Hands and pain progression questions

I searched on hands, but most was pretty old.

I want to ask everyone.

My PsA seems to be doing more joint damage in the last year or two. I have one finger that has the OA bump growing in a knuckle. But my hands and fingers are really beginning to hurt. They stay swollen and stiff. At least half my finger joints now have sharp spiking pains on and off. Since I spend most of my day on a computer, my typing is becoming terrible. All my fingers don’t do what they should be doing.

Some nights I am up in the middle of the night running cold water over them because they won’t let me sleep. My hands and feet are so far away from the source that pain meds don’t do much for them. Pain meds don’t do much for me any way unless I get to a dosage level that thinking and driving are a problem.

Before it is suggested, I can’t take NSAIDS, MTX, or Tylenol. My heart doesn’t like NSAIDS, and after nearly 30 years of anti-depressants, my liver and kidney numbers are not what they should be. In desperation, I may take one Allevie once a week.

Heat doesn’t help them much. Sometimes I soak them in an ice bath. I have some compression gloves that help the swelling and some of the joint pain, but typing with them on is a real challenge. Any suggestions or how have you seen the PsA progress through your hands?

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Arm pain is the worse, nerve pain or the “running down your arm pain”. Have you asked for or tried nerve pain medications for neuropathy? I know you work using a computer but could you switch to a talk to text feature on your computer? To give your arms a break?

Yes. I already take Lyrica daily.

In my hands I am slowly getting more sharp pains in my knuckles. The swelling is constant now and adds to the stiffness.

Here are a couple of suggestions. Get yourself before an hand physio. He/she can make you made to measure hand splints to use at night which might help. Don’t buy any off the shelf. And might come up with other suggestions which might help too. It must be a proper hand only physio too.
Go on Amazon and invest in the old fashioned wax bath for hands. People rave about how good it is.

Are you talking about the wax heating machines?

Yes but for hand therapy and not making candles!

Just wondering @tamac, have you ever returned to cold therapy…it seemed to help if I remember right.

It did help the muscle pain, but the place near me went bust!

Without the medications you mention, the damage to your joints will continue. Have you considered Humira or one of the other biologics? Balance is key. Stopping that joint damage is important. More so even than the pain management that NSAIDs can provide. What good are liver and kidneys if you can’t move and are a prisoner in your body from joint damage.

He’s been on most of them @Faye

I didn’t see mention of that in the original post or comments.

I have already done Enbrel, Cosentyx, Humira, Taltz, and now Tremfya. The Tremfya being an every 8 week one really begins to become an issue around week 6.

I agree that I have a bad trade off. Liver and Kidney numbers are not real bad, just not 100%. The problem I have with NSAIDs is not just my liver. My heart doesn’t like them. If I take more than one Alleve every 2 or 3 days it will start PVCs. However, I am beginning to wonder if the NSAIDs cause the PVCs or if the terrible pain causes them. I am going to have to discuss this with my heart doc.

MTX is out because of the LFT and kidney numbers.

A Dos Pak or a shot of roids can help for a week or so. I am one of the lucky people that steroids make my low back hurt, bad. I tried daily steroids but the back pain was more than I could stand.

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