Clicking joints

[Siobhad]

I’ve newly diagnosed with RA and have just taken my 4th Benepali injection. Last week a lot of my joints are clicking quite noisily including my neck, jaw and knee. I don’t have much pain though , just a big in my neck. Has anyone experienced this?

[KittyJ]

There was a similar post a few days ago. I think it’s a common thing not just in people with RA. Here you go,

healthunlocked.com/nras/pos...

[Siobhad in reply to KittyJ]

Thanks Kitty. I’ve checked that out.

[Bagpuss2021]

My joints have always clicked for as long as I can remember, especially my knees and wrists.

[john140]

I thought clicking joints was more associated with Osteo Arthritis ?

[Siobhad]

Thank you for your input. I’ve noticed that the noises are much worse since starting the Benapali injections. It’s weird hearing how loud it is, particularly neck and jaw. Hopefully all benign and harmless.

[Stowe]

Yes I get it at times, not painful but I just seem to have a xay or two of my joints clicking more then it calms down again.

[Siobhad in reply to Stowe]

Thanks Stowe. Does this happen after your injection?

[nomoreheels]

Hiya Siobhad, welcome. I'm sorry you've been diagnosed but it's excellent that you're on Benepali injections so soon (if you're in the UK!), unless it's an indication of severity which, of course, isn’t so good.

The clicking you're questioning is likely to be something called crepitus, caused by escaping air between the joints, really small bubbles of air in the synovial fluid which surrounds your joints. I would think the reason you’re finding it more noticeable in your jaw & neck is where they are, louder sounding with being in the area of your auditory system. That wouldn’t explain the knee, unless that is particularly affected. It's good you don't have much pain as it also should mean you don't have a lot of inflammation either, your meds seem to be doing what they're intended to.

I hope you find it helpful being here. We try to help through experience, there's usually someone around that can relate to something. ☺️

[Siobhad in reply to nomoreheels]

Thank you nomoreheels. Hopefully it’s just a benign crepitus and not an indication of an infammatory process at work ! It’s interesting to read on your bio that you’re back on methotrexate after going through so many drugs. Great you have your disease under control. Are you finding Mtx easy to tolerate ?

[nomoreheels in reply to Siobhad]

Hopefully, the least pain you have the better really.

I've never come off MTX since I started it in 2009, HCQ being my first. SSZ & LEF were tried in turn as double therapy with MTX but now just on monotherapy (injections). It depends on dose how well I tolerate MTX. I have issues above 17.5mg, liver objects & less tolerable side effects, I've tried 20mg 3 or 4 times. At my last meet with a locum Rheumy he obviously hadn't bothered to read my notes as he wanted to increase it again. As it was we decided rather than MTX I’d increase my maintenance dose prednisolone slightly as that would be my only option, he wasn't prepared to discuss biologics. I do ok, as ever things could be better, but until it's decided that biologics are the next treatment option I guess that's the state I’ve accepted for now. It has been suggested twice now, once by a Rheumy & the other by an SpR, but never come to fruition as I never see the same person twice. Depending on how I am at next meet, & I don't expect any great changes, I intend bring up trying ones of the biologics recommended for moderate disease in the latest NICE guidelines as my DAS score stubbornly remains in this group. That said it wasn’t even done last time & when questioned he did as with my other questions & swerved a direct answer. How ever he decided I was in need of a med increase only he knows as the only time he came near me was to look at the DIP joints on my hands because he came across my last X-ray. He showed little interest after that as it's OA which has robbed me of the cartilage. I'd had enough of this treatment from him & thought it pointless to pursue with him so let it lie. Oops, turned tinto a bit of a rant, sorry!

So that's in a not so small nutshell! Can I ask if you'd share your treatment experience?

[Siobhad]

Thanks for all that info nomoreheels. It’s sounds frustrating that you don’t have any great continuity of care. It’s also reassuring that Mtx has served you well and you’ve tolerated it relatively easily also. I was only diagnosed with RA very recently, December 2021. It was suspected that I had tendonitis in my hands for a year as I’m a professional musician but luckily before I had steroid injections done by the rheumatologist he did an mri which showed synovitis. I wasn’t typical RA as all my bloods were normal and I only had hand pain (quite significant), no swelling present. It was quite a shock to discover if RA.

I’d overcome another autoimmune 20 years ago after struggling for 10 years in my 20s so didn’t expect to have another to contend with. That was a condition that doesn’t overlap with other autoimmune disorders. I know a lot of them do so I was just unlucky to get RA.

Because of my profession my Rheumatologist made the decision to start me straight on Benepali injections as MTx can be slower acting. I wasn’t too keen as the potential side effects are scary but he was quite insistent.

I’ve had a good response thankfully and back working but a bit traumatised as all this seemed to start with sore hands and suddenly I’m overwhelmed by a condition for life and having to take daunting drugs ! I’m now noticing pains and aches that I’m not sure were there before! The diagnosis has made me hypersensitive to any tiny ailments and I don’t know what is normal and what isn’t any more- is it RA or just normal 54 year old ageing body. Think I’ve ptsd 🤣. I’m sure this phase will pass. I’m lucky to be so well.

I intend to ask to step down to a less scary treatment after a few months. I know none of the drugs are without their side effects but Biologics seem to coms with more warnings.

I hope that gives you some insight nomoreheels and can possibly assist someone out there.

It’s great to have such an informative and supportive forum.