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

Interested in more discussions like this? Go to the Autoimmune Diseases Support Group.

For Psoriasis and Psoriatic Arthritis Try giving up gluten for at least one month. That almost eliminated my Psoriasis. One piece of wheat bread or slice of cake and I get a plaque. I was diagnosed with Psoriatic Arthritis by 3 different Rheumatologist and have the HBL127 blood factor. My PA disappeared after a number of years of practicing Qigong. Its out there, I know, but it actually happened to me. Can't hurt. No one touches you or gives you anything to swallow. No drugs. It's a 4000 year old form of healing, and the forerunner of yoga and acupuncture. You can even receive treatments from a practitioner on the other side of the globe. Oh yea, I also survived a really rare form of sarcoma. I couldn't find a doctor who ever had treated a case.My oncologist searched the web for a treatment regiment. It worked but nearly killed me. I lost a lung and one side of my diaphragm from the huge doses of chemo and radiation. After my surgery none of the tumor or affected lymph nodes were still malignant. None of the surgeons in my doctors practice had ever seen that happen before. Between all the doctors I consulted with at the U of MN,, Fairview Clinic and Mayo, only one doc had ever seen that happen before. I did a meditation for healing cancer everyday for months and trongs of practitioners worked on me. I'm not saying that Qigong was what healed me but I would never rule it out. I would never tackle any disease without modern medicine and drugs but I would never do it without Qigong. If you want to know more, goggle Spring Forest Qigong. Don't pay anyone large sums for this service. I know plenty of people who work for pennies. I'd work on you for free. Some claim to be healers. I am a helper. I believe Qigong can allow your body to help heal itself and that someone like myself can rebalance your energy to help your body do that. This is complimentary care. Nothing more. It is not medicine. It is not a substitute for a doctor, drugs or modern medicine but many people believe, as I do that they have benefited from it practice. Love and Blessings.

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@colleenyoung

Welcome @lemdjm.
Please allow me to introduce you to fellow Connect members @marylou705 @jewel8888 @jerseygirl926 @julz @boxermomma and @slbeall, all of who have spoken about psoriatic arthritis. Hopefully they will have some thoughts about managing joint pain.

Joint pain and stiffness are known side effects of Arimidex (anastrozole) an aromatase inhibitor used for treating some types of breast cancer. You can read side effects in this drug info from Mayo Clinic http://mayocl.in/2m5bKo9. You may also wish to post a message in the Connect Breast Cancer group to this discussion about anastrozole:
- Concerned about the side effects of anastrozole http://mayocl.in/2d4tiKL

I can imagine that you're concerned about starting anastrozole again. Anastrozole is one of 3 aromatase inhibitors. Each has a different set of side effects. Perhaps a different drug would be better for you. Have you talked to your oncologist about taking exemestane (Aromasin) or letrozole (Femara)?

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I started anastrozole in October of 2019 before my mastectomy and have been taking it ever since. At first I didn't notice any side effects after some initial nausea. Now I have developed arthritis in my hands, carpal tunnel, body aches, severe knee pain and stiffness and insomnia. The answer to my concerns was met with "walk more". Tough to do in the dead of winter and now my knee is so unstable and muscles and tendons are so sore that just getting around the house is a problem. The oncologist has given me a three week vacation from taking it, but it takes that long for it to leave your system so not sure I will notice the difference. It seems difficult to deal with all of this and the fear of the cancer returning.

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They recently found psoriatic arthritis in my sacrum on an MRI with other details I don’t know what it means. Does anyone know what it means when you have edema in your bone marrow? Is that part of PA?

I have lumbosacral radiculopathy, degenerative joint disease in spine, Paraspinal muscle spasm that won’t resolve (since last nov.) I developed swallowing trouble back in Nov, the same time the Paraspinal spasm reared its ugly head. I have other conditions but will keep it to the PA & DJD.

To be brief:
Just finished a 2wk low dose steroid to determine if i have inflammation from PA that it helps. If so, dr wants to put me on an injectable med for PA> I don’t know what that med could be, we didn’t cover that. I have a 2wk diary I’m going over w/her in a couple weeks to determine course of action.

Neuro want to see what determination is made by Rheumy, to see if she will up the pregabalin thats trying to treat my neuropathy. The 150mg is not cutting it. But diet change is doing something for that.

I’m on a host of other drugs for other conditions and I’m scared that this injectable might interact with them. It would not be the first time. Because I’m on so many I’m not taking other meds I need but can’t take them because it might raise bp or affect sodium and chloride levels or something else.

