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The Reality of PsA Comorbidities

One part of managing life with PsA that goes unnoticed is managing the linked health conditions that come with this painful condition.
These linked conditions are known as comorbidities. That's right, living with PsA, can potentially put you at risk for additional different chronic conditions, either at the same time or at different times.
Comorbidities can also affect treatment options. Certain types of medicines can also make comorbidities worse, and some comorbidities can affect the way that PsA treatments work.
Do you live with any PsA comorbidities? How has it impacted your pain management and treatment journey? How about your overall quality of life?
It can be so hard to get people to understand!

  1. Over the last five years I have gained so much weight because I am not active anymore. Just walking from my job to the bus stop at night is a real challenge. My legs are like lead, shooting pains up my legs to my pelvis/hip area, and the bones in my feet are screaming. I have to walk so much slower now it's embarrassing. I refuse to walk with someone else because I can't keep up. I am only sixty and feel like 90.

    1. Hi @sharona361, I can hear how difficult this must be for you. I wish you were not in so much pain. I really hope you have a doctor who is trying to help you manage your pain. I am sending you an article from one of our advocates who shares a similar story, I hope this can help you: Sending you a gentle hug. Jill, Team Member

  2. Hi Sharona361, When I had excruciating pain in my achilles with PsA I had some ultrasound treatments that my GP arranged for me to have at the local hospital. It really helped with softening the pain after each treatment and after the 6 treatments I had, I really noticed the difference. Also every night while I’m watching TV I have my legs and feet elevated on a big comfy footstool. I got in the habit of rotating my ankles and feet every night just a couple of minutes but repeated every now and then whilst enjoying the TV shows. Now I don’t even notice that I’m even doing the exercises, it’s just automatic. I do it with my fingers as well. It’s all very slowly done but it gently stretches the ligaments that allows easier movement when you need to be using your hands and feet. Thinking of you and sending you my best wishes and a gentle hug 🤗, Bez

    1. I have enthesitis that effects my lower body and I can’t walk because within a mile into my walk my legs lock up and the pain is off the charts I sit and stretch and take breaks and it alleviates it for a few minutes and comes right back but worse… Im terrified that I could be stuck in the woods unable to move (walking sticks) help but doesn’t take away the crushing pains and same issue when I use exercise machines … on Cosentyx and Otezla both help a bunch except with this horrible locking issue.

      1. I have had my share of experience with enthesitis, but nothing to the degree you are experiencing, I will be sending you my thoughts and prayers as well! One thing that really struck my in your post though, you mentioned your fear, I would encourage you to find ways to mitigate your fear so you don't end up stopping the things you love! Maybe you could go in the woods with a friend, partner, spouse, relative, whomever so long as you all have a plan in place in the event you don't feel like you are able to walk back home, to your car, etc.

        I would also suggest talking to your rheumy regarding your treatment protocols. Enthetitis is known to respond to TNF Inhibitors (Humira, Enbrel, Remicade, etc.), Cosentyx is an IL-17A Inhibitor and Otezla is a PDE4 Inhibitor. I'm not sure about the Cosentyx, but I do know there are studies underway to test the effectiveness of PDE4 Inhibitors in the treatment of enthesitits, but currently TNF Inhibitors are the only accepted treatment class I am aware of, so as much as it is a literal pain to change protocols, maybe it would be helpful and at a minimum worth a conversation with your care team.

      2. Hi, Im not able to use humira due to cancer. I feel like the Cosentyx and Otezla have helped me a lot more together vs. separately and I won’t walk alone but in the future I would like to.

