Little knuckles:big pain

So today I thought I'd write about a big "huh?" I'm having. Stay with me as I think this through. The prednisone takes away most of the swelling. The MTX still hasn't fully kicked in (week 6 today). I'm experiencing pain in my joints. I get how PSA is an inflammatory disease. But what the HELL makes it hurt so bad?

I look at my fingers and toes and I can see the redness and the weird shapes they take when they hurt but my X-rays and MRI's are "normal". I can feel the pain in my joints and the referred pain in muscles but my inflammatory markers are "normal".

Can someone tell me how these tiny little joints on my fingers and toes can cause so much pain. And while you're at it, would you care to explain the process behind this? Is the swelling pinching a nerve? Is the swelling on the nerve itself? And if all my tests are "normal" is there any swelling at all?

See, this is the part that makes me think I'm going slowly bonkers!!

Have a good weekend PSA Warriors. I'm off to give myself a shot in the belly.

Jane

In Psa the tests tend to be normal unlike other inflammatory auto immune diseases. The pain is so intense because the joints are so little. In larger joints there is more room for the swelling to take up. In little joints there is just no extra room. There is some information on the net, I like both Mayo Clinic and Web MD. Louise on this site suggested Psoriatic Arthritis: the facts by Dafna Gladman and Vinod Chandran which I purchased on Amazon and really like it. Good luck with your joints.

@Michael and Jane - My bloodwork comes out completely normal, and I have never even had an elevated SED rate. For me, there is no connection between the two, and I am still thankful that my rheumatologist diagnosed me so quickly, with completely normal blood work.

I know the small joints vs. big joints issue. One ankle and one knee have been swollen forever, with very little pain most of the time. That said, I'm realizing that at some point I'll likely need to have imaging done on my knee. . . It now clicks, so I'm wondering if there is something going on there now.

@Michael- I got that book on my kindle, and now just need to get around to reading it.

Jane, I found that I did a lot of reading when I was first diagnosed, and still do a lot of reading 5 years later. And I still find that I am learning new things. I knew, for example, that tendons could become inflamed as part of the disease, but didn't realize just how pervasive (or how painful) it could be. My eyes are an ongoing problem as well, due to inflammation. And I get the feeling that a lot of the obnoxious neurological stuff that I get now is due to inflammation as well. None of it is much fun, but a lot of it can be managed. The goal is to prevent joint damage, and we need to make certain that we take good care of ourselves and advocate for ourselves. This forum is wonderful for learning and sharing.

@Stoney, @Michael,
thanks for responding. I'm like Michael--everything's "normal". Those little joints, though, WOW! I'm very open to being a scholar of PSA--it seems like most who have been diagnosed take that path, My rheumatologist is great and very responsive and I intend to ask more questions in two weeks. I think I've not understood which questions to ask yet. Cheers to you both.