. Prior to this though it affected my whole arm up to the shoulder.
Shingles can be nasty, sorry you've succumbed to it & I hope you're feeling on the better side now.
I've been on methotrexate for about 10 weeks. My hand symptoms have been slowly getting worse since I finished the steroids at the beginning of January. The nurse I saw at the end of December, for my rheumy education, said that it was the steroids that was helping with pain I had experienced and not methotrexate. I don't think it's working anyway.
I have tried various splints and support bandages, not tried the metal ones yet though. I will contact the nurse and see what they say. Thank you for your help.
Ah, that makes sense, it could be that even by 10 weeks MTX hadn't had time to take over from the steroids being as the symptoms have been creeping back in since finishing them. It's quite normal to be prescribed them when first diagnosed & starting a DMARD, I was too plus a couple of NSAIDs, which is something else your GP may be able to prescribe for you to keep the inflammation in check & ease the CT symptoms. Unfortunately DMARDs don't work instantly as you're aware & as your nurse explained the steroids temporarily tackle the inflammation & in turn pain whilst waiting for that 12 week target (approx, can be longer). Needing to halt MTX for just a couple of weeks even when it is fully up & running will set you back because it builds up in the system. So the CT is likely caused by the inflammation which has returned after finishing the course of steroids & once MTX has reached it's potential it will abate. I needed a CT release op because I was otherwise well controlled.
It could be rather that MTX not working the dose needs adjusting/increasing though this may not be assessed until your Feb appointment as you need to factor in the build-up period. I started on 15mg & have been on 17.5 & 20mg both upping the dose & reducing it at various times as the disease demands. I'm currently on 20mg injections which have greater bioavailability so tablet equivalent is around 22.5mg.
Do ask about rodded wrist splints, they support the wrist better & when or if they need adjusting help with the pins & needles & pain caused by the median nerve being trapped, or they are available online for around £10. Mine were supplied by Occupational Therapy but I have bought replacements. You'll be able to discuss all this with your nurse, she's your go-to person for any problems you have.
Thanks, I did contact them and they can't do anything for me because I've been taking antibiotics. I'll probably have to take more antibiotics and they said I have to wait till a week after I've finished them before they can help, by that time I'm seeing the rheumatologist anyway. Just have to suck it up and get on with it.
Hi blackdog99 your situation is more complicated and painful than mine. I also have carpal tunnel but not too serious thank goodness. I looked on internet for carpal tunnel
remedies and saw one where he placed black electrical tape around wrist - not tight. If it hurts in any way I remove it. So simple but effective for me. Another one was two physical therapists who demonstrate 3 exercises which I have found helpful. One was fingers touching back of head and gently moving shoulders back.
I also wear a fingerless workers glove designed to minimise vibration from machinery with a velcro strap that adjusts pressure on wrist which is also helpful.
Kids run away from me because it looks like Michael Jackson!
Any way hope you find relief from your pains very soon.
Thanks for the reply. I've had carpal tunnel for years, I have a mild form too. I just live with the pins and needles in the tips of my fingers, it's not too bad. You can have steroids injected, I haven't, I looked at Google on how it's done and put me right off lol.
I’ve had RA for over 22 years and at the moment I am in a fairly good remission. I have been on methotrexate for at least 15 years if not longer. I am on a combination of NSAIDS (Non steroidal anti inflammatory drugs) that I take alongside it. I was on Salazapyrin first then Methotrexate and gradually had other things added to it over the years until a combination was found that was right for me and I now take both of those also Hydroxichloraquine, Nebumatone with Co Codomol and folic acid. I also take LansoprozoI to help prevent stomach problems from the other meds. I will say that it took over a year of being on arthritis drugs until I started to feel better so if I would say give the drugs time to work and that you will always have relapses and remissions it’s the nature of the disease unfortunately. Ask your Rheumatologist to prescribe other anti inflammatory that you can take alongside methotrexate if it’s not working and also use some Voltarol gel or cream or Fenbid gel which can offer some relief all be it temporary, failing that ask for steroid injections. Not always helpful but can give up to a few months relief if you’re lucky. A good bit of advice also is unless you have to miss your methotrexate for health reasons try not to forget to take it as the only way these drugs will work is if they have chance to build up in your system, the same with pain killers. Take the maximum dose at regular intervals up to the allowed amount daily. These are most effective when they’re able to build up in your system creating a barrier against the pain. All of the above is taken from my own experience. Once they get your meds right you will feel so much better. I hope this is helpful to you. I hope you feel better
I don't think myself or my employer will wait a year for me to get better. I have taken my meds as regular as clock work albeit when I've not been allowed to take it. Everything is just getting worse again, even my knees are starting to hurt again. I have to go to work tomorrow and I'm in so much pain plus I'm not sleeping, I don't know how I'm going to cope. Thanks for your reply, at least I know this is survivable.
Hi black dog have you tried compression fingerless gloves for your hands, I find them great and wear them all the time at the moment especially in this cold weather, maybe the methotrexate hasn’t kicked in yet as it can take up to 12 weeks to work properly plus what disease are you on as I’m on 20mgs but can’t go any higher as I can’t take 25 mgs , so if you’ve just started it I would give it a bit off time to get into your system
I did look at the compression gloves on Amazon but I've wasted so much money on buying different things that don't help, I just can't afford to buy anymore. I am on 20mg of methotrexate and I have only taken about 6 or 7 doses because of having shingles and taking antibiotics. I have been on it since the end of November. The steroids were great but I suppose the effects from them will be wearing off now. I suppose I just have to wait though I don't know how long I'll last with this pain.
I have just purchased fingerless compression gloves from my chemist (in Oz) and finding them a great help.
Here is a video by two physical therapists in USA explaining carpal tunnel and three simple exercises to assist - the exercises are helping me. Hope the link works. If not google CT and 3 exercises.
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