For those of you who don't know me as I am pretty new to this board, I have had P for years and probably PsA as well, but was only recently diagnosed with it about 6 months ago. Have been on Metho for 5 1/2 months and just took my 5th injection of Humira on Saturday. I have to say that something is helping somewhat. I am actually typing with all of my fingers which is a great thing since I am a software trainer and spend hours each day typing so it is great to be able to use both hands without alot of pain. Mind you not that it is gone, but much better. Something is also helping my foot as the swelling is down and I can actually wear something other than a tennis shoe for a change! I don't know what caused the swelling and pain to go away but I am not going to question it, those parts of me feel like a different person than I was a few short weeks ago. I have seen my rheumy several times over the past few weeks due to what she was calling a major flare and while I do love her and she at least appears to be listening to me and understands to a point, we still have a disconnect somewhere.
Problem is my back, to be more specific, I think my SI joint maybe? For the past few weeks I am having problems sitting, standing, walking, sleeping, I guess you get the drift. I am miserable. I don't think she gets how much pain I am in with my back and plus my leg is going numb. She gave me a shot in my back 3 weeks ago and while it helped for a day or 2, it was then over. She recently gave me Tramadol but I am one of those people who cannot take this type of med. It makes me sleepy, ditzy (and I am old and blonde so I don't need anything to further encourage this type of behavior), sick, etc. so I'm not taking it anymore. I asked about seeing an ortho or OT or PT and she doesn't seem to think it would help. I am about at my wits end. I travel alot for work and in the next 6 weeks I have 4 trips. So I guess my question is about seeing other doctors, should I just make an appointment with an ortho, or PT. What do you think? I got the feeling from my rheumy that she would frown on me doing that. Help me understand here, shouldn't they all work together? If it is something specific to my back then shouldn't she refer me to an ortho? How do you know which doctor to see? How do you know which is the best doctor to help you? And most importantly why can't someone find a cure for these types of diseases and let us all live better? OK, well maybe no answer for the last question, but suggestions on what to do for the others will be great!
I would definitely go to a PT, your rheumy shouldn't have any problem with it. You might need an ortho to refer you. Before I was diagnosed, I had a very stiff neck and a swollen finger. PTs fixed both problems.
I don't see an ortho for my back because I have the spondylitis variant of PsA and at this point there's nothing to be done until we get my PsA under control. I have partially fused SI joints and they cause a ton of pain. I find the way I carry my body to be very helpful with the back pain. I don't sit in soft chairs or on couches. I have a four-inch memory foam topper on my mattress. I do exercises to help increase my core muscle strength and stabilize my pelvis/back. I stretch (pregnancy stretches work great!). I balance movement and rest as much as I can.
As far as doctors / pt's go, ideally they should work together, but that's not always how it happens. I have a great family practitioner who tries to keep everything straight (I see a rheumatologist, endocrinologist, gastroenterologist, and hepatologist).
Basically I ask my rheumatologist what he would recommend, and then ask him if he thinks ___insert idea here ___ would work for me. He gives me his opinion, but ultimately if I think something is going to work for me, I give it a shot.
Totally agree with Nym, ultimately it is your care and it is up to you if you feel that you need more specialized care. That is one thing I love about my GP, he openly admits that he is not a specialist and would prefer that I see one!
In any case, you could probably benefit from both PT and an ORTHO. PT can help you retain range of motion, retain strength and function, and help manage pain without drugs. An ORTHO can at least offer you a second opinion if you don’t feel like your rheum is hearing you. It does sound like you have nerve impingement somewhere as evidenced by the numbness you are experiencing. I know that when I have had similar problems in my hands, I have seen an ORTHO for it.
There are also other meds and methods for pain management than opiates and their ditzifying friends, so one has to explore what works best…especially when blonde!
MAT, I am going to see Ortho soon. It can't hurt to see another doctor. I am already trying to sort this complicated disease out. I am at my wits end to. I have some knee joint damage from PsA and want to talk to some different doctors to see what they think. Maybe they can help me more then Rhuemy. I don"t know but until I am satisfied exploring what is the wrong with me. I will continue to talk to all docs while finding solutions to what is wrong with me. Best Wishes
Tim
I typically see my rheumy, but. . .. I will ask for a referral for PT as necessary, or see an orthopedist for a specific problem that won't come under control. As an example, last spring multiples tendons in my ankles became inflamed, and I was having days at a time where walking was excruciatingly painful. I did PT for about 4 months for this, and continue to do exercises at home. I will likely need to do PT again for my shoulders, which get weak with the tendonitis.