This might be obtuse, but just wondering if anyone has info. On this subject. It would seem normal weight bearing could help this demon on its way. Any thoughts???
I don’t have an answer but this is a good question that has been in the back of my mind
They say use it or loose it and this definitely applies to your joints and erosion's. Exercise is a key in living with the daily pitfalls of this disease. It also helps you relax and that is key in staying mobile. Get yourself a good topical anti inflammatory like aspercreme and rub and go as much as you can:)
I wondered the same thing, Angela. I have a lot of inflammation in my feet, and walking can be very painful. Enbrel hasn’t yet done its magic on them. I asked the rheumatologist whether standing and walking while my feet are sore would cause further damage to them. He said not.
I can’t say that I understand how it wouldn’t, but now I don’t worry so much when I have to be on my painful feet.
Seenie, that is good to know. I too have been wondering.
It’s not going to make it go away. It may
relieve stiffness, but it really depends on severity. There are definitely times where joint protection is appropriate. This is definitely something to discuss with your doctor.
There are people here at all levels of physical activity. I’m typically fairly active but there are times where I need to modify activities due to pain/stiffness.
I think there is a sweet spot in our mix of exercise and rest. The problem is that it may be a moving target. When my joints are very inflamed or I am having a flair my Rheumy says to take it easy as they are more vulnerable to injury. But a certain amount of activity really helps maintain ROM and strength. Our muscles need to be exercised to be strong to support our joints. But if we overdo we end up with tendon and ligament pain and swelling. I work with PT every couple of years to figure out exercise that works for me. I then carry out a plan of exercise throughout the week but it can be derailed by flares and/or fatigue. I figure if I maintain it most days of the week that is pretty good!
I agree Michael, there is definately a moving target as far as what is a right balance any given day. My OT has always said keep as mobile and active as possible but if it hurts stop…but I can understand that as far as exercise goes but what about everyday stuff…It hurts to get dressed so do I go naked? I just try to find ways to get minimise everyday pain. I think it may depend also on what exactly is causing pain, is it already damaged bone? Is it enthesitis? Because none of us always know what is causing the pain how can we tell if we are making it worse other than to listen to our bodies when they say “that’s enough!”
In terms of damage, everything I’ve read says it makes no difference, and my Rhuemy backs that up. That’s a bit counterintuitive to me, because I actually get quite an obvious inflammation response for about half a day after I’ve been to the gym, so if inflammation is the damage mechanism… But then I don’t think anyone is precisely sure of the damage mechanism. Besides, do you just mean bones? That’s a metabolic disorder - what about all the soft tissue damage?
I think in practice that what micheal said hits the nail on the head - there is a sweet spot between rest and exercise, but its a moving target. In my case , before I got effective medication, it could move from a 1 block walk being too much, to a 5 k walk being too much, in the space of a week.
Now I have better control, it doesn’t move so far- but the types of exercise are certainly relevant and I find that no matter what I do or how good I am feeling, prolong walking or jogging no longer works for me. The Mayo clinic recommends that if it doesn’t cause unusual pain for more than 24 hours, a weights or exercise program should be fine - and that’s about what I follow.
Thank you to all for sharing your experiences, opinions and knowledge. I am very active and when I have little to no pain and swelling I exercise at least 3x’s p/week. I was always told much of the same advice from my rheumatologist, too. Then, a couple of years ago I was having a flare up and was wrestling with the idea of starting Enbrel, again. My rheumatologist told me of a fellow pt he had been following for 10+ years with the dx of psoriatic arthritis. She was a nurse (as I am) and was not very compliant with her MTX. She usually only had complaints of pain and swelling in her hands and wrists. He decided to do X-rays of her hands and feet and said the results were surprising. She had no joint destruction/erosion in her hands, but had total joint destruction to the point of loss of bone in one small area of her foot. He said it looked like someone took an eraser to her film. She obviously went on aggressive therapy. I guess this just brings the other question to my mind that when we think we are in medical remission, or have no pain…is the disease smoldering under radar? I know this is a grim discussion, but I guess I am dealing with the ? Of going on long term biologic therapy verses stopping the meds after feeling better (a year or so which has been my hx with Enbrel). Maybe I’m thinking too much.
