Am I being dense?

polly123

Hi Guys,

Anyone out there with PsA have time to share their story with me?
I have PsA and OA - diagnosed with OA 2 years ago, and then finally PsA at Christmas. I started mtx in January, and am in the process of putting it up to 20mg - currently at 17.5mg. I take folic acid the other 6 days, and also lodine and amatryptiline for trapped nerves - I have slipped discs in my lower spine.

I'm still stiff and sore, but better than before - but I guess naively I though it wouldn't get significantly worse now? I know I have PsA in my spine, hips, knees, ankles, neck shoulders fingers and toes, however I now have significant pain under my left foot - it feels like my tendon is being stretched and I'm struggling to put my foot to the floor for a while in the morning, and in my right hand - my thumb joint into my wrist and radiating outwards. This is significant enough to make writing/typing and fine motor skills more difficult than usual.

I guess I'm wondering if this is usual - not particularly these symptoms although i'm interested in that too - but the deterioration whilst on mtx. I had a rheumy appointment three weeks ago and don't have another one until April - not sure whether to see GP, phone rheumy nurse or just see how it goes.

would appreciate any input,

Thanks, Polly

lizzieuk1

I have ra not PSA but was on mtx for years til it stopped working. I would def call the rheumy nurse they may well alter ur meds, certainly get a blood test to check ur inflamm markers and see what's happening that will help the nurse monitor u.

Boomer13

Hi Polly;

I have PsA too and been on methrotrexate since Feb 2013. I know PsA and other seronegative athritides can cause symptoms like you describe in the foot and thumb and other places as well. I believe it's enthesitis (inflammation where ligaments and tendons insert into bone) that causes these symptoms. I don't think it's the methotrexate per se, but rather the disease not being controlled by it.

I keep my own diary and report new symptoms to my GP. She orders imaging if warranted and sends results to rheum. They work together well but I know this is not always the case. Maybe you could call your rheum office and at least report what's happening?

Hope that helps.
xxAnna

dreamdaisy

No matter what the meds are they only slow the progress of the disease. Like you I have both PsA with OA and I have gently deteriorated over the years. I started with one joint and needing one stick, then more joints joined in and I progressed to crutches, now I have a rollator despite being on a triple therapy; 'tis the nature of the beast. The pain under your foot sounds like plantar fasciitis (please remember that I am not a doc) and that can occur as a consequence of arthritis. I've had it under my right foot (diclofenac helped me) and I now have Achilles tendonitis in my left ankle.

Arthritis of any sort is a progressive, degenerative condition, but the rate at which yours progresses and degenerates is unique to you. You will have your better times and your worser times, just like the rest of us, and adjustments will have to be made because that helps us to cope - you never know, this may be as bad as it gets for you and I hope it is. We are each different in how and to what extent we are affected but, once we have arthritis, there is one thing we know for sure: it won't be going away. I wish you well. DD

polly123

Hi,

Thankyou for your replies - I visited my GP this morning who prescribed painkillers. He is putting it down to not being fully controlled by the mtx and suggests waiting a further month until a full therapeutic dose is reached (20mg) and see how I am then.

I guess I'm just shocked that as well as continuing to deteriorate in the areas I was previously affected I'm affected in new places (my hands).
For some reason I thought I would pretty much stay as I am!

Silly really as my son has an immune disorder and I *know* it doesn't work like that :-)

stickywicket

If you're still increasing the meth then your rheumatologist obviously feels that it's not controlling the PsA enough. It does take some time to work. I guess Jan>August is a reasonable crack of the whip but, if it's only recently been increased then you'll need to give the increased dose more time.

The meth won't help your OA though. That will progress in its own way and time. I think your GP has a point and I hope the dullers help in the meantime.

polly123

Thanks Sticky - think I need to make a worst case scenario plan and work towards a bit resilience. Under the new pension rules i'm supposed to have another 13 years left to work - can't see that happening!

stickywicket

I think the problem is that arthritis doesn't read the rule books and, unfortunately, dictates our pace whether we like it or not. Trying to rush things results in stress and arthritis just gobbles that up and grows stronger :roll: It really is difficult for those still working and I do hope the increased meth and dullers helps.

polly123

Totally agree - I've had a lifetime of experience of this with my son, now 21, so I *know* all this, but somehow am having trouble relating it to myself - silly I know.

stickywicket

I think it is silly but we all do this kind of silliness. We just manage to detach ourselves from the reality although we're so aware of it for others. Do as I say not as I do is my watchword :oops:

dreamdaisy

Being sensible and realistic for others is always far easier than being it for ourselves, we all know that. Sticky is right, we can make all the plans we like but arthritis will take no notice because its plan is already being executed. DD

polly123

yup it's an aggressive little whatsit!!!!! GP calmly pointed out also that whilst the PsA is treatable to a degree the OA in my spine will progress regardless.

Thanks for that!!!!!

destiny0321

I have PsA & OA oa 30yrs & psa 10yrs i am on meths ect & lots of pain killers OA of spine& hands my back is really bad i have a prolapsed disc but they could not do anything as arther would eat it away waste of there time & mine.everywere else i have PsA & lately it is getting worse but we try to keep going dont we a dr told me once LISTEN TO YOUR BODY when you need rest do it just do not over do it god bless

polly123

Hi destiny, thankyou for sharing.
Your doctor is right, we do need listen to our body and rest when necessary - makes it really difficult to have a life those doesn't it? Particularly if you have commitments such as work.
Keen your chin up,
Polly

petals

Agree whole heatedly, working with arthritis is a challenge. Even though I have cut my hrs down to 20 per week I can't see myself working for another thirteen years before my official retirement is allowed.

I really don't know what the answer is to be honest, I am simply taking one day at a time. The nation seems to think we are a bunch of spongers who have a "little bit of arthritis" and all want to live on benefits. Ha, they should try living and working with chronic pain and often the depression that goes along with it.

If it was so simple, then there would be no need for forums such as this, the very fact that we NEED support just to get us through the challenge that is arthritis speaks volumes.

Sorry, got into a bit of a rant there, where did that come from lol

Petals x