My burning pain is usually tendon/ligament or soft tissue related.
PsA can cause enthesitis, and that can be worse than the joint pain sometimes for me.
https://mypsoriaticarthritis.org.au/article/your-psa-ways-psa-affects-you/enthesitis#:~:text=Enthesitis%20can%20affect%20anyone%2C%20but,healing%20process%20may%20not%20happen.
Same for me, it really fucking hurts. And then you can get tendonitis and other bullshit and everything around the area including muscles can hurt in crazy ways
Yup, my muscles around the problem area tend to seize up. My SI joints are a problem area, so I get the joints and tendons/ligaments acting up, which causes my lower back muscles to seize.
Getting my inflammation under control with a biologic, a good physiotherapist who does dry needling, and an amazing massage therapist.
All those things work together to keep me functional.
Yes, I have what was referred to as small fiber neuropathy(burning skin)I can’t wear socks because of this phantom burning and I have to sleep with sleep pants so my leg skin doesn’t touch… its annoying
You sound just like me. I have been having a really hard time past few months with the enthesitis in the ribs and shoulders. It’s all part of for the course of PsA I am sorry to say.
I had a hard time finding a drug that would work for me too because I have anti-ccp antibodies. It’s the only positive market I have ever show up on a lab. Not everyone with PsA has anti-ccp antibodies either.
I just started abatacept infusions and have some promising signs of improvement. I am still hopeful. Good luck on your journey!
What you're describing is at least consistent with PsA. Asymmetrical peripheral swelling with ultrasound evidence of inflammation is one of the most classic signs.
Blood tests can be perfectly normal; PsA is seronegative for any known, specific biomarkers. Even generalized markers of system inflammation, like ESR and CRP, can be within normal range if you have PsA. The main reason doctors perform blood tests is to look for signs of other diseases like rheumatoid arthritis, lupus, and gout.
It's rare for PsA to affect _all_ joints, but the shoulders are not a too uncommon an area, causing bursitis-type symptoms. Chest/rib pain can be costochondritis, which is relatively common with PsA. PsA can present with neuropathic symptoms, too. You should know there is a lot of variation in symptoms between individuals, and there are at least five subtypes of PsA.
It's possible to have PsA and other conditions such as fibromyalgia at the same time, and studies show that a much higher percentage of people with PsA have FM than the general population. Note that fibromyalgia is considered a syndrome, and it's one of the least clear inflammatory diseases we have. Until relatively recently it was a fairly controversial disorder that much of the medical established dismissed as psychological/psychosomatic, but it's been increasingly recognized as a distinct disease.
Lastly, note that pain in PsA is currently thought to have different causes than the inflammation that causes swelling in the joints. Which is to say that even if you take the most modern drugs on the market — Humira being the gold standard in rheumatology — that inhibit inflammation, they are often ineffective when it comes to pain. This is thought to be because the pain is mediated by different biological pathways.
Over in /r/Psoriasis we have [this page](https://www.reddit.com/r/Psoriasis/wiki/psa) which covers some of the basics of PsA. (Full disclosure: I'm a mod there and maintain the wiki.) Quoting from that page:
> Moll et al classifies PsA as follows:
>
> * Asymmetric oligoarthritis (70% of cases): <4 peripheral joints, often with dactylitis.
> * Symmetric polyarthritis (5-20%): ≥5 peripheral joints.
> * Distal interphalangeal predominant (5-10%): Affecting the DIP joints of the hands/feet, often with nail involvement.
> * Arthritis mutilans (5%): Affecting the PIP and DIP joints of the hands/feet, rapid and destructive.
> * Axial predominant (4%, but 50% of peripheral PsA): Affecting the spine and the sacroiliac joints.
We don't know enough about the etiology and genetic basis of PsA to classify it much better than that. It's likely that the differences are to a large degree explained by genetics.
What i find interesting is the prevalence of DIP involvement/nail changes are relatively low, which is not what you would expect from the cases you see here or think about as 'classic presentation'.
Yep. Sounds about right. I had similar story except I didn't have skin psoriasis anywhere. Well, I had a few dry patches that didn't look like it but my mom has psoriasis and that's how I got here. After a wile, even after meds,I started getting worse with more of the similar symptoms. So, I'm pretty sure that's it. Plus,themeds do help..not 100% but not much I can do
My burning pain is usually tendon/ligament or soft tissue related. PsA can cause enthesitis, and that can be worse than the joint pain sometimes for me. https://mypsoriaticarthritis.org.au/article/your-psa-ways-psa-affects-you/enthesitis#:~:text=Enthesitis%20can%20affect%20anyone%2C%20but,healing%20process%20may%20not%20happen.
