Arm pain worse at night

Hello, I’m 8 weeks into methotrexate, recently switching to injections. I have psoriatic arthritis & for the last four weeks both arms are painful when lifting a kettle, iron & much worse when I’m in bed. My sleep is quite disrupted at the moment as the pain wakes me. I take ibuprofen & paracetamol before bed but it isn’t helping. It feels more like muscle pain not joint. I use my TENS machine when I wake which really helps but can you suggest anything to help me sleep at night please?


  • jamieA
    jamieA Member Posts: 657

    Hi @DawnEcc

    I also have PsA. It's reckoned that about a third of PsA sufferers also contract enthesitis which I have also been diagnosed with. That's when the tendons and ligaments get inflammed at the point they attach to the bone. It affects me most in my forearms with my right being the worst. My right wrist swells and my right elbow feels like it's got tennis elbow. Overall it feels like I've overworked my arms. It also affects my feet and feels like plantar fasciitis with the heels and balls of my feet most affected. My rheumatologist said that these are classic signs of enthesitis.

    I'm on sulfasalazine, MTX and the biologic adalimumab. I also walk a lot and do my exercises. That keeps it at the achy or aching levels. When it gets worse I've got compression socks for my feet and tubigrip for my arms which I think helps. I think the standard medication is non steroidal anti inflammatory drugs like Naproxen and Etodolac which I was on initially but cannot take now due to heart medication.

    I can only suggest you get in contact with your rheumatology clinic to see if they can help and maybe get a referral to a pain management clinic if your local health authority has one.

    I hope you get some respite soon.

  • Hi @DawnEcc

    Thank you for posting on our Online Community, we are sorry to hear that you have been diagnosed with Psoriatic arthritis and that it is affecting your day-to-day life.

    You have mentioned that you have been taking methotrexate for 8 weeks but you are still in pain, depending on the individual person methotrexate can sometimes take 12 weeks before a person can start to notice a difference in their condition, but like @jamieA has said do contact your rheumatology clinic and speak to the consultant if you continue to struggle with the pain.

    You could try the heat and ice treatment which can help with pain and swelling, heat can be in a form of a hot water bottle, wheat pack warm shower or placing your hands in a bowl of warm water. Ice can help with pain and swelling also so that can be a bag of frozen vegetables wrapped in a damp tea-towel.  

    Getting on the right medication is so important so do please consult your healthcare professional if the pain continues then hopefully once you get help with the pain then hopefully you will get a better night's sleep.

    Best wishes


    Helpline Advisor

  • DawnEcc
    DawnEcc Member Posts: 8

    Thank you both for your advice. I’ve got Naproxen so I’ll try that tonight. I saw the rheumatology nurse last week & she said it can take 12 weeks to fully work so hopefully it will go.