Just getting started

[sailnavy]

So I've had psoriasis for the last 7 years or so (recently started spreading and now have at least one quarter sized spot on all limbs, some more), and last may I started getting neck pain.

I've changed mattresses, and have more pillows than I care to think about trying different combinations and permutations. The pain seems to have migrated to include knees, hands and wrists from the neck over the last 6 months. I originally thought it was some throat thing, but after reading about PA I'm thinking that is more likely.

My Derm wants me to see a Rheumatologist when I brought up the joint pain. My Primary Care Physician says RhFactor negative and no Sed Rate issues mean that I don't have arthritis, and since my fingers aren't "sausage like" and I don't have nail pitting so he doesn't think I have PA. I'm pretty confused, and wondering if I have a real problem, or am just whining.

My neck and knees have been pretty bad recently, to the point where I'm walking a little funny, getting up and sitting down carefully, and getting sharp pains like someone is driving a nail through my neck if I turn my head too fast. When I rotate my head, it feels like someone put sand in my upper spine, and if I move it fast, it can really hurt (nail). The knees feel like my knee caps might blow off when I'm going down stairs. Can anyone tell me if this is consistent with PA?

I haven't seen too many good descriptions of the pain, and I don't seem to have all the stereotypical signs (fingers and nail pitting).

I'm also randomly getting hives, and I'm worried that is in conjunction with the use of 600mg Ibuprofen before bed to stop the neck pain from preventing sleep.

What should I expect from the Rheumatologist appointment, I'm thinking xrays, or more? I just don't have a clear picture about what is used to make a solid diagnosis, and if the types of pain I'm feeling are consistent with PA.

Thanks for any words of wisdom. Seems like a lot of good info here.

[Ihurt]

Welcome to the forums! I know how you are feeling. I needed to know in the beginning what I was feeling too, and had no one to turn to.

My neck hurts whenever I turn to the left (they call this Pa spondylitis)
My knees, ankles,toes, especially at the back of the feet (achilles tendons) and heels (classic for PA)
Hands hurt at the tops, wrists ache terribly, elbows send jabbing pain.
Lower spine for me is the worst. Within 4 years I was dx'ed with severe degenerative discdisease. I also have the spondylitis, and have had epidural procedurs.



I had these sypmtoms for 13 yrs before finally getting dx'ed. All my ana apnels, RH, and all other testing was negative. I was finally dx'ed in 2004. I also have p. I was in a strong denial for a long time thinking I was a hypcondriac, and of course I was being told by all the docs who misdiagnosed me that it was "all in my head" for a long time.

YOU DO NOT HAVE TO HAVE nail pitting present to be dx'ed with pa. Many people will not and do not have pitting. A rheumatologist will test you for a genetic marker called HLA-B27 which is more times than not found in people with spondylarthropathies (Psoriatic arthritis, Ankylosing spondylitis, Reiter's Syndrome, etc).

From what you are describing you could very well have PA. I too broke out with Guttate before anythng else, and Guttate is strongly associated more so than other forms of p with PA,, although no one knows why.

A good Rheumy will use your exam, blood work, x-rays and history of P and anythng else ruled out to make his/her dx.

About the hives...it could very well be the Ibuprofen. Try something like Aleeve, use lots of heat, heating pads etc on your joints.,

I wish you luck at your Rheumy appt and again I welcome you to the forum. I hope you start to feel better really soon! PS: YOU ARE NOT WHINING.....your in pain.



Elaine

[nosirnotme]

Ignore what your doctor said about you not having arthritis. Let a rheumatologist make that determination. There are many types of arthritis. I believe some people have symptoms without the supporting bloodwork, so that doesn't mean the symptoms should be ignored. Also, not everyone has sausage like fingers. I can bend my fingers, but they hurt so I'd rather not bend them.

I imagine the doctor will want to do an x-ray or a CT-scan of your neck to try to figure out what is going on.

Good luck!

[Re]

Yes get a real doc. I have no pitting on my nails just on one big toe which I seem to lose the nail it is half way grown in now. I like Elain have the neck, knees, wrists, ankles, fingers, toes, lumbar (had 4 surgeries to figure that out with pedicle screws and rods) hip pain and flippin ribs to boot. Psoriasis is not all over but spotty here and there it is the itchy kind and I bleed. None in scalp but it always feels burnt when I brush it. Vision problems too. Some time the light bugs me so I have some of those fit over specs so I can see using my glasses, conjuctivitis, blepharitis and such debilitating pain in feet. Get a good doc....,.RHEUMATOLOGIST
Re

[sailnavy]

Good info, and I appreciate the help.

