I have had mild psoriasis for years and recently noticed stiffness in 2 joints. My rheumatologist diagnosed early stages of psa and is suggesting mtx. There is no jont damage, only a little swelling. There is not much pain so I'd like to delay the meds. I have been taking omega 3 for a couple weeks and my pain is almost non-existent. I'm hoping that I'm not hurting myself by delaying the meds.
Prednisone is over used and has many long term side effects. MTX is miserable for many people with some major complications and side effects. However, there is damage being done even if you aren't in pain. 1 year before I had joint pain I tore 2-3 ligaments in my ankle while I was sitting with zero weight on them. The damage was that severe. It was 4 months after my arthritis diagnosis that we were able to connect it all (14 months after the injury). I'd try ibuprofen or something over the counter (an NSAID) that helps with inflammation (not tylenol that deals less with inflammation but more with pain). Side effects and damage is minimal, it's inexpensive, but it might save your joints or delay the need for major meds like biologics or MTX.
I wish you well and hope that you have a long time to go until you are in pain!
I started off with on and off pain, mostly in my hands and feet. It's been almost 6 years now, and I have followed all medical advice. I started off with just NSAIDs, added in Plaquenil, then a few years later added in MTX before switching to Leflunomide. My joint damage is fairly minimal, but is certainly there. And the most obvious joint damage is in my fingers, where this first started. As a matter of fact, the finger that has a swan neck deformity now is the finger that first started hurting me. My point is, even if you are not in pain right now, damage can still be occurring. And any swelling means that there is inflammation, and damage can be occurring.
There are options, and you may want to express that you are concerned that MTX might be starting off too strong. Then again, if I had started a DMARD right away, would I have less damage? Who knows.
The pain and the disease are not always (or even usually) related. The question you will have to answer for yourself is which side effects are most likley to screw up you life forever, those from the disease or those from the drugs. I'm not going to try and influence that decision ( well maybe a little) but my experience is that during an active phase of the disease is when I have the WORST time with meds.
In terms of side effects and permanent damage to you from drugs, in order its prednisone, Nsaids, narcos, DMARDs, and biologicals. You'll note the first three are used for acute disease flairs (what happens when the disease is not controlled.) The other thing you need remember is when you get pain from damage, treatment will not make the pain go away. That pain is not coming from the disease............Even if the inflammation is controlled, you may still have pain, and there is little beyond pain management that can be done for it.