Has anyone done any research or have any treatment ideas for different types of pain.
Before the PsA, I did not have aches or pains beyond typical injuries/headaches/surgical wounds. Now, it's a whole new ballgame.
Types of pain I have:
1. flare-up pain - For me, this is akin to an invisible gnome running around with a match and lighting it on a specific joint. One minute it's the left knee, the next minute the right elbow, then a specific joint in my left index finger. Some swelling, some redness. Treatment - pain meds, rest, heat.
2. usage pain- Sometimes these joints from #1 above get so flared and painful that days later I find they hurt if I over-use them. Treatments - rest, splints
3. pressure point pain - this is the one I'm stumped on. For the first time, I have very specific spots on my body that if you touch them, I will yelp and jump away. Not on a joint but near a joint usually. Above my elbow, between two joints on my thumb, above my knee (possibly IT band), between my shoulder blades, and my entire SI Joint. Massage made this much worse. Heat helps a little. Almost like a deep tissue bruise.
With number three you talk to your doctor. My motto is when in doubt make a call.
I find when I use my hands a lot they hurt as well as my shoulders. These areas need to be retrained for I used them sparingly six months ago because of sever stiffness.
I just figured out something. Your "pressure point" pain. . . .Could this be tendon inflammation? I started finding spots that felt badly bruised, yet there was nothing there. Then one day, I felt around the area, and was able to follow the whole tendon through pain, in multiple areas. I discovered all sorts of tendons this way. Tendon involvement, especially where they "connect" is a hallmark of the disease. Does this sound about right to you? And yes, massage would definitely make it worse.
I have enthesitis and I still get massages. Another one of those differing opinions. Not everything works the same for everyone. Massage does finds sore spots I never knew I had. It takes a few days for me to get over the massage but the longer term results have been worth it for me. Listen to your body it will tell you what works for you. Give your body 3 or 4 days after a massage to see if there are any benefits before you completely rule it out.
Piganli said:
Thanks, guys,
Yes, I'm now guessing it's enthesitis (sp?) which is the tendon inflammation. No more massages for right now! Boo.
If you look at Traditional Chinese Medicine which has been around for thousands of years, you will discover that so much of it is based on the known pressure points in the body. Chinese Acupuncture and Chinese massage are based on the pressure points in the body.
Western medicine does not have all the answers and that does not mean alternative medicines do either when it comes to PSA.
All I do is try and have an open mind and consider all the healing options that are available throughout the world and use what ever I can that will help me and my health problems.
Thanks, all. Bella, I just got several friends to refer Chinese medicine specialists here in town. I am discounting nothing these days and have wide respect to many traditions. Thanks for the suggestion.
I don't discount the other, or alternate medicines. My masseur has studied them and I now benefit from it! I also followed pain up, like Stoney, and found the tendons and the insertions. These are indeed my pressure points. My worst are the perineal insertions, very painful and start singing when I walk too much. I also have a labral tear that tries to sing harmonies with it sometimes! It's like having a rock concert in my hip! The pain comes around to the front in the groin area where my stomach (flat as a rock of course!) attaches to my leg. It's really interesting the way each bone is connected to the next bone until all the bones are singing<3
I still get massage with enthesitis. But I know where my sensitive spots are and I instruct the therapist before we start what she should avoid. Also, if I am have more tendon pain than usual or I am having a flare, deep massage can make it soooooooo much worse. So I just have her adjust the depth and I am okay the next day.
I usually attribute these weird tender spots to enthesitis, but make a note to mention them to your doc. There may be something he can do to help you out. I would think that paraffin dips would feel really good for this, or maybe he could give you a local steroid injection. As long as he uses lidocaine or similar to numb the area before the injection, they aren’t too bad. If he wants to do it without numbing, offer to try it on his hand first with no lido.
I have never had my enthesitis injected, I thought because it is where the tendon inserts it was not done due to the risk of tendon rupture. I have ruptured a few without help and it is so painful. I have had bursitis injected and it did help but I found if I treated the bursa and joint with rest/heat and topical pads like Salonpas pads on them they do not get that bad, so I do not have to risk infection etc. The injections I use to get went into the center of the finger joints. He used lidocaine but the pain was incredible. I couldn't use my whole hand for at least 48 hours but then the triggering and the pain would be gone for 6-8 weeks. I stopped having it done about the time of the outbreak of fungi meningitis due to steroid injections in spines. I decided the pain and risk for infection were just not worth it.
I think I've about given up on cortisone shots. They don't seem to work on me, and I've now had them done in a bunch of different situations, over time.
Sorry, I wasn’t clear. Sometimes if the doc can inject the joint, some of the other tendon inflammation will go away or at least subside. It has worked for me a few times, but it may not work for others. It was sort of a pleasant side effect from a joint injection! Also, instead of enthesitis, it could be referred pain from the joint. In that case it would help. I’m really sorry that I wasnt clear. the words forgot to make it from my brain to my fingers.I have had a few fingers done and I hurt, but I didn’t think it was too terrible, especially with the amount of relief I got. I don’t know if it makes a difference, but I have my favorite hand surgeon at work do the injections for me when he comes in. He’s supposed to be hot stuff in the hand world.
Interestingly, I work at a center that does a lot of steroid injections for pain management. The steroid that was being used was a generic for the steroid Kenalog. It was produced by one company which has since been shut down. I don’t know how I feel about epidurals, but for peripheral steroid injections, I’m ok with them. It was really a terrible time for our patients, who have terrible pain and were afraid to get their injections ( and right to be cautious). We had printed out the lot number and a picture of the bottles to let our patients compare them. Our center didn’t even have any of the steroids from that company! It was really awful for my pain peeps! I felt so bad that they felt like they couldn’t get their injections. If you still wanted to try injections, make sure they only use brand steroids. After that terrible outbreak, our center no longer buys generic injectables, and are very selective about our distributors. But, I completely understand if you don’t want to risk it, but it makes me upset that these azzhats ruined a good thing for some people. WAY OFF TOPIC, SORRY!
I know what you mean. I stopped getting epidurals at that time too. I decided I needed to make every effort to get my PsA under better control as every other week I was getting something injected. Now I ride the Remicade train! I hope it works for me as well as it has worked for you :-)
The remicade train is wonderful! First you start out in the coach seats, then you move up to middle class seats, then you get to ride in the private, first class compartment! Im working my way up to first class. But I think that even with remicade working, I want to do other things to provide relief too my problem areas, like massage, PT, and steroid injections if I need them. I have this theory that if I keep up with these things regularly then it will keep me strong, loosened up, and help me retain ROM. I guess I feel like even if I do feel better, I should still treat myself well. Plus they feel good, and insurance covers a chunk!
I wish you the best of luck with the remicade. Now that I know it actually does work and that they haven’t been giving me placebo, i am willing to advocate for it a little. I truly believe that the worst part about remicade is the waiting for change. During that time, you hurt like the dickens and it looks like there is no relief in sight. Also, my doc was not clear about how long it can take to feel effects, so I was very disappointed with every infusion. Hang in there and try not to lose hope. I have seen many more folks rave about their successes with it that those who haven’t. Keep that in mind when you get frustrated.
Good physical therapy can do wonders. Try to find someone who understands inflammatory arthritis. But you may end up not needing it. The remicade may get you very far a long.
the words forgot to make it from my brain to my fingers.I have had a few fingers done and I hurt, but I didn’t think it was too terrible, especially with the amount of relief I got. I don’t know if it makes a difference, but I have my favorite hand surgeon at work do the injections for me when he comes in. He’s supposed to be hot stuff in the hand world.