I have another question. As some of you may know, my biggest problem are my SI joint, and my feet. There is definite inflammation in my left SI, which was visible in both my MRIs, my feet never got x-rayed etc but there is flattening in both of my feet (my arches are flattening) and heel pain, and some changes in my feet, like my right heel drifting outwards.
Anyway, those two areas, I'm sure of PsA. But, lately I've been getting this wrist pain along with the pain in my third knuckle, but it doesn't last very long, just comes and goes. And my wrist feels a little weak. So I was wondering, is this PsA? Does every joint pain mean inflammation? Or is it possible that this is both PsA and not inflamed, not yet at least? Because there currently is no swelling visible.
Hi LL. In my opinion, it is PsA-because you have PsA. If it's coming and going, that's good, because it sounds like it's not really full-out inflamed. I hate to tell you, but as my PsA was in its early stages (developing?) I got little temporary aches and pains all over--with no swelling. They were annoying, but so minor I never mentioned them to my doctor. They were in or around my knees, hips, pelvis, wrists, feet--you name it. And, I frequently had upset stomach, which was different from the usual upset stomach, if you know what I mean. I often wondered if it was possible to have psoriasis on my stomach lining! Looking back, I had lots of weird pain over the years I never mentioned to my doctor because, like yours, it wasn't very severe and it would come and go. Or, even if it was steady for long periods of time, it wasn't disabling--just annoying. I would wonder if it was fibromyalgia. Then, about 12 years ago, accompanying our now 23-year old daughter to an appointment with her pediatrician because she was being tested for having a lot of aches and pains (dx'd finally as growing pains) he mentioned that doctors generally think fibromyalgia is a farce and the dx of fibro just means the person is nuts and they don't have anything "real". The thought of having PsA NEVER entered my mind, so if I mentioned these pains to my doctor during my physicals, I would just casually say "oh just the normal aches and pains of getting older" if they asked me if anything hurt.
But, since you're already dx'd with PsA because you started out with some severe inflammation in your feet and SI joint, your aches and pains are most likely going to be chalked up as more PsA symptoms. You might as well mention those to your doctor. Over time, my little, temporary pains turned into tendonitis-especially my wrists. And, PsA seems to start a little in your fingers and pretty soon it's in all of them! For me, the swelling was so gradual that I didn't really see it--well, I could see it in my hands, but I know now my feet and ankles were swollen because since I've been on Enbrel they look so much skinnier.
Over time, I'm afraid, those pains will (or could) cause you much discomfort-at least if they're PsA pains starting up similarly to how a lot of my PsA started. That's why I'm on Enbrel now. Sorry. :-(
Yeah, I think it's PsA too - I just don't want it to be :) I will definitely tell my doctor every little thing when I see him soon. The last time I was so confused and shocked by the diagnosis, I just nodded my head and left the room... Now I know so much more and I know what to look out for.
You know what's weird? Everything that hurts is somewhere that I had already experienced discomfort or problems in my childhood. My first visit to an orthopedist was because my feet and ankles hurt terribly. I was 10 or 11. There was nothing wrong, and the doctor had told me it was either growing pains, or because I had strained myself too much as an athlete. I used to do every kind of sport when I was a child. But I was especially good in athletics. Then it went away. But I kept spraining my ankles over the years because I'm so clumsy. My second visit was because of my back pain. Of course it was because of my scoliosis, but what sent me to a rheumy was spine related too, an area I already had problems with- and my back pain is so much better since I began treatment. And now my wrist... when I was 10, a stupid little boy sprained my right wrist so bad, that my tendons almost ripped. I used a wrist supporter for a year - when I finally took it out, my right wrist was half the size of my left wrist! It was so scary. The doctor said it would never be a 100 percent again, and it took almost ten years to be completely pain free again.
What I'm trying to say is, I think PsA is choosing places that was already damaged to attack. Do you guys think there could be a connection here? This is something I plan on asking my rheumy...
LL, you may be right. I know psoriasis can show up where there's damaged skin, so I s'pose PsA can attack damaged joints. Lately, after my p.t. I hurt more than I should. I keep wondering if the strengthening equipment is actually causing my PsA to flare. I wish I knew because I'd discontinue the p.t. if it's just going to make matters worse!