Your nurse friend is typical. Pain and inflammation is one of many RESULTS of this disease. It is not the disease let alone the biggest part. If ones concern is only pain and cntrolling it, they will assuredly have more pain than they can ever imagine. AND they will be disabled as a result.There are only two things that will control this disease aggressive medication and physical activity. PsA is frequently considered the mildest of the three main Arthris groups, not because its the mildest results (its not 20% of the time) but rather because suffers have the most control of outcome of the three.
Anyone whi says physical actvity won't hurt has never been successful at anything physical (sports running etc) Thats not to be confused with pain that damages.
Thank you so much for your input. I Have come to the resolution that aggressive medication is the answer and that I cannot run from the medications and their side effects anymore. I am acutely anxious due to waiting all weekend for the results of hands, feet, knee and sacroiliac film results. I have only been keeping the disease at bay with Mobic for three years since a 10 month successful round with Enbrel. Pain and fear IS the precursor for change. Whoda thunk it??
Did you have side effects during the 10 months on the Enbrel, Angela? Or is it the potential for negative effects that concerns you?
Thanks for asking. It is the potential for negative results like TB, lymphoma and other cancers. My father’s side had every kind of cancer you can name. My father also died of a malignancy. (My husband is a Pulmonologist and sees patients frequently that have TB and have not been diagnosed…yippee!)
I am 40 and have 3 children. The youngest is 6. I just want to be around, but I think this is where faith digs in it’s heels.
My experiences with Enbrel we’re AMAZING! I felt like I could fly by the second injection. I too, thought it was my imagination, but it really helped almost every joint. My Achilles’ tendon was still a little sore, but that had been going on for months before initiation of the drug. I only stopped after 10 months because I caught a nasty viral bronchitis and had fevers for 12 days. I was getting married in four months and felt great rheumatologically. I took a chance and had a remission of almost 6 years.
After my labs and X-ray results come back tomorrow, I am sure I will choose the Enbrel journey. Also, for those of you who are interested, I had the typical skin rash, itching and burning at the injection site the first time on Enbrel. However, the second time I only experienced mild redness which resolved in a day or so.
Peoples’ experiences with this disease and its treatment are so varied and so interesting. Yes, I can see where you are coming from, Angela: you’re now looking really closely at the risks vs benefits. We’ve all done that. In my case, I was making the decision at 61: benefits greatly outweighed the risks for me. And I’m sad (well, if the truth be told, I’m angry) that I was not offered the aggressive treatment much earlier. I have terrible damage, and a lot of it happened during my twelve months under the care of a very conservative rheumatologist. During that time, I must add, the good folks on this site were saying that I needed a biologic asap. I chose to go with what my rheumatologist prescribed. 
Sybil, the relationship between OA and PsA isn’t clear. I don’t think that rheumie really knows either! There is, though, something called Koebner Effect for Psoriasis (skin injury provokes an outbreak of psoriasis) and they are now thinking that there might be a similar effect in the joints. I’ve seen it referred to as “Deep Koebner”. Whatever … it’s a chicken and egg question, isn’t it. My knees and hips were supposedly OA too, and they went to hell really quickly. By the time my hip was replaced, we had proof that the damage was inflammatory (PsA). Since then, I have it on good authority that all my damage was PsA. It doesn’t really matter, I guess. You’ve got PsA and joints can get damaged pdq unless you get aggressive treatment. And yes, that treatment also has downsides. Once you’ve got the disease, it becomes benefits vs risks.
Yes, I hear what you are saying regarding looking back AFTER the damage is already done. I have grinding in both knees so bad that people look over in exercise classes at the gym to see WHO and WHAT is making that horrible sound. You can only cough so much to cover up the sound without disturbing class and getting out of breath LOL!!! I have been putting off the orthopedic visit. My shoulders are now starting the same clicks, pops and grinding.
Risks vs benefits…quality of life rings a bell.
P…S… I used to practice Oncology nursing. That, I’m sure, has made an impact on some of my past decision making.
There is a disease out there called Inflammatory Osteo arthritis. Its way over looked and I suspect a cousin of PsA. It needs much more attention than its getting.
My rheumy also said I had OA settle in a knee joint that had recurrent inflammation needing aspiration after a couple of PSA flares. Imaging confirmed. I am going to do look up koebner effect. Thx.