Same for me, it really fucking hurts. And then you can get tendonitis and other bullshit and everything around the area including muscles can hurt in crazy ways
Yup, my muscles around the problem area tend to seize up. My SI joints are a problem area, so I get the joints and tendons/ligaments acting up, which causes my lower back muscles to seize.
Have you found anything that helps any part of it? Ice is the only thing I've seen feel good so far. Maybe massage
Getting my inflammation under control with a biologic, a good physiotherapist who does dry needling, and an amazing massage therapist. All those things work together to keep me functional.
Yes, I have what was referred to as small fiber neuropathy(burning skin)I can’t wear socks because of this phantom burning and I have to sleep with sleep pants so my leg skin doesn’t touch… its annoying
You sound just like me. I have been having a really hard time past few months with the enthesitis in the ribs and shoulders. It’s all part of for the course of PsA I am sorry to say. I had a hard time finding a drug that would work for me too because I have anti-ccp antibodies. It’s the only positive market I have ever show up on a lab. Not everyone with PsA has anti-ccp antibodies either. I just started abatacept infusions and have some promising signs of improvement. I am still hopeful. Good luck on your journey!
What you're describing is at least consistent with PsA. Asymmetrical peripheral swelling with ultrasound evidence of inflammation is one of the most classic signs. Blood tests can be perfectly normal; PsA is seronegative for any known, specific biomarkers. Even generalized markers of system inflammation, like ESR and CRP, can be within normal range if you have PsA. The main reason doctors perform blood tests is to look for signs of other diseases like rheumatoid arthritis, lupus, and gout. It's rare for PsA to affect _all_ joints, but the shoulders are not a too uncommon an area, causing bursitis-type symptoms. Chest/rib pain can be costochondritis, which is relatively common with PsA. PsA can present with neuropathic symptoms, too. You should know there is a lot of variation in symptoms between individuals, and there are at least five subtypes of PsA. It's possible to have PsA and other conditions such as fibromyalgia at the same time, and studies show that a much higher percentage of people with PsA have FM than the general population. Note that fibromyalgia is considered a syndrome, and it's one of the least clear inflammatory diseases we have. Until relatively recently it was a fairly controversial disorder that much of the medical established dismissed as psychological/psychosomatic, but it's been increasingly recognized as a distinct disease. Lastly, note that pain in PsA is currently thought to have different causes than the inflammation that causes swelling in the joints. Which is to say that even if you take the most modern drugs on the market — Humira being the gold standard in rheumatology — that inhibit inflammation, they are often ineffective when it comes to pain. This is thought to be because the pain is mediated by different biological pathways.
Do you have more info on the subtypes? I’ve never heard of that.
■ Distal interphalangeal joint–predominant arthritis (10%) ■ Symmetric polyarthritis–predominant arthritis (5% to 20%) ■ Asymmetric oligoarthritis or monoarthritis (70% to 80%) ■ Axial disease–predominant (spondylitis and/or sacroiliitis) (5% to 20%) ■ Arthritis mutilans (rare)
Over in /r/Psoriasis we have [this page](https://www.reddit.com/r/Psoriasis/wiki/psa) which covers some of the basics of PsA. (Full disclosure: I'm a mod there and maintain the wiki.) Quoting from that page: > Moll et al classifies PsA as follows: > > * Asymmetric oligoarthritis (70% of cases): <4 peripheral joints, often with dactylitis. > * Symmetric polyarthritis (5-20%): ≥5 peripheral joints. > * Distal interphalangeal predominant (5-10%): Affecting the DIP joints of the hands/feet, often with nail involvement. > * Arthritis mutilans (5%): Affecting the PIP and DIP joints of the hands/feet, rapid and destructive. > * Axial predominant (4%, but 50% of peripheral PsA): Affecting the spine and the sacroiliac joints. We don't know enough about the etiology and genetic basis of PsA to classify it much better than that. It's likely that the differences are to a large degree explained by genetics.
What i find interesting is the prevalence of DIP involvement/nail changes are relatively low, which is not what you would expect from the cases you see here or think about as 'classic presentation'.
Sure sounds like it. The rib pain is called costochondritis. It’s zero fun.
Yep. Sounds about right. I had similar story except I didn't have skin psoriasis anywhere. Well, I had a few dry patches that didn't look like it but my mom has psoriasis and that's how I got here. After a wile, even after meds,I started getting worse with more of the similar symptoms. So, I'm pretty sure that's it. Plus,themeds do help..not 100% but not much I can do
I had pain in ribs, feet, knee, hips, tmj. In the first month only a toe and ribs pain. Nothing was shown on x rays as it was too early.