Our youngest daughter had so many aches and pains as a kid. She also has an enlarged thyroid and it's quite obvious. Doctors have been watching it for years and they keep telling us her thyroid number is normal. Well, I think it's normal because her thyroid is overworking and that's why it's enlarged. If they'd put her on a thyroid med she'd probably feel better.
Our daughter (30) who's 3 months pregnant has woken up two mornings this past week with a swollen, painful ankle. It scares me because I'm worried she's got a start of PsA or RA. Seeing all the people in this support group whose children and/or siblings/parents also have the disease, I think it'll be awfully unusual if none of our kids get it--and, especially because psoriasis is also on my husband's side of the family!
Getting back to your wrist--it's probably not just a coincidence that it was injured when you were a kid and now you're having unexplained pain in it! Beware--PsA is so sneaky and can attack in many ways besides joint pain. Mine caused me extreme weakness, too. I'm sure that was due to all the tendonitis.
Grandma J, pt was definitely causing my SI more trouble. I think exercise is the only good way to go, at least it is in my situation. My p therapist gave me permission to do any kind of movement unless it is too sudden and doesn't cause me pain and discomfort.
I hope all your children will turn out ok. But at least you/they know the family connection. I'm not even sure about that! My mother's wrist has been hurting for over a month now, and I think there's some deformity there - her right wrist looks different than her left. And I remember her talking about wrist pain for some time now. And her lower back has been achy since I can remember! But never went to see a doctor about it. My grandmother's back is the shape of a question mark now - she is really old, of course, but does every old person have a question mark shaped back? And she has had aches and pains all her life too - never went to a doctor about them. I remember my great aunt having major surgery scars on her knees - and now her daughter has swelling knees. But I don't know what the problem is. My grandmother on my father's side talked about having rheumatism, but she's gone now and she talked about a lot of illnesses!
I had this conversation with my rheumy and here is what she said. Pain that comes and goes, while it hurts, is typically not problematic, in terms of damage. Pain and inflammation that stick around in a given joint is the stuff that can cause damage. You will not be able to see inflammation in all joints, some are more obvious than others.
My experience with weak joints has been that they become painful over time. I've done a lot of PT, and am a huge proponent of it. When my shoulders were painful all of the time because they were weak, I did a stretch of PT, and now keep on top of things by going to the gym and working on them. Much less painful now, because the muscles are helping to hold the joints in place better.
I'm suspecting that the pain in my wrist is mostly caused by muscles... Inflamed or not, I don't know. Because it made me think back and remember the pain I had fifteen years ago!!! It very much resembles the pain and weakness I used to have when my tendons almost got ripped there. But it's definitely a relief to know that the pain that comes and goes is not problematic. Although tonight it kinda stayed all night along with my ankle pain. I'm hoping for a pain free day tomorrow...
I am only a year diagnosed with PsA, but my experiences with the little, annoying, come and go pains have gone on to become more consistent over time. A joint in my finger would hurt, then stop, but now several of my right fingers hurt, along with a knuckle, and swell often. Sorry to sound depressing. And Stoney, your reply helped me understand the "damage side" much better. Thanks for sharing.
Years ago, aches and pains were called arthritis or rheumatism. My mom's mom had a lot of that and back then, aspirin was all she took. My dad had the question mark back. It was osteoporosis-his mom had it, too. My mother has lost 4" of height, but her back doesn't look like a question mark yet. I think the older people didn't go to the doctor for their aches and pains because the only treatment was aspirin, and they could get that OTC. My dad had "fungus" toenails and dry flaky skin, but he was never diagnosed with psoriasis or PsA. He also had celiac disease most of his life. Even though he ended up with the question mark back when he was about 70, he never had arthritis anywhere else and never had any other symptoms of PsA, such as tendonitis or fatigue. But, I've often wondered if that fungus-like stuff in his toenails and dry patches of skin were psoriasis never diagnosed. I'm headed for having a question mark back--we found out from my dexa scan in December. That's one reason why I need to work out on the exercise equipment with weights besides taking Calcium/Vit. D. I'm hoping I get used to it soon and the workouts don't cause me so much soreness. You guys are right-exercise is necessary to stay strong and loose!