So, oh I also have skin psoriasis but its not that bad. But it hangs on. I ignore it. So, I’m wondering:

1. What drugs (injectables) are out there to treat PA found in sacrum?
2. Are there any serious side effects?
3.What questions should I be asking my Rheumy about PA because quite frankly my lower back has been bugging me but the neuropathy is worse. Except for the unresolved back spasm.

Thank you kindly for your time! Nemo1

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I have been diagnosed with autoimmune psoriatic arthritis in my sacrum with edema in the bone marrow and joint trouble. I am in my mid fifties. My rheumy also thinks the problem I’m having with a toe is autoimmune. I was sent to her to see if I had sjogrens. Those lab tests came back negative even with dry mouth and dry eye. I wasn’t even complaining of my back problems (pain and stiffness). Then two MRI’s later I learned I have problems there on top of mechanical troubles.

She wants to put me on Embrel. Either self injectable or infusion. She had me on a low dose steroid for two weeks to see if it helped my pains and problem. It did. So she wants me to start that drug.

I did some research. My loved ones did research too. They are against it due to what it does to the body and organs. I’m not sure how bad a “flare” I could have although I can tell with my shoulder and knee.

I know I would feel better on it, but i have other health problems that are causing worse trouble then the PsA. Point 1: Diabetic Neuropathy with muscle spasms. Vision trouble, high intra ocular pressure, vision was in “jeopardy” but since meds for that the pressure improved.

I have stable perinephric fat stranding (PFS) found on CT.

I have other issues but my main question is:

What other options are there for people like me who don’t want to attack the arthritis with Embrel?

I am going to try physical therapy, anti inflamatory diet…

What else can I do?

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@nemo1

I have been diagnosed with autoimmune psoriatic arthritis in my sacrum with edema in the bone marrow and joint trouble. I am in my mid fifties. My rheumy also thinks the problem I’m having with a toe is autoimmune. I was sent to her to see if I had sjogrens. Those lab tests came back negative even with dry mouth and dry eye. I wasn’t even complaining of my back problems (pain and stiffness). Then two MRI’s later I learned I have problems there on top of mechanical troubles.

She wants to put me on Embrel. Either self injectable or infusion. She had me on a low dose steroid for two weeks to see if it helped my pains and problem. It did. So she wants me to start that drug.

I did some research. My loved ones did research too. They are against it due to what it does to the body and organs. I’m not sure how bad a “flare” I could have although I can tell with my shoulder and knee.

I know I would feel better on it, but i have other health problems that are causing worse trouble then the PsA. Point 1: Diabetic Neuropathy with muscle spasms. Vision trouble, high intra ocular pressure, vision was in “jeopardy” but since meds for that the pressure improved.

I have stable perinephric fat stranding (PFS) found on CT.

I have other issues but my main question is:

What other options are there for people like me who don’t want to attack the arthritis with Embrel?

I am going to try physical therapy, anti inflamatory diet…

What else can I do?

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Ps: I’m also on a boatload of medications.

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My dx is from RA to Psoriatic arthritis, Methotrexate almost killed me with severe anemia. My new doctor wants to try sulfasasdine. Do any of you have experience with that drug?

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I’m 65 and just developed psoriatic arthritis following a prolonged use of antibiotics for an infection I got from a bandaid. Turns out I am allergic to latex. The initial reaction was over my body with breakouts and itching. I was given a dose pal of steroids which did the trick. I’m having a skin biopsy late Jan but my knees low back and shoulders are very painful. I’m using Varna lotion to control the itching but nothing else really helps. Stay warm my friend

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Benadryl may help with the itching, it will make you drowsy.

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@tedjones77494

Benadryl may help with the itching, it will make you drowsy.

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I do take Benadryl at night for allergies and it does help with the itching as well. I hate waking up at 3am itch like crazy!

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i’m looking for anyone who can help. I was diagnosed with Psoriatic arthritis. this last year i’ve had one of the worst flares and it’s never ending. my skin is covered in a rash, from toes to breast, all areas present different. I get terrible infection, most recently my jaw and chin strap muscle. everyone’s answer is steroids, which I was on for 9 months of this year. i take a biologic shot monthly. I also have two modules in groin lymph nodes we are watching, but no one addressed. i’ve been to rheumatologist, immunologist and dermatologist. in the middle of this a cardiologist because i’ve supposedly had a heart attack too! i’m 52! I feel 80! I need clear answers and diagnosis. considering Mayo. please help!

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