I was wondering what others have experienced before their fingers appear bent or locked in place. I have been on MTX and Humira for about 9 months and I have found some relief from pain and fatigue but my PsA is still very active.
I have a few fingers that I can't fully bend and their range of motion is much less despite the continued treatment over the last year. Is this inability to bend digits and severe stiffness a phase or the beginning of deformities? A few of my PIP joints are enlarged all the time and all my fingers are swollen and puffy. I appreciate any feedback...I just don't know what to expect. Thanks
I would suggest you tell your Rheumatologist and ask for a PT referral. I am a nurse and have been very careful to maintain my ROM (range of motion) in all my joints but have discovered I have lost some range. I am seeing PT again to try and regain some. Some of my joints click for awhile with bending. I do rest them in splints and exercise them in the warm water with full ROM very gently. If they do not respond eventually they lock and have to be injected with cortisone and lidocaine to get them going again. I have also had them stiffen up usually in a curled position but have had them stiffen up 1 or 2 in a fully extended position. I use to wonder why people would report on here they could no longer make a fist. I had much more problem with them tightened into little fists and have to un-stiffen and uncurl them. I now have experienced both and the only difference is what position they are in when they stiffen up. But the stiffening up that I can un-stiffen myself is very different than when they lock up and have to be injected to loosen up. It mainly happens in my hands but has also happened in my elbows. I have not had my elbows injected yet. They have been clicking when extended for about a year. Now sometimes it is locked and I can not fully extend it. It will do this more and more frequently and will eventually need to be injected too. But it really doesn't feel like the stiffness that comes from over use and ends with rest, splints and gentle ROM. I hope this helps but do check with your doctor and PT is really important for us PsA patients.
Any continuing inflammation is when you are likely experiencing damage. Enlarged all of the time certainly fits th\is description. I have fingers that are mildly damaged, and click and lock, as well as twist somewhat, so they don't line up. Some are painful, some aren't. Keeping ROM is critical, and I second Michael. Get a referral to a hand therapist, and see your rheumy.
My local OT department have lovely hand specialists, they document your range of movement with an extensive list of measurements, then tailor the exercises to your particular needs at that time. They made me resting splints for my wrists which were moulded over my lumps and bumps for a comfortable fit. I’ve continued with the full range of exercises they gave me even when my hands have been good just to keep my hands in a good a condition as possible.
Often the tendons/ligaments of my fingers are tight stiff and sore and prevent me closing my hands effectively especially first thing in the morning and at the end of a work shift.
Thank you all for the responses. I will check about a hand therapist. Only concern is my rheumys response. I expect he will say “that happens” and leave it at that. He isn’t the most sensitive and odten I feel that any feedback is not welcome. I think its time to move to another doc. Thanks again…
Thanks for this discussion. I've been having off and on issues with my hands, and have started waking up with "claw hands" during the week before my infusion. I'll talk to my rheumy about it when I see him next. It's amazing how much of the specifics I tend to overlook looking at the big picture...that is, until a post like this reminds me that I need to take care of it! :)
Definitely see a hand specialist. You want to preserve as much ROM as you can, for as long as you can. My rheumy never refers me to PT, I say I need to go and he writes a referral. It's not his job to help me keep ROM, a PT does that.
If he won’t listen to something as simple as a request for PT, it is time to move on. You aren’t requesting a pile of narcotics!
HoneyBunny said:
Thank you all for the responses. I will check about a hand therapist. Only concern is my rheumys response. I expect he will say "that happens" and leave it at that. He isn't the most sensitive and odten I feel that any feedback is not welcome. I think its time to move to another doc. Thanks again...
I am new to all of this, but the stiffness and unbending fingers was how my dad said it started for him. Currently the first 2 fingers on each hand, and my right thumb are affected with swelling, stiffness, pain and lack of ability to bend / straighten depending on where they lock. I can also visably see the beginning of some deformity but according to the Rheumy there are no changed on my xray's. Grateful for small things here!! I recently started MTX, so I'll have to wait and see how it goes.