This summer I developed constant moderate pain in my lower right side of my back. Bad enough that I had to quit running (I love running). Then when it started getting cooler, I had night sweats and my shoulder, fingers, wrist, knee, and right hip all swelled up and fairly painful. Anyways got diagnosed with psoriatic arthritis (Inherited from my dang mom!).
Right now just doing palliative measures (tramadol 50 tid and Celebrex 200mg bid) as rheumatology wants labs, xrays before start treatment.
I live in America and have pretty good insurance through my job with United Healthcare. What should I expect at my next rheum appointment?
1) Will they deny treatment if it’s early and I don’t have bad structural abnormalities? (I really want it treated due to pain and functional limitations)
2) If they do start treatment (which I hope to god) will I have to start with a DMARD? Like methotrexate? Or since it presented in my lower back and MRI shows some degeneration at my SI joint will I get to skip to biologic? (Otezla/Humira)