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freds_got_slacks t1_iu66xcs wrote

Reply to comment by GypsyDarkEyes in Newly discovered species of bacteria in the microbiome may be a culprit behind rheumatoid arthritis by geoxol

just keep in mind there's two main types of arthritis; osteoarthritis and rheumatoid arthitis. Osteo is basically just mechanical wear of the cartilage as where rheumatoid is an autoimmune disease that attacks the cartilage.

this article is specifically talking about rheumatoid arthritis

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perrumpo t1_iu6cu16 wrote

There’s also psoriatic arthritis, which is worth mentioning because it can seem like rheumatoid arthritis. In fact, testing negative for the rheumatoid factor is one of the ways to help diagnose psoriatic arthritis and distinguish it from RA.

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odhali1 t1_iu6p9j6 wrote

I was diagnosed with PsA after years of aero-negative RA. Achilles tendinitis changed everything

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eatingganesha t1_iu6re6e wrote

And yet that’s not tendonitis. It’s enthesitis, which is a PsA thing that feels and acts like tendonitis. Entheses are where the tendon attaches to the bone. Hurts like hell and responds poorly to tendonitis treatment. Mine is plantar.

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perrumpo t1_iu6rfz7 wrote

Sorry to hear you’ve had so much trouble. That really sucks. I’ve had joint pain since I was a kid, and it got worse throughout adulthood. Finally in my thirties, I got diagnosed with PsA because my dermatologist noticed my nail pitting. Then I went to a rheumatologist. I had other symptoms as well.

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djkoch66 t1_iu6z3v1 wrote

After 15 years of a nonspecific inflammatory arthritis, I developed scalp arthritis. Now I’m off my old meds and on a new one that’s working. Freedom!

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newdaynewnamenewyay t1_iu7cx5g wrote

What is your scalp arthritis like?

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djkoch66 t1_iu7y21b wrote

It started in July 2020 and felt like I had acne patches on my scalp that were so itchy it would disrupt my sleep. I couldn’t see it and it took a few televisits to realize I needed to be seen face to face. Phototherapy helped get rid of it and then I started Otezla. Joints feel much better but my scalp gets itchy from time to time but that’s about it.

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dmf109 t1_iu7cfgj wrote

I have psoriatic arthritis. Not fun. It’s a weird disease; one day I have crippling pain in hands and feet, then another no pain at all. Weird too: getting up in the morning hurts like hell, but it can be gone in hours after using the joints. I just did some jogging, then had nearly a week with no pain. Such a strange thing.

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Snake57 t1_iu85nsf wrote

You are describing my exact symptoms, but I haven’t gotten any diagnosis yet. One day I feel like I’ve lost like 50-60% of my grip strength, the next it seems fine (I have Psoriasis as well).

I used to weightlift pretty intensely for a while about 8-12 months ago and figured I just overdid it, but the pain never went away after I stopped because of it.

I have an appointment at a Rheumatologist soon in the hope that they can figure out what’s wrong.

Can I ask what they checked to diagnose it? What did they suggest for treatment? Have you noticed anything helping, or making it worse?

Sorry for the many questions, your description just hit the nail on the head for me, and I’m just hoping to be able to find some kind of treatment.

Thank you for sharing!

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dmf109 t1_iu8gti4 wrote

Mine started as psoriasis back in 2011. I had patches on my legs and scalp. It was annoying, but manageable. I also had frequent pain and swelling in one pinky toe, with on/off hip and wrist pains. I was also a heavy drinker.

I started doing a lot international work with lots of travel and stress. I was in a hotel room hungover one morning in the fall of 2014. I woke in lots of pain. Both feet and ankles were swollen. Most toes were stiff and swollen. I started getting pains in various joints.

I got back home and saw a doctor. They diagnosed as psoriatic arthritis due to my psoriasis and the swelling of toes.

I went on methotrexate first. I also stopped drinking (8 years yesterday). The methotrexate knocked down all the swelling and eased some pain, but did nothing for the psoriasis. That was fall of 2014.

Sometime in 2015 I switched to Enbrel. At that point, I still had skin issues and lots of pain, but little swelling. The Enbrel seemed to help a little, but really not much, and also did nothing for my skin.

