Psoriatic Arthritis: How do you manage PA and flares?

Posted by lemdjm @lemdjm, Feb 27, 2017

I am a 74 year old female who has had psoriasis for over 40 years. The psoriasis was present on my scalp and ears in flares from time to time. I never experienced joint swelling and joint pain until recently. About one month ago I experienced an abrupt onset of severe joint swelling in my hands wrists, feet, and neck with severe pain. At first I suspected that it might have been related to my oncology medication, Arimedex that I began taking approximately 4 months before my sudden joint problems began. Testing ruled out Rheumatoid Arthritis and Lupus. My oncologist did not think that the joint issues could be related to the Arimedex, however, he recommended that I suspend taking the cancer medication for 4 weeks while I was given oral Prednisone for 23 days (referred to as Pulse and taper). I am on day 22 of the Prednisone and the joint swelling and pain is no longer present. My oncologist wants me to resume the Arimedex, however, I am afraid that the severe joint pain will return. I am hopeful that additional diagnostic testing will determine the underlying cause of my joint swelling. If anyone reading this has had similar problems or any information related to my situation I would be interested in your comments. Thank you.
lemdjm

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Nemo1 | @nemo1 | Jan 15 12:40pm

We decided against meds until it spreads. The doctor wanted me on meds as a measure of prevention. An MRI diagnosed the autoimmune PA. I also have psoriasis. Not everyone with one has the other. I am to be on an anti inflammatory diet which is severely restrictive. However, it helps when I followed it so I am back on it. Additionally physical therapy helped tremendously. I have to go back every year to do “maintenance” PT. They also did neurological reeducation which also was phenomenal. I hope you find the help needed. The best.

sluicebucket | @sluicebucket | Jan 16 12:54pm

I have PSA and am extremely cognizant when I eat anything in the nightshade family.
Peppers are my worst enemy - immediate reaction. Tomatoes are the second worse, followed by potatoes. You need to do your own research on what nightshade fruits & vegetables work for you. It took me almost a year to figure it out. Since then, I no longer take methotrexate and that makes me happy. Also, I do a lot of meditation and find that being positive helps me. I may have PSA but it doesn't have me!

seniormed | @seniormed | Jan 16 3:07pm

Keep in mind it is vital to control systemic inflammation for prevention of atherosclerosis.
Have a cardiac risk assessment with the knowledge that
PsA is a known factor.I agreed to statin therapy for the
first time when my cardiologist became aware of my
diagnosis and the related concomitant major vascular
events.

dw27 | @dw27 | Jan 30 3:17pm

In reply to @peach414144 "correct. it is all in the MONEY." + (show)

I take Rinvoq for soriatic RA. My scalp is mildly affected currently & looking for OTC shampoo. Prescription shampoo does not work. No other issues. I consider myself in remission. I do get a day of fatigue every week or so. I always have pain in wrists, ankle& fingers when waking in a.m. but it passes with activity after about an hour .Several joints swell & ache, especially with over use..wrist & thumb, I use the joint less & it gets better. I rarely take pain meds. I do vigorous exercise 3x a week(zumba).I am age 74 & diagnosed at 63 after having a allergy reaction to Tetracycline.

dw27 | @dw27 | Jan 30 3:33pm

For severe flares I take steriod for 1 week. I start at 30 mg. I avoid steriods because they affect bone density. Have not had a severe flare for many months. I think exercise is the key.

seniormed | @seniormed | Jan 30 4:04pm

My rheumatologist offers prednisone short bursts for flares. None in several months but my nails show new lines of activity. I rotate four shampoos.Most weeks I am shampooing 4 or 5 days.
Zinc pyrithione (or Head and Shoulders)
3% salicylic acid Neutragena extra strength
Selsun blue house brand selenium sulfide
Rx 2% ketoconazole
Leave them in contact with scalp for a few minutes and use a gentle scalp massager.
I can still itch the next evening.
OTC Dermarest 1% hydrocortisone lotion for itchy ear canals

ihanrath | @ihanrath | Feb 5 9:44am

I had psoriasis at age 11, no family history of this. I developed PsA at age 33 but my skin disease resolved with methotrexate used to treat my PsA.
For some reason short use of prednisone does very little for me. For flare-ups I'll use NSAIDs for short time use.
I am now 66 and find that my joints are stiff for longer, especially thumbs and pinkies as well as lt hip. I agree that moving is best but some days it is a hard balance to know how much is enough or too much.
Wishing you well