Question for folks: My meds (Stelara) seemingly have both my severe psoriasis and my PsA almost completely under control ... except for one thing ... Does anyone else notice problems with your tendons even if the PsA is medically controlled? I am naturally an athlete (Crossfit is my thing now) and also an avid and passionate volunteer trail builder here on the North Olympic Peninsula - yet no matter what I do nor how kind I am to my body nor how much I warm up, stretch, don't overdo it ... I *always* acquire new tendon injuries. And they *never* seem to heal. Each one gets added to the list of chronic tendon problems in my body. So each one takes me further and further away from my passions. I've struggled for 10 years with my lower body being hampered from multiple tendon problems (the latest and most aggravated being the achilles tendon) and now the tendon near my elbow is hurt. So I'm out of commission ... again and for an indetermined length of time. It is beyond frustrating. So my question: Is it possible, even though the meds have me under control, my tendons are still always affected by this disease?? Any advice would be greatly appreciated (ps - I'm new to this site and trying to get a proile pic uploaded so you know who you're talking to, but it seems to be hanging up. Hopefully I'll resolve that soon).
I am still in the process of getting a diagnosis, so you can take my response for what it is worth. I have psoriasis and multiple tendonitis points (elbow, trigger finger, knee, lower back pain and tenderness on the back of my heel). I have been very prone to tendonitis and heel spurs. My psoriasis has been smoldering for 15 years and just before Christmas it all began to flare. I have found that when I am out in the cold - even just a chill - I begin to hurt in more places. For instance, I had the trigger finger and the tennis elbow. We went to look at a piece of property a couple of weeks ago, walking the land. It was cold and windy. By the time I got home I hurt all over, especially my knee. Ever since then I have had tendonitis in my knee. Perhaps it is coincidental, but cold always seems to shut me down.
Yep - seems even when the joint pain is 99% gone (steroids), I still frequently get a lot of tenderness in my tendons. I’ve only recently got PsA, and only in the last few weeks had most of the joint pain gone, so I haven’t damaged them (that I know of). It seems probable to me that it is related to the PsA. Unfortunately I don’t have much knowledge of how to get it under control. Have you tried low-dose steroids in addition to a dmard?
Hi Reid, That is very affirming to me ... that I'm not making this connection out of nowhere. And I read so much about the heel tendon being a problem. I don't even have an "official" diagnosis ... it's just plainly obvious that's what I have and the Stelara I take for my psoriasis is currently also working for the PsA ... except for this. You're making me think maybe I should try hot baths. I typically don't like those, but I do live in a damp, chilly climate so you've got me wondering if heat will help. Thanks!
Reid said:
I am still in the process of getting a diagnosis, so you can take my response for what it is worth. I have psoriasis and multiple tendonitis points (elbow, trigger finger, knee, lower back pain and tenderness on the back of my heel). I have been very prone to tendonitis and heel spurs. My psoriasis has been smoldering for 15 years and just before Christmas it all began to flare. I have found that when I am out in the cold - even just a chill - I begin to hurt in more places. For instance, I had the trigger finger and the tennis elbow. We went to look at a piece of property a couple of weeks ago, walking the land. It was cold and windy. By the time I got home I hurt all over, especially my knee. Ever since then I have had tendonitis in my knee. Perhaps it is coincidental, but cold always seems to shut me down.
Hi JenAus,
I haven't tried that but shall ask about it. What is a dmard? Thanks!
JenAus said:
Yep - seems even when the joint pain is 99% gone (steroids), I still frequently get a lot of tenderness in my tendons. I've only recently got PsA, and only in the last few weeks had most of the joint pain gone, so I haven't damaged them (that I know of). It seems probable to me that it is related to the PsA. Unfortunately I don't have much knowledge of how to get it under control. Have you tried low-dose steroids in addition to a dmard?
Hi Rebecca, Stelara is an example of a DMARD (disease modifying anti-rheumatic drug)
Rebecca said:
Hi JenAus,
I haven’t tried that but shall ask about it. What is a dmard? Thanks!
JenAus said:Yep - seems even when the joint pain is 99% gone (steroids), I still frequently get a lot of tenderness in my tendons. I’ve only recently got PsA, and only in the last few weeks had most of the joint pain gone, so I haven’t damaged them (that I know of). It seems probable to me that it is related to the PsA. Unfortunately I don’t have much knowledge of how to get it under control. Have you tried low-dose steroids in addition to a dmard?
Oh! Okay. I'm not so familiar with the terminology. Thank you!
JenAus said:
Hi Rebecca, Stelara is an example of a DMARD (disease modifying anti-rheumatic drug)
Rebecca said:Hi JenAus,
I haven't tried that but shall ask about it. What is a dmard? Thanks!
JenAus said:Yep - seems even when the joint pain is 99% gone (steroids), I still frequently get a lot of tenderness in my tendons. I've only recently got PsA, and only in the last few weeks had most of the joint pain gone, so I haven't damaged them (that I know of). It seems probable to me that it is related to the PsA. Unfortunately I don't have much knowledge of how to get it under control. Have you tried low-dose steroids in addition to a dmard?