In 2016 I switched to Stelara. That helped the pain AND completely cleared up my skin. No more swelling, but still morning stiffness and occasional flareups of pain.

About 3 years in, the Stelara just stopped working. My skin was always great, but my pain and stiffness increased, especially in the morning.

I switch to Cosentyx in December 2019. That felt like when I started Stelara, but even that has stopped being as effective. I have some skin issues on my scalp now and the arthritis can be severe in the morning. I’m looking at options for what I can do next.

I find exercise helps a lot. Mornings are horrific, with intense pain in feet and hands. But it goes away as I move. But sometimes the pain lingers all day like a toothache.

My plan now is to exercise more and stretch. I’ve found stretching at night right before bed helps with the mornings.

It’s a scary disease in how variable it can be. It really makes me wonder how much time I have left.

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tankuall t1_iu9uwv1 wrote

Do some reading on Tremfya. I've been on Humira and Cosentyx. Humira only provided marginal improvements, so I switched to Cosentyx, worked great for about two years, then stopped working. So far Tremfya has been working great for a year and has provided me with much more relief than the Humira or Cosentyx. Definitely worth looking into.

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Maleficent_Soft4560 t1_iu96w75 wrote

For me, my PA was made worse by taking anti-inflammatories (e.g., ibuprofen, NSAIDS, methotrexate, etc.) They would work, but when they started to wear off and it was time for another dose, the inflammation was debilitating. It got to point where I had to take the medication right before bed and get up early before it wore off, otherwise it was a struggle to get up in the morning to take more medication. Well, I worked with my doctor and got off the medications and started making time for light exercise (e.g., going for a walk) everyday. I also looked for ways to reduce stress and not sit at a computer all day. I also started applying nail conditioner to fingernails and toenails because I also have the nail issue with psoriasis. I started doing these things about 15 years ago. I’m still dealing with the psoriasis, but the PA doesn’t give me much trouble these days. If I do have a bit of a flare up, I try to think back a couple days and figure out what may have triggered the flare up and try to adjust my routines to avoid the triggers. The biggest part for me was actually getting off the anti-inflammatories. I know it won’t work for everyone, and you should consult your doctor before altering your medication plan, but it did work for me.

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FlamingButterfly t1_iu96cub wrote

I have been having almost the same exact issues, I have days where I hobble around at work and then a few days later I'm fast walking everywhere without any pain. I described it to my doctor as being like waves, sometimes it recedes but it can come back hours or days later and this rash near my eyes isn't going away but at least it hasn't flared up as bad.

After getting minor improvements with the rash and no change to the pain when it shows up I'm finally convinced to tell my rheumatologist since he already treats my fibromyalgia.

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my5oh t1_iu6fixr wrote

Psoriatic is often in conjunction with psoriasis. With RA they aren’t testing for a rheumatoid factor. They test for inflammatory markers. And it is possible to be diagnosed with RA without having any inflammatory markers. It is called seronegative RA.

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perrumpo t1_iu6iare wrote

It is possible to have psoriatic arthritis without any psoriasis rashes on your skin, which is the case for me. Nail psoriasis, such as pitting in your nails, is another sign and there are others.

They most certainly do perform rheumatoid factor tests. I had those tests done for it. I realize that’s not the only tests though. But my point anyway was about distinguishing PsA from RA, not how to diagnose RA.

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Hoarfrosty t1_iu6m2hr wrote

I have PSA. Sucks. My skin is good except for 3 knuckles and my lower back. My joints are in hell.

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Sheeple3 t1_iu78145 wrote

Have you tried working out? Mainly strength training, not running/traditional cardio. I have it too and when I started working out it was painful, but after awhile my joints felt better than ever! Probably due to the muscles doing more of the work and taking the strain off the joints and movement lubricates the joints as well. Start with really low weights and if an area is bugging you just do less reps or drop the weight even lower that day. Also with arthritis it’s important to not workout first thing in the morning when you’re stiff, your joints need time to warm up.

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mazurzapt t1_iu7f7lh wrote

I have some kind of arthritis- fingers wrists have been itching like crazy. For some reason I wondered if weights would help.

