CAN PA JOINT DAMAGE BE REVERSED

[Caroli]

(((Friends)))

my latest question i posed to my rheumy last visit was can joint damage from PA be reversed. his response was "yes".

i have started this thread to ask you all what your experiences are in joint damage reversal. should our treatment goals not only strive for pain relief, prevention of further joint damage, improved mobility and function, but include reversal of existing damage? i guess this question depends on the extent of damage already done but i wonder at what point can the body no longer repair the damage. have any of you experienced this?

[ouchyk]

My rheumatologist told me " joint " damage, as in erosion, bone remodeling etc cannot be reversed short of surgery.

Not sure if your talking soft tissue stuff ? tendons, bursea, ligaments?

I have friends who have had joint replacements/need joint replacements...my uncle has one damaged joint ( he's been in remission for 30 years ) that needs surgery....although he said it doesn't bother him so why go thru it. I've seen two spine surgeons to see if there was anything they can do for me hoping that my lower lumbar was mechanical in nature - it's not - its PA.

so I really am not sure what you mean Caroli.

Thanks. good thread to start.
Karen

[Mybadgenes]

In my case the joint damage to my hands cannot be reversed. You will know when this happens. I need joint replacements in the left thumb and possibly the right and most definitely in the right "pointer" finger.

My left thumb was unbearable for a time and was near surgery time when I broke my shoulder and put up with that for two years. Meanwhile the thumb settled down into a somewhat useless state (using the two middle fingers to grasp things). It is always swollen and sometimes numb but not painful like it was. So I will leave it alone. I just moan with my right hand.

The pain to other joints come and go....notably toes and ankles. Right now my lower back is giving me constant fits and the right lower rib cage. Those never go away.....just different pain levels. The knees are holding up pretty well so far but do a "remember me" yell occasionally.

Of course I am older.... :) .... and that has made a difference to me. And today will be an Etodolac day to help me get through recovering some chair seats.

If your rheumy says a biologic will stop....slow....or reverse joint damage I would go for it. No, I do not take one at this time.

Be well,
Juanita

[Momelie]

Unfortunately my joint damage is not one that can be reversed. Mine is in the pinky and index fingers of my right hand and my SI joints. From the time the symptoms appeared until my actual PA diagnosis was about a year. I was treated for carpal tunnel with trigger fingers, and even had the surgery. It was in the recovery room from that surgery that the hand surgeon decided to send me to a rheumatologist.

I went through over a year of rheumy treatment totally fixated on getting back the use of those fingers. The day I learned that it would never get any better, and that all the treatment I'd been getting (and would receive in the future) was to prevent further damage, something just "plopped" in my gut, and it made the whole disease seem so much more real and nasty. Until that point, the thought of my fingers being permanently changed was just totally unreal to me, and I thought if I could just find the right treatment, then I could get back to "normal." I've since had to adjust to the concept of a new "normal" and am very happy to have found a treatment regimen that keeps me going, and doing most of the things I want to do. I still have some flares (stress is my biggest trigger), but for the most part I'm doing OK.

For instance, even with PA in my hands, knees, ankles, feet and (my worst spot) SI joints, I recently returned from 8 weeks in Italy, attending grad school in Florence, and basically travelling all over the country. My roomate and I (another 40ish mom) wound up being best buddies with 4 20 year old guys, and they dragged us all over the place. The only thing my PA kept me from doing was climbing to the top of Florence's Duomo (463 steps each way). I did the catacombs outside Rome, cliff-dived in Cinque Terre, hiked in Sorrento, went over every inch of Pompeii (well, I fell there, but recovered quickly), and walked many, many miles of museum and landmark miles. I did have to take many NSAIDs (no such thing as hot showers, LOL), but very few flares and no problems.

I guess to answer your question, yes, I have joint damage that can't be reversed, but all other treatment goals are being accomplished, so I'm satisfied that this is as good as it gets, and making adjustments where needed.

[AnnieB]

I was lucky enough to be diagnosed with PA before it permanently damaged my joints--as in the actual bone. Most of my pain was from tendon inflammation. So that has improved greatly with Humira. As mentioned, there is some damage that is permanent.

It took me a while to get diagnosed because whenever I had xrays (for trigger finger and foot problems) nothing would show up as "arthritis"--it was all soft tissue problems. My feet still have pain, but I wear orthotics to take the pressure off the forefoot.

PS: I also had trigger finger surgery which worked out fine. The surgeon noticed a lot of inflammation, which was an early clue as to my having PA--he tested for RA and it came out negative. At the time, I didn't mention my P and he didn't notice it because it was mostly out of sight.

[SandraJean]

Hi,

I'm one of those that have had paperment destruction of my knee joints. Unfornutely my knee's have gone now to a permantely fused bent position that can not be corrected with any surgery. I'm in a wheelchair asI can not walk.

Sandy

[princesstwinsmom]

I was under the impression that once the joint is damaged, it's irreversible. Like AnnieB, I was fortunate enough to be diagnosed very early - before any permanent damage was done. My rheumatologist did take a series of x-rays at my diagnosis appointment to give her a baseline of where my joints were at that time so we can track any deterioration. She has told me several times that her "goal is perfection" and she treats PA aggressively in order to completely alleviate pain and restore full function and mobility.

[LoriASoCal]

My doctor said surgery might improve some of my joints but not others. And I'm not a big fan of back surgery so for now that is out. I guess that brings up a question that has been in my mind. Are most people happy with the results of their surgeries? Was it worth it in terms of your recovery time versus regained mobility? Did your problems come back?

[AnnieB]

The only thing I had done was a "trigger finger release". It was outpatient and didn't take long. I was awake for it (local) and then had to wear compression for about a week. It worked really well. But that was more a tendon problem--not the actually joint.

[wthiwwm]

My right knee is completely destroyed and I have a major flexion contracture. So I walk with my knee bent. The only way that's the damage is reversible now is to have a total knee replacement. I'm holding off as long as I can right now because I'm still fairly young to have one.

[nla]

I have always been under the impression from my rheumy that "permanent" damage is just that...."permanent". I have permanent damage with disfigurement in 4 fingers which (according to my doctor) cannot be reversed. But, I have been on Enbrel for 3 1/2 years now to slow and prevent that type of damage in my other joints.

I'm curious....ask your rheumy why they call it "permanent".

Nancy