Managing Psoriatic Arthritis and Knee Pain
Psoriatic arthritis picks its fights in many areas of the body. For me, my neck is the most painful, followed by my back. Most inconvenient, however, is when my disease is active in my knees.
Knee pain is by far the most complicated for my wider health and physical ability. In this article, I'll explain why.
The pressure of psoriatic knee pain
For over a year, I have had active disease, without remission, in one of my knees. That horrible, deep-burning sensation, like your bones, are rubbing together with no cushion in between. Sometimes the throbbing of it makes me feel (and on occasion, be) physically sick. It's not pleasant.
What is often overlooked with arthritis in the knee is the weight-bearing joints that lead to secondary issues. Every time I get arthritis in my knee, it will be followed by a bad back within a week or two.
You're holding yourself in an unnatural manner that puts pressure on other areas of the body. You might not know you are changing your gait. You might not even have a limp. I promise you will be walking and moving differently.
Factoring in additional pains
Sleep disruption and fatigue is also an issue, especially the disease is active in my knees. I tire easily as I work harder to move during the day and my body fights the self-inflicted inflammation around the clock.
I also find that I get a lot more broken sleep when my knees are affected. I would more than with pain in my hands or heels. Every time I turn over in the night, sometimes, just the weight of the duvet is a problem.
Tips for managing arthritis pain in the knee
One final problem that I experience, is the loss of mobility. I try to be as active as my body allows but arthritis in the knees causes me a real problem in maintaining fitness and a healthy weight.
Through most flares, I can keep a level of fitness up through cycling, swimming, or tailoring my workouts at the gym. However, with knee pain, it often rules a lot of these out. Over time, if my weight increases, it puts more pressure on my joints and it can be a slippery spiral.
Inevitably, it eventually impacts my mood, confidence, and mental health alongside that of my physical health. Here are a few tips for managing pain in the knees.
Tip 1: Move, rest, repeat. Everyone's joints are different but for me, I have to keep the affected joint moving as much as possible. It's a case of 'use it or lose it' with arthritis and have had the disease since I was 11, combined with a real passion for sport, I can't afford to lose mobility, personally. You have to listen to your body but know when to push it too.
My trusted routine is to wait until I am at the peak of my treatment cycle, so a day or two after I have injected my biologic or a few days after a knee injection and well-rested - that's when I push. It might be a simple walk, a swim, or depending on your circumstances, the day you get out of bed.
Use the knee as best you can and then rest. When the pain or swelling returns to where it was prior to the exercise, then you go again and over time, you should see an improvement - either being able to exercise for longer, or the recovery periods shortening.
Tip 2: Learn from experience. As you've probably found with exercising a sore joint, you won't get it right every time. We've all had those mornings where, like a night on the town, we've woken up and realized we overdid it!
The important thing is you learn from it. If you're a bit of a data nerd like me, keep a journal, score your pain, movement, stiffness, and mood each day out of 10, learn the patterns of what worked and what didn't.
Tip 3: Stay on top of your pain, don't react to it. I'm as guilty as anyone of complaining to my spouse about being in pain only to be asked 'well have you taken your painkillers?' and having to shuffle off to the medicine cabinet with my tail between my legs.
Personally, there are two reasons I do this - I like to know where my pain is at, unmasked and secondly, there's comfort in knowing you have pain relief in your back pocket, in reserve, so to speak. However, I know this approach is wrong. It's easier to keep the pain out than try and remove it once it's already set in.
My doctors have told me this numerous times. So be better than me - own your pain and manage it proactively, rather than firefight when it's too late.
Tip 4: Find a distraction. Being in constant pain sucks. There's no glossing it up but you don't have to let it take over your life. Yes, there will be days when it ruins your plans and stops you from doing what you want to do but find something else to occupy your mind instead.
For me, when I am unable to play sport, it's writing. It's the primary reason I started blogging. Not only will this tactic distract you from the pain but you can go to bed at night feeling like you've achieved something, rather than focusing on what you couldn't do.
Try something new that doesn't involve your knee, you might find you're a natural at something you never knew.
Tip 5: Be kind on yourself. I am my own worst enemy with my disability. I constantly measure what I am unable to do against what I could do when I was younger or in remission. Don't. It's mental torture, it's an unfair comparison and it won't help your recovery.
Know when to give yourself a break. Get into the mindset that if your knee doesn't let you get the gardening done today, it can wait until next week. With everything going on in the world at the moment, it's the perfect time to shift your perspective.
Be realistic about your pain and recovery timeline
Don't set deadlines on things that really aren't important and please, reflect with the mindset of 'celebrate what you've achieved, don't grieve for what you once were'. It's a little mantra of mine that I wrote when I started this journey.
Be kind on yourselves, you climb mountains every day, my friends.
Can you exercise with your PsA symptoms?