How long for Methotrexate to start to work?

After 3 months on sulfasalazine doing nothing, my Rheumatologist finally took me off the stuff and had me try MTX, 8 tablets (20 mg) weekly. I have done so for 4 weeks now, and I have to say I have been getting progressively worse during this time. My hands are the most swollen "sausage fingers" that I have ever had, and so painful that I can barely do anything anymore. Typing is so painful (used to be good at it, now it is hunt and peck method!), I am dropping things because I can't grasp them fully! ( I posted new hand pictures on my page if you want to see the ugly things).

My question in, how long does it take MTX to start to work? Should I be getting this much worse on it??? I can see it not helping, but getting worse??? ARRRGGHH! The spinal pain and achilles ankle pain is worse too! I swear, there are days when I want to cut off my fingers just to get some relief! Can I expect some relief soon (or at all???)




I understand it takes 3 months to feel the full affect of all these drugs. I took it for 4 months, did not help me, but it still may help you! I just wrote you a book in response to your e-mail, check your in box.



Oh, Dani, I'm sorry you're not feeling any relief yet. I understand, though, that it can take 2 - 3 months to take hold. So keep your fingers crossed ... ouch ... poor you. If you think you're getting worse, the mtx isn't working. Yet. But why don't you give your rheumatologist a call and ask?

Take care, stay strong, hope for better days ahead.


Hey Dani, you and I seem to be going along the same path. I've been on MTX for 6 weeks and am doing ok, however I just did my visit to the Rheumy who is happy with the progress and stated that I won't see the full effect until 3-6 months.

Dani call your rheum !!! get secretary Rachett to get you in. I'll call you tommorrow :) I wish you had my nurses to call for advice. I wonder if you could call the rheum dept at our hospital and talk to one the the nurses? It may help you out and or give you some advice on how to or what to say the rheum. oh an what about contrast baths. Stick your hands in hot water for a minute then into cold water for a minute. Do this for 4 or 5 minutes ending with cold. My massage therapist swears by this for helping with pain . She does this to me with my back, heats me up then ices me ( with ice brrrrrr) it helps with my back spasm from hell if you cn believe it.The cold actually works better.

Keeping my fingers crossed that MTX will start working soon. 4 weeks is early and unusual as it can take up to 3 months.. .

you could ask for a short course of prednisone it would definitly work or a steriod shot That would carry you over this bad part. The bad part is when it wears off you may be in pain again (or not) if the MTX has not started it's magic.

chat ya tomorrow