Enthesitis
I believe that the majority of my PSA pain is likely enthesitis. I really only hurt when I move. I had pain in my fingers recently that throbbed and hurt constantly, but that doesn't happen that often. I read someone on a PSA Reddit thread who described joint pain as a constant pain, but enthesitis as hurting more when moving which makes sense to me. Does anyone have mostly enthesitis and if so what treatment has helped the most? I "failed" five biologics. Currently taking hydroxychloroquine, prednisone, tramadol, cymbalta and ibuprofen for pain. I'd like to stop Tramadol. Very mild skin issues, pain is the main problem. Is stretching or PT helpful?
Hi
, thank you for reaching out to the community here. I hope you'll get some helpful replies. You might be interested to read through the following article, where some of our community members shared their experiences with enthesitis: https://psoriatic-arthritis.com/living/enthesitis-patients
I have a reasonable amount of enthesitis/tendon/ligament issues (feet, knees and elbows). At the start of my journey I was given NSAIDs to try to deal with this (meloxicam and celecoxib), which didn't help. I was also referred to a physiotherapist and a podiatrist to try to get on top of the issues with my feet and knees. Both gave me exercises to do, which, at the time, I either wasn't able to do at all or wasn't able to do to an extent that would be beneficial. I have since been able to do them "properly" and have found them helpful. I was also referred for hydrotherapy but again, wasn't able to do this at the time. I believe the idea was to strengthen the muscles around the tendons/ligaments to take the strain off of them a bit.and I were actually talking about this the other day - you can read our discussion in the comments section of the following article: https://psoriatic-arthritis.com/living/rheumatologist-understand Eventually, I was put on methotrexate and this has really helped me. Turmeric supplements also seemed to make a difference to my Achilles tendinitis/plantar fasciitis for a while.
Do you mind sharing whereabouts you have this enthesitis pain? And how are you getting on with your medications at the moment? Sending hugs! -Catherine, Community ModeratorThanks for your response and encouragement : ) The pain is mostly in my hips, knees, and feet. My hips and feet are more painful than my knees. It makes it difficult to walk at times. None of my medications seem to be working well right now. I've had to increase the Tramadol quite a bit which leaves me sedated and makes me worry that I'm developing a tolerance to it.. I will try the Tumeric. How much did you take? Unfortunately, methotrexate did not work for me and gave me a rash. I've thought about asking my doctor if she could send me to PT, but I've had it in the past and it didn't help all that much. At the time, I thought I had fibromyalgia, so maybe the exercises would be different now that I have an accurate diagnosis.
, you're so welcome. I'm sad to hear that these symptoms are making it difficult for you to walk (although I can unfortunately relate) and I'm sorry that none of your medications seem to be working well at the moment. Are you due to check in with your rheumatologist about this at some point?
It may be worth asking about the PT again. I can't actually remember if I had my PsA diagnosis when I was referred for it or not (I was initially misdiagnosed with chronic fatigue syndrome). I have remembered, though, that the podiatrist also gave me some insoles to put in my shoes, as they thought maybe the issues with my Achilles tendons/plantar fascias may have been impacting my knees. We actually eventually found out via an MRI that my knees had their own issue going on with the enthesitis. Have you had any imaging done of these areas lately? As Eric mentions, there are other types of "itis" that can affect us.
Regarding the turmeric, I unfortunately can't remember how much I took. I just got a supplement from a local health food store and followed the instructions on the bottle. We're all different but I did find it helpful at the time. You might be interested to read Vickie's experiences with turmeric: https://psoriatic-arthritis.com/living/benefits-tumeric If you do decide to go down that route, be sure to check in with your doctor or pharmacist first - turmeric can interact with several medications and isn't suitable for everyone. I really hope you can find something that helps. It's horrible being in so much pain and having your mobility affected. Hugs! -Catherine, Community Moderator
A lot of the pain is actually synovitis, inflammation of the synovial lining of your joints. That's why, despite x rays looking relatively normal in earlier stages of PsA, the joint pain still feels like something destructive.
