Hi,
I have PSA. Aside from a few fingers and toes, most of my constant pain is tendon, rib cage, sternum and neck(upper spine). Do biologics work for this type of pain and inflammation? I mainly hear about joint pain being treated with biologics. Even my rhuemy seems more interested with the joint stuff.
Hi there, I know what you mean, one of the rheumatologists I see is like that … Not too worried about tendon enthesitis issues. Like you I get a lot of pain in the sternum, ribcage, upper back etc and is often painful to breathe let alone move…and don’t get me started about if I sneeze or cough! The last doc I saw at my Nov appointment took it all on board and increased my MTX dose to max (25mg) and told me that regardless of joint inflammation or inflammation of tendon and ligaments the treatment is the same. I’m still going through the UK NHS system of medication escalation an will move on to a biologic in time, I hope!
I found it useful to keep a pain diary which let the doc see where, when and how much I was hurting and the restrictions to my life. Good luck and I hope you find relief soon
Short answer is yes, but then do you realize how many joints you just mentioned??? Its not that your doc isn't interested its just that its virtually impossible to find/feel inflammation in those joints. In the chest it requires a pretty sophisticated ultrasound (its becoming more common) and in the spine you need to have specific MRI sequences requested (STIR sequences). Some docs will also ask for MRI with contrast, though theoretically you should see the same stuff on a STIR sequence without the added risk of having contrast injections. The Chest particularly is a specific kind of inflammation called enthesitis - inflammation right at the point where tendons join bone. Enthesitis is fairly classic for spondyloarthritis and evidence of it can help clinch a diagnosis.
My doc has two or three favaorite spots to poke on me and can generally figure out whats going on.....
Both Enbrel and Remicade helped the arthritis in my chest and my spondylitis. I'd assume it could be different for different people, as some people react differently to drugs than others.
TNT thanks for the info on MRI. I will be mentioning STIR to my doctor.
tntlamb said:
Short answer is yes, but then do you realize how many joints you just mentioned??? Its not that your doc isn't interested its just that its virtually impossible to find/feel inflammation in those joints. In the chest it requires a pretty sophisticated ultrasound (its becoming more common) and in the spine you need to have specific MRI sequences requested (STIR sequences). Some docs will also ask for MRI with contrast, though theoretically you should see the same stuff on a STIR sequence without the added risk of having contrast injections. The Chest particularly is a specific kind of inflammation called enthesitis - inflammation right at the point where tendons join bone. Enthesitis is fairly classic for spondyloarthritis and evidence of it can help clinch a diagnosis.
My doc has two or three favaorite spots to poke on me and can generally figure out whats going on.....