Re: Odd that you mentioned eyes. I've pretty much always been a bit light sensitive. Even in college (93-97) I had to be careful with too much bright sun. I'd get headaches. I don't know if that is associated or not, but recently (the magical last 6 months) I've had a couple bouts of what I thought was a stye in my eye. The eye lid was red and inflamed. It went away over time, and I just discounted it as a clogged pore or tear duct.

I also have a pretty good sized patch of psoriasis on my scalp. It's about softball sized, another one that grew out of my eyebrow and covers the bridge of my nose and my favorite is the one on the dividing tissue on the bottom of my nose, it always looks like I have something hanging out (priceless), or that I'm picking my nose (classic choice, do I pick or let it look like I have stuff hanging out).

My derm talked about putting me on Enbrel as soon as I mentioned the joint pain. I think he already thinks it's PA, and I think I agree. I do wonder if I should try methotrexate first (I'm a little afraid of the lymphatic cancer risks of enbrel, and seem to have a recurrent sore throat so I'm concerned about repressing the immune system).

When this all started I just assumed I was going to have sand paper elbows for the rest of my life. Now that it's grown out on my face and scalp, and the joint pain is starting, I've begun to realize just how serious it is. Thanks, I appreciate the feedback.

[sailnavy]

Good info, and I appreciate the help.

Re: Odd that you mentioned eyes. I've pretty much always been a bit light sensitive. Even in college (93-97) I had to be careful with too much bright sun. I'd get headaches. I don't know if that is associated or not, but recently (the magical last 6 months) I've had a couple bouts of what I thought was a stye in my eye. The eye lid was red and inflamed. It went away over time, and I just discounted it as a clogged pore or tear duct.

I also have a pretty good sized patch of psoriasis on my scalp. It's about softball sized, another one that grew out of my eyebrow and covers the bridge of my nose and my favorite is the one on the dividing tissue on the bottom of my nose, it always looks like I have something hanging out (priceless), or that I'm picking my nose (classic choice, do I pick or let it look like I have stuff hanging out).

My derm talked about putting me on Enbrel as soon as I mentioned the joint pain. I think he already thinks it's PA, and I think I agree. I do wonder if I should try methotrexate first (I'm a little afraid of the lymphatic cancer risks of enbrel, and seem to have a recurrent sore throat so I'm concerned about repressing the immune system).

When this all started I just assumed I was going to have sand paper elbows for the rest of my life. Now that it's grown out on my face and scalp, and the joint pain is starting, I've begun to realize just how serious it is. Thanks, I appreciate the feedback.

[ouchyk]

HI,

Here is a great post by Jesselou;

http://www.psoriasis.org/forum/showpost.php?p=74786&postcount=3


MTX works for a lot of folks, bios do too. Most doing well with no adverse reactions...

PA can be a puzzle to figure out, no one person fits into a neat package, that would also hold true for medications, our immune systems are as diverse as our DNA itself.

Hang in there, good luck.

Karen

[AnnieB]

Btw, methotrexate also affects the immune system. And they have to keep an eye on your liver function. You also can't drink alcohol. Too bad all the drugs have some kind of POTENTIAL side effects. That doesn't mean everyone reacts the same (except for that no drinking rule with MTX)

I am on Humira and the only problem I have had is getting some itchy injection site reactions that go away in a few days. I don't seem to be getting sick more than usual.

[Re]

okay, I used to think I would always have dry rough elbows too. Heck I could have even sanded paint or varnish off of any surface. I too always have a sore throat in the a.m. this a.m. the pt called to see if I wanted to come in 30 minutes sooner and she say gosh you sound like a guy this morning. I tell all it is my Kathleen Turner voice. lol I read that chronic fatique can often here are a few things that I found for you. one give an outline of PsA and the other talks about chronic fatigue
Re
http://www.medicinenet.com/psoriatic_arthritis/page2.htm
http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-topic-overview

[sailnavy]

That post from JesseLou is priceless. Outstanding information.

[DebraO]

sailnavy: I am sorry you doubt your own pain, but I did it too! I do not have sausage fingers and/or pitted nails. I do have P over 50% of my body and lots of stiffness and pain head to toe--prior to PA medication (now much better). There are uninformed doctors that look ONLY for sausage fingers and/or pitted nails, but you will find many folks on these boards with PA that do not have those specific symptoms. It is an easier and a quicker diagnosis if those symptoms are present and blood levels point to inflamation (SED rate)etc. But it is definitely not required.

The best advice anyone ever gave me about this condition and my pain/stiffness was, "Do not give up--it can take years to get a proper diagnosis."

[RichJ]

hi debrao and sailnavy,
welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

have a good night all

richard