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Excruciating wrist pain

Hey everyone. I've been diagnosed with RA in May 2018 and since August I've been on MTX 15 mg weekly. The treatment has been really effective, and my rheumy told me about 2 months ago that I'm in remission, since I was diagnosed in a very early stage on RA. I was supposed to have a new set of blood tests soon, and since I've been feeling really good, having just a dull wrist pain at the left hand, I stopped the treatment for about 3 weeks. I didn't feel really good after my last MTX shot and I decided to stop the treatment during my exams. I have an appointment next Friday, but this morning I woke up with such an excruciating wrist pain. I can barely move my hand and when I do, it's really painful. Is it possible that just a couple of weeks with no treatment could have made my RA go crazy and stop its remission?

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My rheumy was going to lower my MTX dose to 7,5 mg if the blood test results were ok. I am afraid that the results won't be good and I will continue with the 15mg dose..

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Your wrist pain: is it across the whole wrist? My recent flare involved all compartments of the wrists and affected flexor tendons too, meaning the range of movement was severely restricted. I wore my smaller splints much of the day and night too till I got a steroid intramuscular injection and doubled dose DMARD.

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Well, until this morning, the dull pain I had was located in the left side of it, but now the pain moved towards the right side and towards the fingers. It's an intense pain, which makes it difficult to use my fingers, too. I get the pain not only when I move my hand/wrist, but when I try to use my fingers, also. Moreover, there's a kind of a swollen bump next to my wrist, which is warm

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Definitely get urgent care!

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We all find our body reacts differently to various drugs. It seems very likely that stopping MTX has allowed RD to return. Best to get urgent blood test and meantime resume MTX. It can be shockingly quick when a flare happens. :-)

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It may have been useful for you to hear that your remission most probably was a clinical remission meaning that you are dependent on the med to keep the inflammation at a low level. Unfortunately by stopping the med the RA got a stronger hold again.☹️

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Yes. But my rheumy had no idea that I would stop my treatment...and I just assumed that a few weeks without treatment won't make a difference...

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It could. It's when off MTX for me but such wrist pain could be the precursor to a full blown flare with you not injecting your MTX. Or, it could be isolated to inflammation in the wrist area only.

Unfortunately for you it would seem you've misunderstood somewhat what remission in your case means, not your fault if it wasn't explained. Seems to me it's clinical remission, sometimes also called medical remission, that the meds are working so well you have no symptoms of the disease when you're treating it.

I notice a difference if my dose is reduced too, I flare, not terribly but enough to ask for my dose to be increased to the previous one.

It might be a painful reminder that we should seek advice if we wish to halt our meds for any reason. Sometimes an alternative can be prescribed such as a short course of steroids or steroid injection if we have an important event we don't want hindering by possible side effects we have.

Do see what your Rheumy nurse thinks, it could be just restarting your MTX is all that will be needed to relieve your pain. I respond quickly when I starting injecting MTX again, hope you do too.

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RA will always need to be managed as it is progressive and not cureable. Upto a two week break for medical reasons is occasiobally ok and occasionally necessary but sometines you run the risk of the drug not getting reintroduced back into your system effectively. It sounds like a flare and may need a short course of steroid. Not sure which you are but Sero Positive can flare quite quickly and take more controlling, not a condition to be ignored as once the damage starts it can be slowed but not reversed.

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Sadly you’ve learnt the hard way that you can’t just stop and start your meds without consequences 🙁 Hopefully you will soon start to feel better now you’re back on them. Talk to your rheumy if you’re having side effects from mtx and they are affecting your life that much.

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HAVE BEEN ON MTX AND PREDNISONE FOR ABOUT 7 YRS. NOW. MY RA STARTED THE SAME WAY-ONE DAY FINE AND THE NEXT, RIGHT HAND AND WRIST BLOWN UP LIKE A BALLOON AND SO PAINFUL I COULDN'T MOVE IT.I TOO HAVE TRIED GOING OFF OF MTX 2 TIMES AND BOTH TIMES I ENDED UP WITH A NASTY FLAIR UP.IT JUST DOESN'T WORK FOR ME. HAVE WORKED MY WAY DOWN IN DOSAGE, BUT KNOW I COULD PROBABLY USE A LITTLE MORE BUT TIRED OF LOSING SO MUCH HAIR . I FIGURE I MUST BE FIGHTING A SLIGHT FLAIR UP AS HAVE BEEN EXTREMELY EXHAUSTED AND THE BONES IN THE TOPS OF MY FEET HAVE BEEN SORE AND AT TIMES ACHING. CAN'T SAY OUR WEATHER IS HELPING MUCH-ONE DAY MILD, NEXT FREEZING OR RAINING A LOT OR SNOWING.TRY TO STAY ON YOUR MEDS. ON A CONSISTENT BASIS AND IF PROBLEMS SHOULD CONTACT YOUR DOCTOR FOR ADVISE. BEST OF LUCK AND HOPE YOU ARE FEELING BETTER NOW THAT YOU ARE BACK ON MEDS, WILL PROBABLY TAKE A COUPLE OF DAYS OR MAYBE A WEEK TO START FEELING PAIN FREE.RA IS A FUNNY DISEASE-YOU GO THROUGH PERIODS WHERE YOU THINK WOW THIS IS GREAT AND THEN IT SLAMS YOU AND YOU FEEL AWFUL AND IT JUMPS ALL OVER YOUR BODY SO YOU NEVER KNOW WHERE IT'S GOING TO SHOW ITS NASTY SELF. ROLL WITH THE PUNCHES AND TRY TO KEEP YOUR SPIRITS UP-AS MY GRANDMOTHER USED TO SAY------"AND THIS TOO SHALL PASS" AT LEAST FOR A WHILE---------LOL.-KEEP THE FAITH !!!

