I have recently been diagnosed with psoriatic arthrit... - NRAS

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I have recently been diagnosed with psoriatic arthritis.....my fingers are swolen ...cant get my shoes & socks on & getting in and out of th

mickyb profile image
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have recently been diagnosed with psoriatic arthritis.....my fingers are swolen ...cant get my shoes & socks on & getting in and out of the bath is a nightmare....Im on now 25mi mtx and have now been given sulphaz as well ..have been on mttx for two months ...doesnt seem to be helping much. the only relief ive had is when I was given a steriod jab....is this how it goes ??

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mickyb
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Hi Micky. I'm not sure quite how it goes as everyone has RA or PA differently so there are no rules for this disease really. I believe from others with this disease that PA can be quite difficult to treat effectively - perhaps because it usually takes longer to diagnose being sero-negative - by which time it may have taken more hold of the sufferer perhaps (I'm speculating here but when I was on the Arthritis Care Living with Arthritis forum a while back there were quite a few PA sufferers and that's how I formed my ideas about it).

But my RA wasn't controlled properly with MTX for at least 3 months and then I had another DMARD, Hydroxy, added in so now it is certainly much better. I did find that as the doses rose I got much less joint pain but unfortunately I also suffered more unpleasant side effects so now am back down to 15mgs of MTX and the symptoms of RA are coming slowly back - with sore knees just now. However it did seem to knock the worst stuff that was in my fingers, knuckles and wrists on the head after about 3 months and that hasn't returned so I can bath and get cloths on again now.

Give the drugs a chance and hopefully the MTX and Sulpha mix will pay off for you soon - it can take quite a while to get the right combination of medicines to halt the disease but I'm sure you'll get there in the end. Tilda xxx

Hi mickyb,

I was diagnosed with sero-negative inflammatory arthritis back in June, most likely Psoriatic Arthritis.

Like you I found that steroid injections helped a lot and I was also given oral steroids, Prednisolone, which I think have helped enormously - stiffness and fatigue were banished within a week of starting them. Started on Methotrexate just a little later but I've not expected much of it so far since, as Tilda says, it is not thought to have much noticeable effect for some months.

Much as I appreciate the steroids they are not recommended for long-term use & I have to come off them soon. I'm dreading it but at the same time I've got to the point where I want to know what my disease is actually doing. The steroids provide a temporary respite which sometimes feels like a fool's paradise. I'm just hoping that when I do come off them I'll find that some of my current sense of well-being is natural or is being provided by the long-term option, MTX.

Seems our Rheumys have taken different approaches with us two: you're doing it the hard way while I've been protected while the MTX kicks in. Either way it'll end up the same with us both hoping the DMARDs do what it says on the tin. I have got some qualms about that - if you google 'Methotrexate and Psoriatic Arthritis' you'll find a scientific debate about just how effective MTX is in preventing PsA from damaging joints - some scientists argue that it helps PsA symptoms but is not as effective in preventing damage as it is when used against RA. However, some scientists seem to think that giving relatively high doses of MTX to PsA patients from the start is the way forward rather than going straight to costly Biologics with their different and somewhat unknown risks.

Your 25mg sounds quite high-ish to me(?) so maybe your Rheumy thinks like this? (I'm just wallowing around with 17.5mg of MTX and no Sulphaz in my steroid la-la land!) Sounds like it's been an uphill struggle for you so far but from everything I've heard on this site & elsewhere you've got a good chance of feeling the benefits quite soon.

I'm very interested to hear how you get on,

Christina xx

su2po profile image
su2po

That's the way it went for me too, it was very painful and very exhausting. It did get better though and I feel nearly normal again. It took a long time and I wasn't prepared for that it's a year and a half since I got diagnosed and I'm just coming back to myself physically now. It was two steps forward one step back,I did get breaks from it though. I think I panicked and that made it allot worse. I hope you get some relief soon.

Hi,

While you are waiting for the drugs to have some effect, there are one or things you can do to help swollen fingers etc. I got lots of help from an Occupational Therapist and a Physiotherapist. Do you have a full team to help you? Or just a Rheumatologist?

There are hand therapies (ice baths or hot wax baths) and exercises to do. And gadgets to help.

It will get easier, but it can be so frustrating waiting.