Hi Trees,
Okay, you have this same problem ... more and more affirmations for me. Doesn't make it any easier to deal with, only that I'm not going crazy. So many people think that it's cuz I push too hard with my athletics. That was true when I was younger - I ran too much. But in my mid-40's and tired of tendonitis, I actually take things slowly and carefully and do everything possible to avoid injury. Still, the tendons always injure. You are the second person to mention heat. Does that speed healing or just make you feel better for a while? BTW, you are right in that Stelara is a biologic - it's an immune suppressant. I did know that - I figured maybe dmard was another term for it?? I guess not. Thank you so much for responding.
trees said:
I have chronic tendon problems too. It makes everything a challenge with PsA .Tendonitis is related to PsA and it is usually enthisitis which is inflamation at the insertion point . I find that infra red saunas are helpful I love the heat. Don't know what to tell you except my rheum says to rest rest rest and never overdo it. PsA definitely changes our lives.
i thought Stelara was a"biologic response modifier"? I 've gotta look this up. I hope things get better soon ;)
Hi Trees and Rebecca,
You are right about Stelara, I just skipped the detail - because it works in a very similar way to the biological DMARDS, I just put it in that category. I guess the essence was more that you are already on a bDMARD style of treatment (even though it may not be formally approved for that purpose), so you may need to try something else.
Hi JenAus,
Yeah, I wonder about that too. Except the Stelara has been remarkably effective with both my severe psoriasis AND the acute joint pain of the PsA. I guess I'll have to explore if there is something out there that can ... in addition ... stop these tendons from being chronically injured. Bummer we all have to deal with this ... :-(
JenAus said:
Hi Trees and Rebecca,
You are right about Stelara, I just skipped the detail - because it works in a very similar way to the biological DMARDS, I just put it in that category. I guess the essence was more that you are already on a bDMARD style of treatment (even though it may not be formally approved for that purpose), so you may need to try something else.
Trees, I understand the meltdown. I am trying to find a rheumy that specializes in PsA in my area that takes my insurance. I have an appt. with a rheumy - don't know if they know beans about PsA - but that isn't until June 14. There's another doctor I might be able to see about a month sooner, but he is the jerk of the century. My family physician, who doesn't think tendonitis exists with PsA wants to start me on prednisone to reduce the inflammation, but the last time I did that with an autoimmune disease, it took the rheumatologist a year (at Hopkins) to diagnose the exact disease because prednisone masked the symptoms. Meanwhile my in-laws formally moved in with us this past weekend and I don't want to complain to them, they need help unpacking, but I hurt so bad I want to cry.
Hi Reid and Trees,
I'm totally with your frustration and urge you to STAY AWAY from doctors who don't listen and/or don't understand PsA. Your family doc says tendinitis doesn't exist with PsA? Has he or she done a simple google search that any of us without a medical degree can do? Ever heard of listening to the patient? It's all over everywhere you look about PsA. That's how I started putting two and two together. Yes, I'm "living the life" on Stelara too ... man it's the good stuff. Beautifully clear skin (I have psoriasis head to toe normally), no acute joint pain ... now. I live in fear the Stelara will quit working for me just like Humira did and so did Enbrel. Humira and Enbrel each lasted 6 months. Stelara has been taking care of me for a year and a half so far. However, I'm wondering now if it's starting to lose its effectiveness - there are signs that it is. But, even on Stelara at its best, the tendons are a continual source of injury, pain and frustration. Reid, you shouldn't have to suffer. Please tell your in-laws. Gie them printed information so they can read up on your condition, maybe? It's bad enough we have to deal with this, never mind trying to be the perfect daughter-in-law. Big hug for both of you. Trees, please tell us how your appointment goes on Thursday.
Reid said:
Trees, I understand the meltdown. I am trying to find a rheumy that specializes in PsA in my area that takes my insurance. I have an appt. with a rheumy - don't know if they know beans about PsA - but that isn't until June 14. There's another doctor I might be able to see about a month sooner, but he is the jerk of the century. My family physician, who doesn't think tendonitis exists with PsA wants to start me on prednisone to reduce the inflammation, but the last time I did that with an autoimmune disease, it took the rheumatologist a year (at Hopkins) to diagnose the exact disease because prednisone masked the symptoms. Meanwhile my in-laws formally moved in with us this past weekend and I don't want to complain to them, they need help unpacking, but I hurt so bad I want to cry.
More tendon issues: I have a question. Since developing tennis elbow (outside elbow) in my right arm, I have developed a painful bicep and tendon on the top of my forearm. I am favoring my other arm because the elbow hurts so much and have not abused or overused my right arm. I cannot find a reason for the bicep and forearm pain. Has anyone else experienced this type of pain. Just trying to figure out how to make it better. This is a constant pain that does not seem to wane at all.
Yep, I've got the same forearm pain. In fact, it was exactly that which made me start this discussion in the first place. Just another in the long line of tendon problems. Frustrating! Does yours travel down to your wrist at times too? I suspect, with our tendency toward tendon problems, that you may have stressed it helping your in-laws unpack?? I haven't yet figured out what to do to make it better. :-(
Reid said:
More tendon issues: I have a question. Since developing tennis elbow (outside elbow) in my right arm, I have developed a painful bicep and tendon on the top of my forearm. I am favoring my other arm because the elbow hurts so much and have not abused or overused my right arm. I cannot find a reason for the bicep and forearm pain. Has anyone else experienced this type of pain. Just trying to figure out how to make it better. This is a constant pain that does not seem to wane at all.