I think some joint pain can be just from under or overuse even if you have PsA, but it can indicate issues that might spur off PsA in that joint, like spurs from osteoarthritis or injury to a joint. I'm pretty sure the pain that's stiff in the morning and works out with exercise is active inflammation, where pain after a workout or later in the day is other pain- not necessarily unrelated to or not caused by inflammation, but not active inflammation itself.
What Stoney said about pain that sticks around and about PT is very, very true. In regards to pain, it's also true that PsA (while definitely painful) does not necessarily cause pain with active inflammation. So you could have a very painful joint, and a normal-feeling but stiff joint, and the first could just be from repeatedly lifting things that are too heavy without realizing, and the other could be really inflamed and causing damage, both things are (in different ways) bad news for your joints- and both can be helped with PT. PT helps you build muscle, and correct mistakes in posture that lead to pain. It's all around a good thing. :)
Oh, Ladylazarus, you’re good. Really good. You said –
What I’m trying to say is, I think PsA is choosing places that was already damaged to attack. Do you guys think there could be a connection here? This is something I plan on asking my rheumy…
There is, in fact, a phenomenon called a Koebner effect which happens in both psoriasis and psoriatic arthritis. Here’s the article. Read it and really impress your rheumie! https://jrheum.com/subscribers/08/11/2085.html
Seenie, I love your shared wisdom always! For me I am their obvious study patient. My diagnosis came from trauma to my rib which over rotated for what seems like the millionth time. My worst foot pain is on the foot I had surgery on when I was 15 yrs old and my shoulder pain from a car accident. Once my inflammation levels went high my fingers joined in as I am an industrial mechanic/electrician ( millwright) need I say more. I did not need a study to tell me this but to just listen to what my body tells me. Knowing dictor get this is what studies are for. I notice a majority of my minor pains are from over use when I am already flaring even if minor somewhere else (high test levels prove this). I notice new pains everyday but only worry about the ones that last more than a week anymore. If you truly pay attention to your body such as even food cravings you may find that it alone tells you what you should eat. I solved my anemia probs by noticing my cravings even unhealthy ones included hi iron foods. Life is full of worries, questions and reactions our bodies feel the same things and minor aches are reactions the major pains are for worries. Don’t know if I am rambling too much but new brief pain will never stop happening but if you listen to yourself, weather its PSA or not, doesn’t matter much. Your body is telling you it wants your attention that’s the question part.
Thanks Rachael. I’m their obvious study patient too. Years ago, I had a bad fall on ice in which I cracked my tailbone. OWEEEEEEEE. While that was healing, I started getting sore shins and pain around my knees. I couldn’t understand why falling on my butt would make my shins shore. But it did. I shrugged it off, but after that, it was years of mystery symptoms, pain, joint damage and replacements. Twenty years and two knee replacements later, I was diagnosed with PsA.
When I went to the specialists’ specialist PsA research clinic, during the very long intake interview, the doctor asked whether I had ever had physical trauma before all of the aching started. I told her about the tail bone fall. She nodded. I asked. She said that my PsA might well have been set off by that. But she was quick to add that if it hadn’t been that incident, there would have been another.
Your advice about listening to your body is spot on, Rachael. Trouble is, sometimes you need a doctor to believe that too. And, unfortunately, it doesn’t always happen.
I get brief finger pains too but I tend to ignore them. I hope they only stay as little, annoying, come and go pains for the time being :) But I'm aware of the fact that, as you said, they will probably become more painful over time...
Needs answers said:
I am only a year diagnosed with PsA, but my experiences with the little, annoying, come and go pains have gone on to become more consistent over time. A joint in my finger would hurt, then stop, but now several of my right fingers hurt, along with a knuckle, and swell often. Sorry to sound depressing. And Stoney, your reply helped me understand the "damage side" much better. Thanks for sharing.
