Is it PsA? Needing relief

I am a woman that has had fibromyalgia on and off since 1998 until it became permanent starting in 2001. That is when I saw my first rheumatologist who diagnosed me with rheumatoid arthritis. For me, my toes, ankles, knees and elbows, wrists, and fingers feel as if someone is scraping the muscle just nearest the joint. I have been very flexible since the fibromyalgia started and tend to get a lot of joint injuries and tendinitis symptoms.

Experiencing lower back pain

About 5 years ago now, my butt started hurting. It turns out that the pain was actually in my SI joint or sciatica. Then my lower back became very painful due to my vertebrae being out of alignment causing muscle spasms and pulling my vertebrae out of alignment, which caused more spasms, etc. At the same time, I began to get migraines so often that I would wake up with one and go to bed with one. I couldn’t shake it. My saving grace and what has kept me mobile is morning and evening yoga.

It turns out that my doctor tested my blood in 2018 and my C-reactive protein value was very high and so I started on an anti-inflammatory. Why he didn’t discuss it with me or try to figure more out, I’ll never know.

Developing psoriasis

Then last summer I developed psoriasis lesions all over my body. Pretty much on every body part except my face. I even have it on my scalp (huge dandruff flakes and itchiness), and under my nails so that the nail peels away from the nail bed. It took about 4 months to get an appointment with a dermatologist, who diagnosed me and began treating me with Tremfya.

A week after my first shot, the psoriasis symptoms began to significantly dissipate, and in another week I woke up, got up and prepared to do my yoga, and realized with complete shock that my spine pain had nearly vanished. In another 2 weeks, the relief from both psoriasis and the back pain was back. But it did not seem to get as severe as before and I could do more things without having to stop, do a bit of yoga, lay on a heating pad, writhe...

After two more shots, the pain is completely back again after less than 3 weeks after the shot and I can feel my anti-inflammatory wearing off about 2 hours before I am due to a dose.

In the meantime, I have visited my dermatologist who is pleased with my level of psoriasis control (I sort of wonder if she should have her eyesight tested) and wants to stick with the Tremfya.

Working with a rheumatologist to get more answers

I messaged my new rheumatologist – the first that I had ever seen that actually listened to and believed me, who is not satisfied with my level of control. After the last time I saw her, she ordered a full spine and pelvis X-ray. It turns out that my lower back arthritis is osteoarthritis, I have scoliosis curving to the right/left in the lumbar region and scoliosis curving to the opposite side in the thorax region, and inflammatory arthritis to the neck. She said that it is really impossible to see tendon/ligament inflammation with an X-ray and the treatment wouldn’t change even if we found that inflammation.

Does this sound familiar to anyone?

Does it sound like psoriatic arthritis to anyone?

Could it be anything else?