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Anyone experience Enthesitis with PsA flare up?

I'm really pleased to have found this place and look forward to getting to know some other people with psoriatic arthritis! I'm hoping to pick brains a bit, too. My feet and hands are really flaring up at the moment, I'm getting very bad foot and ankle and now lower leg enthesitis bilaterally which is worse at night. Morning stiffness is increased and I have numbness in my hands. I'm up even more than usual in the night with enthesitis (and also what feels like bone) cramp-like spasms. I've had this for years, it sometimes leaves bruising on my ankles and feet where the spasms were concentrating and it can make me scream in pain (and I didn't scream during either of my children being born).

My new rheumatologist recently referred me for USS and nerve conduction and whilst I'm still waiting for neuro results, the ultrasound result says only mild changes in my right hand. Whilst I'm obviously very pleased there appears to be no major damage even after 16 years of PsA I'm really surprised given my ongoing symptoms. I was really hoping that I would be finally listened to about this by a doctor. I might get some results which could point me towards some (any!) relief from this particular symptom and I feel a bit disheartened. I've had bloods checked and nad, I walk regularly when I'm not flaring up, I eat 5 a day, with minimal red meat and I'm kept pretty active with my kids.

Any advice or shared experiences, please? Thanks for reading.

  1. Hi there -
    I’m just new to the community and newly diagnosed but I experience similar to what you are saying.
    Every flare that I’ve had starts with red, swollen, hot, tender area that is somewhat widespread.
    With my toes it leads to dactylitis.. but I had a long flare (?few months) of my entire left dorsal hand and wrist that eventually just settled into a stiff 1st metacarpal area.
    Currently I have a discoloured area on my left inside ankle.. no injury.
    I am an ultrasound technologist so can periodically check myself.. and I will see the tendon surrounded in fluid with high vascularity.. and when I search for the affected joint it is often vascular and inflamed too.
    I mentioned in another part of the forums I have been trying the ketogenic diet and coincidence or not - my most recent flare with the ankle is the only one which has not ended up in excruciating pain for a period of several weeks like all my other previous starts of flares.
    It is not curing my very sore feet / plantar fasciitis but, it has not developed as much as other flares..

    1. Hi sarahr do those spasms make your legs shake uncontrollably and keep you awake if so I know how it is I have been suffering for about the same amount of time the only thing that I have seen relief from for that was the cbd oil it helped me sleep a lot better and we all know that sleep is very helpful so I hope this helps good luck and take care

      1. Enthesitis…….. in 25 years with this disease, misdiagnosed for 20, no one ever ever used this term with me, from PCPs, Rheumys , Neuros, PT folks, etc…. But today and after studying the last year or so, believe most of us with PsA and the other Spondy diseases may have chronic enthesitis. I don’t think it ever goes away for us, it just moves around. The “ cure” is prednisone, rest and anti-inflammatories. But who wants to take prednisone all the time?
        I truly believe most of the pain I suffer is enthesitis, and I’m on pain meds because I can’t live through the day without them.


        What is the best test to ask for to show active enthesitis?

        1. Hi . Enthesitis can be difficult to diagnose, but a physical exam combined with blood work and imaging that detects inflammation, like MRIs and ultrasounds, can be helpful. I wish you didn't have to take pain meds daily. Here is an article from one of our advocates about natural pain relief that you might find interesting, especially if you reach a point where pain meds no longer help: https://psoriatic-arthritis.com/living/natural-pain-relief?fbclid=IwAR3ugVOCbesKWoNfmw5icnoeI_BtMv5L9w9WnUIt98VeYR85NJ1fKx4JbzQ&utm_source=facebook.com&utm_medium=organic. My heart goes out to you. - Lori (Team Member)

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