I'm much better today Grandma J, thank you very much... I think this bad weather is causing all this discomfort. I can't wait for the spring!!!
And take care of your back Grandma J, keep up the exercise! At least we know now, unlike the ones before us, what we can do to avoid more damage :)
Grandma J said:
Years ago, aches and pains were called arthritis or rheumatism. My mom's mom had a lot of that and back then, aspirin was all she took. My dad had the question mark back. It was osteoporosis-his mom had it, too. My mother has lost 4" of height, but her back doesn't look like a question mark yet. I think the older people didn't go to the doctor for their aches and pains because the only treatment was aspirin, and they could get that OTC. My dad had "fungus" toenails and dry flaky skin, but he was never diagnosed with psoriasis or PsA. He also had celiac disease most of his life. Even though he ended up with the question mark back when he was about 70, he never had arthritis anywhere else and never had any other symptoms of PsA, such as tendonitis or fatigue. But, I've often wondered if that fungus-like stuff in his toenails and dry patches of skin were psoriasis never diagnosed. I'm headed for having a question mark back--we found out from my dexa scan in December. That's one reason why I need to work out on the exercise equipment with weights besides taking Calcium/Vit. D. I'm hoping I get used to it soon and the workouts don't cause me so much soreness. You guys are right-exercise is necessary to stay strong and loose!
Rosen your differentiation between achy joints and active inflammation was very helpful. Thank you very much!
rosen said:
I think some joint pain can be just from under or overuse even if you have PsA, but it can indicate issues that might spur off PsA in that joint, like spurs from osteoarthritis or injury to a joint. I'm pretty sure the pain that's stiff in the morning and works out with exercise is active inflammation, where pain after a workout or later in the day is other pain- not necessarily unrelated to or not caused by inflammation, but not active inflammation itself.
What Stoney said about pain that sticks around and about PT is very, very true. In regards to pain, it's also true that PsA (while definitely painful) does not necessarily cause pain with active inflammation. So you could have a very painful joint, and a normal-feeling but stiff joint, and the first could just be from repeatedly lifting things that are too heavy without realizing, and the other could be really inflamed and causing damage, both things are (in different ways) bad news for your joints- and both can be helped with PT. PT helps you build muscle, and correct mistakes in posture that lead to pain. It's all around a good thing. :)
I'm like ancient philosophers Seenie, I look at myself and I look at the world and I make the connection, only I don't have to try so hard because actual doctors have thought about what I'm thinking about and made relevant research :D
Just joking of course, but I will talk to my rheumy about it. Because there was degeneration visible on my spine too, but my PT thinks its because of the scoliosis, and not arthritis. So you see, if she is right, for me, degeneration came before the arthritis. It's like that question, which came first, the egg or the chicken? :)
Seenie said:
Oh, Ladylazarus, you're good. Really good. You said -- === What I'm trying to say is, I think PsA is choosing places that was already damaged to attack. Do you guys think there could be a connection here? This is something I plan on asking my rheumy... === There is, in fact, a phenomenon called a Koebner effect which happens in both psoriasis and psoriatic arthritis. Here's the article. Read it and really impress your rheumie! https://jrheum.com/subscribers/08/11/2085.html
Rachael, you are so very right about listening to your body too much... I'm aware of the fact that I might be doing just that. I have all sorts of chronic conditions, and over the years I have learned to ignore them (a little too much maybe, because now I don't speak up or go to a doctor until it's gotten out of control for the most part). The problem for me is, my diagnosis is still very new, and this is a scary disease. I still feel very much in the dark. I don't know when I have active inflammation, I don't know if what I'm feeling means there is damage being done to my joint, I don't know how to get rid of the fatigue, and the scariest of them all, I don't know how fast it will progress... I don't know if this pain that's been coming and going for a month means it's progressing and I should watch out, or if it's just some normal joint pain because of overusing etc... So I ask these questions, and the answers make me feel more confident about where I'm standing... Help me see what lies ahead. For example, you saying that you ignore the pain that lasts less than a week is very valuable information for me :)
And about the rotated rib - ouch! I can't imagine what it must be like...