    2. I'm so sorry for what your going through, I will be sending prayers your way (or good thoughts if your not into prayers)! I do agree completely with that you have to keep moving, it is the single most important thing any of us can do! Also, for putting the legs up, they also sell wedge pillows on certain online retail outlets that are huge, but they are fairly affordable. I was fortunate in that I was able to be have mine paid for by insurance when I had my hip replaced last May, but it is actually pretty comfy for putting your legs up while watching tv, reading, or just relaxing. You can also get pressure socks to help with the lower leg swelling, which is something I have had issues with and also gets into a comorbidity which is a neurogenic bladder from damage to my spine from Ankolyzising Spondylitis and/or PsA, which causes urine retention. The urine retention then presents in lower leg edema of all things. Without knowing what meds your taking too, some of the meds can make many of these symptoms worse as well, without going into detail of how my care team changed my treatment plan, I would just encourage you to meet with your care team and start with a review of meds, but don't leave any of them off the table, like prednisone or gabapentin, both of which make you feel good but are notorious for making you swell and gain actual weight! I also went through a weight loss journey this last year and lost 110 lbs from Nov. of 2020 to Nov. of 2021. This was done through a program offered through the medical facility owned by my insurance company and I did have to pay a significant portion of the fees, but it was with a registered dietician, life-style coaches, one on one meetings with a GI doc who specializes in weight loss, as well as access to any requested or needed mental health care or social services. After 8 weeks of dietary changes and lifestyle coaching, if you choose to sign up for the 2nd half of the "paid" portion of the program, you then are connected with the Doctor, and he is the one who initiated quite a few changes in meds for me which made a huge difference, not only in my weight loss, but in how I felt everyday as well. I started this program on 12/16 of last year, I had already stopped prednisone, which was a 3 month course anyway, and had lost about 10 lbs. at the start of the program, had bladder surgery on 1/7, still managed to have lost a total of about 30-35 lbs prior to the hip replacement on 5/24 (had also finished the 16 week portion with registered dietician and had changed meds around, but had been diagnosed with another autoimmune disorder as well Antiphospholipid Syndrome, which is a blood clotting disorder) after the hip replacement I spent 3 nights in the hospital due to the clotting disorder, was home 2 weeks, and was back in hospital for 10-15 days (I lost track of time as I was not fully conscious for a period of time) due to anemia spinning out of control and without going into the blow by blow of all the labs, I had gone into sepsis but not due to an infection of any sort from the surgery, it was all related to the anemia and hydration issues, etc., by the time I was out of the hospital and really back functioning at all I had lost 60+lbs and it was the end of July. At this point my activity levels really ticked up and the weight just started melting off. Wound up with a good dose of Covid in October, in spite of being fully vaccinated and having a booster shot, and I still have some lingering effects of that as well, but by the first week of Nov. 2021, while being checked in for shoulder surgery, I was down exactly 110 lbs. from 1 year prior, all while dealing with loads of health crap and on my 50th birthday! I have since plateaued on my weight loss, but I am really pretty close to where I want to be weight wise, and I actually believe I can maintain my weight here as well.

      I'm not going to lie, it has been a tough year for me, it was a lot of work and I've been through a lot as well; however I am beyond proud of myself with where I am now. I do feel better than I have, but its not a cure to lose the weight. As I'm writing this, my back and neck have been giving me fits and I can barely think straight they hurt so bad, but my knees, feet, and ankles feel so much better its indescribable. I was literally facing a knee replacement this coming year and now the ortho thinks we might be able to kick that can a few years down the road, if not more, which I am more than happy to do. My goal for 2022 is to just go 1 year without going to the hospital and finish recovering from all of the surgeries and trauma my body endured in the last year and build my strength back up and to increase my movement more and more!

      I hope you can find nothing but encouragement in the book I've just written lol! I could never imagine what your dealing with daily, the same that none of us can know what any of the rest of us are, and we are all in different places with our treatment protocols, head space, pain levels, etc. I also think a lot of my drastic weight loss was likely due to the health issues I had, without which I probably would still have another 30-40 lbs to go to get where I'm at, but it is the road I was put on, so I just kept moving forward best I could!

      1. You sure have been through a lot, , yet here you are, doing so much better and able to give support and advice to others. That's amazing. You offer some great insight and advice in this "book" that should be helpful to and anyone else who reads it. Thanks so much for sharing your experiences and all you have learned as a result. I hope your neck and back feel better soon and that you are able to achieve your goal of staying out of the hospital for a year. I am sure you have had enough of that right now. Enjoy the holiday season! - Lori (Team Member)

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