PsA plus other problems

bing

Hi there,
you seem quite an experienced lot and I will be asking at my next rheumatology appointment but thought I would ask here too.
I have PsA which mostly causes me pain in my fingers, hands and feet, well thats what I think. I do also get a lot of back/neck pain and right arm/wrist pain/aching. I have old fractures in my spine where I get the pain and an old fracture of my right wrist too (both from being launched from a horse).
So, when I had an xray a few years back the gp said there was a lot of wear and and tear in my neck. Im guessing I could easily have OA in my neck. Im wondering if my back and wrist are the same or something else. My current gp says that I will get flares of pain around the old fractures in my back but this time both back and wrist have flared together.
Ive just this past week noticed at first more pins and needles in my right hand and foot, then last night I had tingling but not pins and needles from my feet up my calves, my hands and lower arms and to a lesser extend my neck and side of face, Im guessing some nerve pressure somewhere.
Oh the joys, I know we are all individual but wonder if anyone has any similar things happen, its still all quite new actually knowing whats going on but Ive not pinned it all down yet and Im no stranger to pain. x
Julie

stickywicket

Hi there, Julie. As regards your last sentence - I agree You sound to have been through several mills but dealing with it all very stoically.

I have RA and OA, not PsA but there are many similarities and I've learned a lot from these forums. What I shall say is no substitute for telling your rheumatologist about all of it and I certainly would do that if it were me.

My guess is that the back pain is OA from the old injury. It happens. The neck and wrist pain could be too. It's common for OA to set in at the site(s) of old injuries. However, the neck and wrist at least could also be from the PsA. Tingling is usually (on these forums) caused by nerve impingement, usually from OA but some of us have managed to get OA as a result of our autoimmune arthritises not being dealt with quickly enough.

If it's OA then your GP will deal with it. If it's PsA, your rheumatologist. If your bloods are OK the rheumatologist will probably say it's OA but will, hopefully, send you for x-rays or scans to confirm it.

Just tell it as you've told us. I wish you the best possible outcome though I've no idea what that is :roll:

When is your next rheumatology appointment? If not fairly soon then I'd be inclined to ring my helpline or at least see my GP. Good luck and please let's know how you get on

bing

Thank you. I have a gp appointment next week and should be getting a rheumatology appointment for next month very soon, they have taken to phoning me lately which works quite well.

If you you have OA in various joints do they tend to flare at the same time as each other or do they flare individually has anyone noticed?

It would be great to just have sticky labels on each of my dodgy parts saying which problem each has lol!!

stickywicket

To be honest I don't regard my OA as flaring at all, not in the vicious, unpredictable, long-lasting way my RA does. If I've overdone things in a joint then the OA lets me know about it but doesn't usually affect other joints unless eg limping to favour one leg means extra pressure on the other.

(I like the sticky labels idea.)

dreamdaisy

Hello, I have PsA plus OA (the latter thanks to the joint damage caused by the former) but unlike you my PsA began in the wrong joints (namely my knees) so I went 'undiagnosed' for a few years until my skin helpfully obliged with a bout of pustular P on my palms and soles. It now affects my knees, toes and occasionally my fingers, whereas the OA affects my ankles, knees, hips, wrists, shoulders and neck.

Like Sticky I don't regard my OA as 'flaring' - to me the increase in pain means I've overdone things and need to rest. When my PsA has a bite I feel it: tired to the point of nausea, can sleep (badly) for England and still wake up shattered, completely lack energy, enthusiasm, verve, interest in anything and have no concentration. The OA does none of that, at least it knows how to behave.

I am on a triple therapy for the PsA plus pain relief and the occasional anti-inflammatory for the OA - what are you taking? DD

bing

Im currently taking 20mg of leflunomide per day and I think its helping with my feet and fingers. I have various other things that I use including diclofenac gel, cocodomol, paracetomol, ibuprofen(dont really do anything though) naproxen but I dont like how they make me feel. Then theres magnesium spray which helps and sometimes frankincense oil helps too and smells and feels nice!

So with Oa is the pain constant? Mine isnt quite like that, it comes and goes and has varying degrees of pain which feels more like a flare. Sometimes Ive noticed that a particular thing has set it off but at others there seems to be noting in particular. When I get the fatigue Im not quite sure it fully is combined with the pain being really bad.
J

stickywicket

bing wrote:

I have various other things that I use including diclofenac gel, cocodomol, paracetomol, ibuprofen(dont really do anything though) naproxen but I dont like how they make me feel. Then theres magnesium spray which helps and sometimes frankincense oil helps too and smells and feels nice!

PLEASE tell me you are using all these as prescribed by your GP because, if not, you are overdosing with potentially serious effects. Naproxen and ibuprofen are both anti-inflammatories which do the same job. It's an either / or. And the diclo gel is also an anti-inflamm. so more potential for overdosing. Check things out with your local pharmacist if you don't want to bother making a GP visit but don't just take both / all.

Cocodamol contains paracetamol so it's one or the other again. You can combine the (ie one of each at a time) but don't take more than 8 tablets in 24 hours.

As for OA pain, yes, I personally find it's constant when it comes though overdoing that particular joint will make it worse. But others may well have different experiences possibly depending on where it is. It's a minefield. And there are no rules :roll:

dreamdaisy

Too many cooks do spoil the broth, these are powerful meds that we take. We are in that unenviable position of taking the meds and not getting better (unlike those who have some pills for a few days and then recover). We may experience a slight reduction in symptoms or pain levels but it all comes roaring back, chastising us fro our temerity in challenging it.

My OA hurts all the time, I'm used to it now and would refuse being pain-free for an hour. Life became easier to manage once I had forgotten what pain-free felt like. If yours comes and goes then the coming may indicate that you have over-done things, whereas the fatigue may be connected to the PsA having a nip. I cannot remember if leflunomide is a daily or weekly med but it could be that it's not sufficiently cutting the mustard. It won't help the OA. DD

bing

Do not worry, Im quite aware of which meds I can use with which.
I should have been more specific in that I have a choice of them and plenty of days I choose none, infact it has to be really bad before I will resort to any and mostly I will choose the oil or magnesium spray to just take off the edge. All I have spoken to my GP about.

Leflunomide I take daily, 20mg which I beleive is the higher dose.
Thank you, theres some interesting things for me to think about and I will definitly be chatting with both my gp and the rheumatologist for their opinions too.

bing

A little update.
Im still waiting to for my hospital appointment but saw my GP last week and I double checked about my back. I have a fracture on T6, wedge (compression fracture) on T7 and OA on T8 and T9. So I feel better at least knowing for sure whats going on in there.
Julie