Rachael said:
Seenie, I love your shared wisdom always! For me I am their obvious study patient. My diagnosis came from trauma to my rib which over rotated for what seems like the millionth time. My worst foot pain is on the foot I had surgery on when I was 15 yrs old and my shoulder pain from a car accident. Once my inflammation levels went high my fingers joined in as I am an industrial mechanic/electrician ( millwright) need I say more. I did not need a study to tell me this but to just listen to what my body tells me. Knowing dictor get this is what studies are for. I notice a majority of my minor pains are from over use when I am already flaring even if minor somewhere else (high test levels prove this). I notice new pains everyday but only worry about the ones that last more than a week anymore. If you truly pay attention to your body such as even food cravings you may find that it alone tells you what you should eat. I solved my anemia probs by noticing my cravings even unhealthy ones included hi iron foods. Life is full of worries, questions and reactions our bodies feel the same things and minor aches are reactions the major pains are for worries. Don't know if I am rambling too much but new brief pain will never stop happening but if you listen to yourself, weather its PSA or not, doesn't matter much. Your body is telling you it wants your attention that's the question part.
I know I haven't been on the forum for a while... But I had another health mystery solved today, and wanted to share! I had initially logged in to see for how long I had been complaining about my wrist and it seems like I have had this problem for more than 7 months now! Unbelievable! As some of you might remember I had been complaining about the pain in my wrist, some hand pain, feeling of weakness in my hand, trouble holding stuff etc. And as I can see now in the discussion here that I had linked those things to a prior (childhood) injury. Well, the wrist pain persisted throughout the summer, and I had been experiencing serious tremors in my hand (both hands actually but whereas the tremor in the left hand was bearable and could be experienced by anyone really, the tremor in my right hand had gotten to a point that distracts me all the time and keeps me from working, eating, holding and folding stuff etc.). Anyway, my mom finally got scared enough and took me to an orthopedist (in case it was carpal tunnel or something), x-rays of my wrist was taken, and as it turns out, there IS something visible on the x-rays. A thick white line that runs through my wrist. Now the doctor's guess is, the childhood injury left some kind of "mark" or a "scar" on my wrist (a stupid boy had twisted my hand and arm really hard, almost ruptured my tendons and I had to wear a wrist brace for a whole year), and throughout the years, everytime I put too much pressure on that wrist or slightly injured it again opening jars or doors etc, there was an inflammatory process that further deepened the mark. The doctor described it "as a callus on the bone". And he told me that if I'm not careful with my wrist, calcification will begin and I'll have osteoarthritis on that wrist soon! He wrapped my wrist with those special bandages used by sports doctors etc, and gave me a pain killer. He said the tremor could or could not be related and it was probably an organic problem (don't know if that's the right translation - he meant that it was a tremor with no cause, that could be experienced by anyone without any specific reason), but to see a neurologist if it persists. But, after he wrapped my wrist tightly, the tremor stopped as well - and I had been wrapping my wrist too to help with the pain and weakness, so I was on the right track I guess. I'm thinking, the tremor was probably the result of months of moderate but consistent pain and discomfort. My wrist couldn't take it anymore. Don't you find it interesting that sometimes the bearable but "nagging" pain causes so much more discomfort than the "big pain"?
Anyways, I want to say shame on my rheumy for sending me on my way twice saying that "it's just fibro" instead of taking me seriously and taking a freaking x-ray! I know, it's not a rheumatological problem yet, but still, he made me feel like it was nothing, so I just let it drag on for months!
So that's my update :) Though it might be off the topic of the forum, I still wanted to give an update after I complained for months and months! I hope everyone's as well as they can be in these warm summer days - though I think I'm slowly beginning to feel the seasonal change! Oh dear, it's not even September yet! :(
Goodness, LL, not off topic at all! We talk all the time about cues that doctors miss! Yes, and the sad part is, that when they don’t know what it is, or they can’t be bothered to look a bit deeper, they call it fibro! I know there is such a thing, very real, and it causes people a lot of miseryy, but it can also be a diagnosis of convenience … get the lady out of here!