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Hi Cosana, I think we've all been in the same boat. Feeling OK and thinking I could just miss a few injections whilst I do exams/go on holiday/ etc. I've worked out through trial, error and a lot of pain that I can only miss one. Any more and it seems to set me right back, so much so that I never go on holiday for more than a week now.

Remember, it's the meds that got you into remission in the first place!

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Hi Cosana

I have missed a MTX dose on the odd occasion with no issues, but last Nov I missed 2 doses as I had a very chesty cough. It was towards the end of the second week that I could feel my hands and feet becoming painful and stiff and one of the joints on my left index finger had started to swell. So I am sure that had I missed another week I would have not been in a good place.

As for your wrist ..... About 2 years after diagnosis (I was on Azathioprine at the time) I had wrist pain. My wrist got more and more painful and I was unable to drive for 6 weeks. My consultant at the time said not too worry. But then it blew up and became badly inflamed. I had an apology from the head of the department and was moved from Azathioprine on to MTX. I was given 2 steroid shots. Neither of which were painful. One into my wrist and one into a joint below my thumb. I recovered within 48 hours - it was bliss!

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Thank you everyone! It's really helpful to hear about others who've gone through this before and get a piece of advice.

I woke up a bit better today, even though the top side of my hand is really red, warm and a bit swollen. A neighbour who is a nurse was nice and came to my place to inject me a painkiller to ease my pain. The good thing is that I can move my fingers. I took my MTX dose before I went to sleep, too.

I had no idea that there's such thing as medical/clinical remission...but at least, now I know for sure that it's absolutely necessary to take my MTX dose weekly.

Anyone here on MTX pills? So far, I was on injections and I have to inject myself...which is a burden every single time. I hate needles and it's enough to just think about MTX's yellowish colour to get nauseous. I wad thinking to switch to pills, but I read a lot on the internet that the side effects are more intense.

What do you think about this?

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I am taking MTX by tablet, now for 2 and a half months. I feel blessed with very few side effects - hair loss, a few mouth sores which cleared up with salt water rinse. Hair loss doesn't hurt and the pain I was in before MTX was unbelievable. I experience no nausea as I am careful to take these with a BIG meal. Hope this info. is helpful. Oh, the amount I take is 15 mgs, plus I just started sulfasalazine as the disease was still active. Oh, also I take prednizone 15 mgs which is being weaned off slowly as these dmards kick in.😮

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I take pills, I tried injecting but I got bad sickness side effects so went back to pills. People do seem to get more nauseous on the higher dose of tablets but many can take the higher dose in the injections with less nausea as it bypasses the stomach.

The tablets are bright yellow too 😊

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IT'S PIT BULL AGAIN. I HAVE NO EXPERIENCE WITH THE INJECTIONS BUT HAVE TAKEN MTX BY PILL FOR ALL 7 YEARS. I CAN ONLY SPEAK FOR MYSELF. I'VE LOST AT LEAST HALF MY HAIR, NOW HAVE NO MID DRIFT( DIDN'T REALLY GAIN WEIGHT BUT I GUESS IT REDISTRIBUTED RIGHT UNDER MY BUST.) MY SKIN IS VERY THIN SO BRUISE AND BLEED VERY EASILY AND DO HAVE SOME INDIGESTION PROBLEMS. SOME OF THIS COULD ALSO BE FROM THE PREDNISONE BUT I DON'T KNOW HOW MUCH. ALL SAID AND DONE I'VE NOT HAD THAT HORRIBLE PAIN THAT I STARTED WITH 7 YEARS AGO EXCEPT WHEN I STOPPED MY MTX FOR ABOUT 3/4 WEEKS. I DO KNOW THAT THE PREDNISONE HAS CAUSED A TEAR IN THE TENDON IN MY RIGHT ANKLE SO NOW WEAR A LEATHER ,LACE UP BRACE ON THAT FOOT. IT WOULD SEEM THAT ALL THESE MEDICATIONS HELP GREATLY IN ONE AREA BUT ALL HAVE SIDE EFFECTS THAT WE HAVE TO LIVE WITH TO ESCAPE PAIN AND TO SLOW DOWN THE PROGRESSION. OTHERS COULD HAVE HAD COMPLETELY DIFFERENT REACTIONS, I'M SURE IT DIFFERS FROM PERSON TO PERSON. HOPE YOU ARE FEELING BETTER EACH DAY-----GOOD LUCK.

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PIT BULL AND MR. DIGGS ARE THE SAME PERSON----SORRY ABOUT THAT------LOL

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You lost all that hair from Methotrexate? OMG is this what I have to look forward too? I don't want that. No way. I inject 6 on a weekly basis. How much do you take?

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Troygirl please don’t worry, different people react differently to each drug plus mrdiggs hair loss might be nothing to do with mtx. I’ve been on mtx for a long time (both tablets and injections) and I’ve not lost any hair, I hope it’s the same for you.

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