Haven't posted in a while but have been keeping up with people.
I have a question. The doctors still think my knees are OA and the rest of my body is PsA, So is it wrong to ask for a medicine to help with the OA because the biologic does not do anything for knee. Going to the doc tomorrow for the 6 month check up and was wondering if I am off base for asking for something.
Currently just on Embrel.
A few thoughts. . … Damage from PsA can lead to OA. If it is “just” your knees, why not use joint specific treatments? What about PT? Strengthening around the joints can make a big difference in your pain levels.
In terms of treatment, I’m wondering about things like cortisone injections, lubricant injections, etc. If you have pain and inflammation from OA then an NSAID might be appropriate, but again, I would want to talk about something local.
I agree with Stoney. I have osteoarthritis of the knees which is considered to be secondary to PsA i.e. caused by it. The timing & sequence of events made the connection pretty obvious: PsA attacked my knees badly, they were very swollen for ages and the OA developed in that time.
I think strengthening the knees / legs may make more difference to knees than to any other joint. The knees take a terrific force and as OA reduces the cartilage cushioning, the bone surfaces can rub together. However strong ligaments and muscles pull the bones apart, therefore reducing the impact. Strengthening takes time but not necessarily massive effort, just regular and determined exercise. Walking has worked best for me I think.
I think all Stoney's suggestions re. treatment are great too. It might be worth asking your rheumy whether he or she is sure that your knees have 'straight', wear & tear type OA or whether it might be secondary to PsA.
What Sybil and Stoney said! The biologic will control the inflammation of PsA, but it cannot do anything for the pain resulting from the damage that already exists. Your knees are damaged (whether by PsA or just ordinary wear and tear) and that hurts. That can be addressed only with palliative measures -- painkillers, lubricant or steroid shots to the knee joint, or physio. I did all of those, and they all helped up to a point. The thought of the injections into the joint sound horrific, but it's not too bad and it did help for a while. The final (and fabulous!) solution for my knees was replacements.
Some rheumatologists can tell from careful examination of an x-ray what has caused the damage. You could ask about that.