So don't be afraid to ask for extra help.

dapper profile image
dapper

ive been on mtx for 18months now (25mg injections)and just been put on sulfa ,my symptoms are decreasing now ,but my hands still swell at least once or twice a week ,i cant give you any answers apart from saying hang on in there ,takes at least 3 months to work ,the nausea doesnt get any easier though

Hi Mickyb,

I have PsA and I can see and feel exactly where you are coming from, I was diagnosed a couple of year ago. As you have been given the steriod injection, every time you see your rhumy nurse or consultant ask them to give it to you. My rhumy nurse called it the 'get out of jail card', it does help to relieve the pain.

I discovered, to have a shower/bath take your pain killers about 1/2 hour before for the effect to kick in, I do this each time.

Socks? Sit on the bed and place one leg on the bed and try to put sock on then, same with shoes. Trainers are best at this time or those walking sandals, I used both of those for work in an office! Since having PsA I have always worn bed socks at night as it's more painful if the cold gets in, even in the summer. I can also recommend 'Hotter' Shoes but try them on the in the shops first before buying online/telephone. You may have to travel some distance for your nearest stockist, mine is a two drive away, but well worth it. The have 'padded' insoles, heavenly!

Fingers? I only wear my wedding ring now, when my hands are bad I hold them as though I have a broken arm, next to my body, it appears to ease them. Is someone at home with you, if so get them to cook the meals and cut your dinner for you, I used a spoon to eat. I found this less painful, I still use this method if they flare up. I tend to use a steak knife and I always ask for one of these if eating out, regardless of what I am eating.

I am sure that you are trying the things that I have suggested, the main thing is to hang in there. You will survive, you are not alone, we are here to help you. We have all been where you are at, and are coming out the other end, by learning to live with it. It's a hard gradual, painful slope but you will get there, I promise.

Take care, Elaine xx

mickyb profile image
mickyb

Thank you all for your help

Jan66 profile image
Jan66

Hi, I'm due to see my rheumy 28th August. Been on MTX for 3 years of 25 mg pills.

BUT now feeling quite suicidal - yes really. All the pains have returned. My question is - will I get a steroid injection if I ask for it at my appointment or is Elaine100 one of the lucky ones.

????????????

Any injection for me now would be most welcome.........

caggy profile image
caggy in reply toJan66

Hi Jan, thats awful that you have all your pains back after 3 years of 25mg MTX I think I would be suicidal too, YES get a steroid injection, ask for it sooner rather than 28th August I contacted my GP who got intouch with my Rheumy Cons who agreed it. so ring your GPor Cons.

earthwitch profile image
earthwitch

If you haven't had oral steroids recently, or had too much steroid in the last year, there shouldn't be any problems asking for an injection. Just be aware though that steroids can cause havoc with your moods, and it is possible that they could make you feel worse. If you are feeling suicidal, you do need to tell your doctor so they can make sure you are safe.

Jan66 profile image
Jan66

Thanks guys -will contact my GP for immediate advise and help.

Managed to have a real rest day today and watched the Olympics which was great. I just thought that I couldn't have steroids as I did have them right at the start and they helped a great deal.

Cheers, Jan

farjer121 profile image
farjer121

Hello All.... Micky/Jan just hang in there! Take things slowly and find coping mechanisims.

I have PA since 1999 but ignorded it until 2004 and have been on MTX since then.

It will take about 3mths for it to build up in yr system and be very diligent with yr blood tests.

Oral steroids such as Prednisolone can be blessings but can have draw backs such as causing Diabetes, but then you would qualify for free prescriptions!

Please take care and dont be affraid to seek support.

Allthe best TC

sheenerweener profile image
sheenerweener

Hi mucky,I get swollen fingers and hands and elbows I have had all the tests and they can,t say weather I have ra or not but they gave me the injection. In July and I had no more pain,swelling or fatigue I felt fab still do (its been 5 weeks so far) I get the odd day where they swell and are painful but no where near as bad as before the injection. Hope you get this sorted and get the pain relief you need xxx

akshayv2 profile image
akshayv2

Suffering from plantar fasciitis for over a year made shopping for shoe a difficult task. I had read about Orthofeet and thought I would take a gamble. They are by far the BEST shoe for me. I had cleared my pain up over the winter months and was ready to get back into my walking routine. I bought my Orthofeet and absolutely LOVE them. Can walk three miles and have no pain afterwards. My walking shoes have turned into my working shoes. I will order another pair as soon as I have time to look and decide.

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