Hi folks, I’m a 24 year old make and have been diagnosed with PA since 2011 were I was put on methotrexate 10mg per week. However since last year and after several flare ups my go has gradually got me up to 20mg per week. I am still very stiff in morning and it seems as thought it’s spreading to hip,shoulders and back. But I don’t get a lot of swelling with this just a lot of stiffness and pain. I am due to see rheumy on 27th of January and I am just asking if anyone could tell me what the rheumy is most likely to do as not having active swelling they seem to think your alright. Has anyone any info on what’s most poss outcome ? Thanks
Morning stiffness is a keystone symptom. Help out your Doc and keep track of how long it lasts. You only will have a couple weeks of data but it will be enough.
If you are taking pills he will likley increase the dose. If wants to do so suggest switching to injections and staying at the same dose. They will tweak or change your NSAID. He most likley will start a conversation about a Biologic. Depending on his exam and how long the morning stiffness lasts he may start it. There are a few enteses points he can palpatate and find inflammation evev if there is no "swelling"
Thanks for your reply. It varies every morning. My right side wrist is crunching when bending forward or upwards feels as though the 2 bones are rubbing off eachother and is painful would this be anything to worry about? Sorry about questions I tend to bury my head under all my problems as I hate complaining. The heel of my feet r very sore to walk on also.
That "crunch crunch" is called crepitus and is one of the palparation points he checks during your exam (for those who keep copies of their medical records it will be noted if there is a problem as "cmc crepitus and ttp" or if there is a really good transcriptionist: carpometacarpal exhibits crepitus and is tender to palpitation)
Crepitus may sound familiar you to you as it is also the Roman God of Flatulence. This is one of the ways they "find" inflammation when the blood denies it and you can't see swelling there are actually about 66 of these spots. But pretty much end up using the same 14 or 18 used for Fibromyalgia when they need a "score" hers a picture of most of them:
In any even there does not need to be visible swelling just a bit of "flatulence" in a few joints. I don't know that I'd be concerned but I suspect there will be some changes in your treatment.....
Hi, Miller. Document all of this. You are not the one to judge whether a symptom is something to worry about, nor are you complaining! You will be helping your rheumy, and helping the diagnostic process by telling the doctor everything. Make a list so that you won’t walk out of the office and say “Oh, I forgot to tell him/her about XXXX”.
This is not the time to avoid complaints, suck it up, or tough it out! You need to give the doc as much info as you can.
Good luck with this! Let us know how it goes.