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perrumpo t1_iu6rjo8 wrote

I’m sorry to hear that. The joint pain really is hell indeed. Started when I was a kid.

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eatingganesha t1_iu6r4q5 wrote

Yup same. Have no psoriasis on my skin, just nails. Was dxd in June with PsA after testing negative on RF, positive on inflammatory markers.

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NasusSyrae t1_iu6yhio wrote

I went through a similar process. Are you on any sort of immunosuppressant or just taking anti-inflammatories if you don’t mind me asking. Has your treatment helped at all with pain if you are on anything?

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odhali1 t1_iu6pg5b wrote

Pitted nails for years now diagnosed with PsA

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perrumpo t1_iu6s298 wrote

That’s what happened with me, too. My primary physicians never figured out my joint pain, and then the first time I went to a dermatologist, they noticed the pitted nails. Rheumatologist after that, and I had other signs of PsA.

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Pickleodeon09 t1_iu6vmng wrote

Hi there, I'm going to my first rheumatologist appointment next week for some weird ongoing pain I've been having. I guess they'll do a bunch of test, but I have some significant dips that run horizontally across my finger nails. Is that similar to what you have? And what other symptoms alerted you to your diagnosis? Thank you!!

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perrumpo t1_iu6zaow wrote

Hello, the horizontal dips in your nails that you describe are different from the nail pitting I have. The nail pitting is like several tiny dot-shaped depressions in all fingernails.

I do not have all of the possible signs and symptoms of psoriatic arthritis, but the ones I do have are nail pitting, joint pain in fingers (they imaged my hands because of this to distinguish from osteoarthritis, and it is also not typical of RA), ankle pain, foot pain, plantar fasciitis, lower back pain, and a negative rheumatoid factor test.

Good luck with your appointment!

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my5oh t1_iu6o2ts wrote

I said often, I did not say exclusively in psoriasis patients. And there was never a rheumatoid factor test. Your doctor may call it that, but they are testing for the inflammatory markers. I have RA and have been on Humira for it for a couple years now. And I wasn’t talking about how to diagnose, I was adding to the point that you can show negative but still be diagnosed with something. And that it has an actual name, not just a misdiagnosis for another form of arthritis.

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perrumpo t1_iu6qowa wrote

Sure, but I wanted to clarify for anyone reading the comments that you can have psoriatic arthritis without psoriasis. That is part of what makes PsA hard to diagnose and to distinguish from RA.

I believe you that there are tests for inflammatory markers, but there are also antibody tests, including RF. Here is a quote from rheumatoidarthritis.org:

> “In most cases of rheumatoid arthritis, the patient tests positive for rheumatoid factor (RF) and/or anti-citrullinated peptides (CPP) antibodies.”

They have a whole page about the RF blood test, so I don’t know what else to tell you. I’m not a physician.

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CrazyCatLushie t1_iu7k8f5 wrote

And don’t forget ankylosing spondylitis, an auto-immune arthritis of the lower spine! It often co-occurs with both rheumatoid and psoriatic arthritis. I don’t recommend it.

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soulsteela t1_iu86f38 wrote

I have this bad boy with a nice side of Crohns collitus, hobbling to the bog in agony then not being able to sit due to agony in hips , breakfast of champions.

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reallyserious t1_iucsyim wrote

For those that are unaware, /r/ankylosingspondylitis exists.

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[deleted] t1_iu6ksgg wrote

And infectious too right? The one you can get after certain diseases no?

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perrumpo t1_iu6r2fn wrote

I think some infectious diseases worsen psoriasis but aren’t the cause of it. It is believed to be genetic, and the cause is not well understood.

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liltingly t1_iu6zofq wrote

I guess GP was meaning “rheumatic” arthritis not RA. That categorization subsumes PsA. I have enthesitis in my knees and ankles, as well as SI inflammation. Doctors keep shifting my diagnosis around from PsA to spondyloarthropathy etc since there’s no smoking gun. I generally just say I have a rheumatic disease as they treat it with the same biologics

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Devine116 t1_iu7oyuw wrote

RA also attacked the synovial fluid in the tendons causing inflammation.

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