Foot issues, Achilles tendon etc - beginning of PsA?

I believe my psoriatic arthritis (PsA) started by problems with my feet. Plantar fasciitis, bone spurs, a torn left Achilles tendon, and partial tear on right. Each problem treated independently. Later pain in hips, shoulders, wrists. No psoriasis. No one connected the fact that so many things were going on.

I believe that the "tell" should have been the Achilles tears. I was a woman in my 50's, not known to play a sport or do anything that would cause 1 side to rip and require surgery and partially tear the other. That was treated (successfully) with a long series of walking aids such as walking boot, cast, specially fitted brace. It took a long time. I was the caretaker for my parents and still working, so a 2nd surgery wasn't in the cards.

My Mother had been diagnosed with PsA for many years, without psoriasis.

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Getting diagnosed with PsA

As a veteran I was able to see a VA physician. She was excellent. She diagnosed me with PsA and started an aggressive treatment with Enbrel. I experienced wonderful relief. Years went by and the Enbrel was discontinued and methotrexate added. I seemed to be controlled. I am also diagnosed with osteoarthritis and fibromyalgia, so pain is a constant.

Experiences with psoriasis

Last year at age 68, I had my 1st episode of psoriasis. On the back of my scalp. I wanted to rip my skin open to stop the itch. I was given a cream and eventually it went away. In the year since then, I have had minor episodes of psoriasis, mostly on my elbows. To my fellow sufferers - it is not fun.

Switching to a new doctor

My rheumatologist just retired and I saw a new doctor He seemed uncertain of my PsA diagnosis. I am now on injectable methotrexate and doing fairly well.

He talked about decreasing the methotrexate. I told him that had been tried before and resulted in pain and decreased movement. He did not change the dosage (thankfully).

I am okay re: no psoriasis right now. Unfortunately I have developed severe spinal stenosis and scoliosis, resulting in terrible pain. I am on big time pain meds, which I guess help a lot. It doesn't feel like it helps when sciatic pain starts (usually in the evening through the night). I get epidurals, but my spine has closed up so that the doctor can't get the needle where it needs to go. He recently tried on the other side with limited success... But that's another story.

More doctors should be aware

Back to PsA, Mom never developed psoriasis. She and I became very good at educating different doctors that you can have PsA and not have psoriasis. We wished that more doctors were aware of this.

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