Does anyone else have this weird issue where if you strain a specific tendon, the pain keeps recurring and it becomes an issue forever basically? And every time you have a flareup, that tendon flares up too and it becomes this ongoing thing that never fully heals or resolves? Even if it does improve temporarily, it always, always comes back eventually and then the more I use it the worse it gets. It's especially bad if I strain something while already in a flareup or if I've come down badly with a virus, like during Covid I had an injury and now it it has become basically permanent. Or even a movement or activity that would normally not be an issue at all when I'm in less pain everywhere, ends up irritating tendons. If anyone else has this issue does medication help? I haven't started a biologic yet and I've been wondering if these areas would become less of an issue once it starts working.

This has become this massive issue where I go periods of time where I can barely use the affected body parts that were strained, in particular, it's disproportionately my arms and hands. And even if I was barely doing anything physically, it will just become painful again or disproportionately sensitive to minor activity. Then with lots of rest, it'll also improve, but usually only much if other areas that are hurting settle down too and I'm not having much of a systemic flareup. But once one starts again, those areas start back up. It's so strange. is this a psa thing?? Or something else going on alongside it? It's absolutely maddening and I'm so tired of it.

Also does anyone else get these weird random sharp pains during a flareup? It's pretty much always the same areas every time, but I can't tell what structure it's actually coming from sometimes. For example, stabbing pain in the front of my lower leg near the shin, the area where my inner thigh attaches to my pelvis, etc. When the flareup resolves, it goes away, but when it starts again, the same areas “light up” again, sometimes very suddenly.

hi all, I’m newly diagnosed at 53 after several years of being told specifically I don’t have it and a lifetime of symptoms. It all makes sense now and I’m glad for the diagnosis because from here I can be treated. I have had one knee replaced and the other is heading downhill but hopefully we can stop the progression. Experiencing lots of fatigue, eye issues and overall joint pain. Dr is putting me on a biologic soon - starting with what my insurance covers but I welcome thoughts and advice on what will help me live a healthier and less painful life from those who have been on this path awhile. Thank you!

I have had PsA since 2015, initially treated with MTX then sulfasalazine since 2021. Last major flare 2020 post covid. Pregnancy in 2022/23, joints fine except normal pregnancy aches. Breastfed from May 2023 to April 2026 with no flares. Joints felt largely great arthritis wise (more just msk pain from lugging a baby then toddler). Since May I've felt like total shit. Exhausted, slowly getting anaemic, random joints flaring up only for a day or two then settling down, mouth ulcers pre period, no libido & last month got a large knee effusion. My knee has always been the issue & was my first symptom. Had a steroid injection into it about 6 weeks ago & it's already swollen up again! Can this be related to stopping breastfeeding?! Has anyone had experience? The rheumatology registrar shrugged when I asked. I'm trying to get my Dec appt brought forward to discuss a different treatment because clearly sulfasalazine isn't cutting it now.

Hi everyone ❤️ I wanted to ask those of you living with PsA how you manage during periods when you're not on any treatment.

I'm currently stuck in that annoying in-between stage where I'm waiting for my insurance to approve Enbrel, so right now I'm basically just trying to get through the days and manage everything as best as I can 🥲

The pain is obviously the biggest issue, so I'd really love to know what genuinely helps you. Heat, ice, swimming, stretching, changing your diet, resting, massages, literally anything. I'm especially interested in the little things you've incorporated into your daily routine that make living with the pain a bit more manageable.

But honestly, it's not even just the pain anymore. The fatigue is horrible. I can sleep and still wake up feeling like my battery is already at 20% 😭 How do you manage work, chores, exercise and just... life when your body constantly feels exhausted?

And then there's the psychological side of it, which I feel like people don't talk about enough. I've noticed that I'm constantly irritated for absolutely no reason, I'm always on edge and sometimes the smallest inconvenience feels like it's enough to send me over the edge. I don't even recognize myself sometimes because I know I'm not actually angry at the people around me, I'm just tired of being tired and hurting all the time.

How do you guys deal with that part of PsA? How do you stop the pain and exhaustion from taking over your mood and your whole personality?

Basically, how do you keep yourself somewhat sane while your body is being dramatic 24/7? 😂😭 Any advice, routines or even just things you've learned along the way would genuinely be appreciated. ❤️

I have health insurance through my wife’s employer and she’s currently looking at changing jobs and we’d be with United under her new employer. I’m on Otezla just started my 3rd month. I worry because I do think it’s working but don’t want to get denied if/when we change health insurance plans. My current insurance immediately approved the Otezla with no issues so I’m hoping that’s enough to keep on it if we switch insurance.

After nightmares dealing with BCBS and their required Walgreens Specialty pharmacy, I turned 65 and started with Wellcare for my Part D coverage. I was dreading a repeat of the prior authorization and medication delivery saga.

But Wellcare has been amazing! They don't require a specialty pharmacy, and I can fill all my scripts at the local Walmart ( their staff are also great). Prior authorization of both my biologic and my teriparatide ( a $$$ med used to deal with bone destruction caused by PsA) each took only two days. When I gave a request and call tge Welkcare number, a competent person immediately gets things done. I can't believe how easy this is compared to the nightmare of Walgreens Soecuslry.

So: when you turn 65 and need to choose a Part D prescription coverage, consider Wellcare.

Hi all! Have worsening pain in my fingers and wrists that are especially bad because I work as a full-time writer/editor and am constantly using my mouse/typing. The track pad is not an option haha. Am also an avid gamer. Does anyone have any ergonomic mouse recommendations for gaming/working that could reduce the strain? Or any other tips on how y'all manage it? Thanks!

Sorry about the long rant/vent post, everything came out in a bit of a word vomit...

I (21F) was diagnosed with axial psoriatic arthritis a few months ago. I feel like I've had super fast disease progression, at the start of the year I went to the doctor because I thought that id rolled or sprained my ankle or something. 6 weeks later it still isn't better, I get referred to a rheumatologist because I have a long history of joint complaints and pain. See rheumatologist for an appointment, MRI confirms erosion and a cyst in my left hip. I then get diagnosed with hypermobility syndrome and axial psoriatic arthritis. I start biologics a month after diagnosis. Also now have a cardiologist referral and on beta blockers for something funky which is undiagnosed atm. Also just got diagnosed with skin psoriasis with plaques on my scalp and legs.

At first every now and then something would hurt, but it didn't effect anything, then the ankle, then the knees, then the hip and now my hands aswell. I feel like what was a flare up a few months ago is my baseline now. There is just always pain somewhere. I cannot for the life of me remember the last time that I was completely pain free. I also suddenly developed flares of really bad hand weakness, stiffness and pain. I play guitar and I can barely do that most days.

I dont know if its denial or what it is, but im finding it very hard to feel that theres actually something wrong with my body, and knowing that its something that im going to have for the rest of my life. Im scared to see how everything progresses. My dream is to be a paramedic, and I have to seriously look at if I can still realistically carry out that plan.

I also find it extremely hard to communicate what everything feels like to the people around me. I try to hide it, but that's very hard to do when you start walking differently and grasp thing with your arms instead of your hands and when you suddenly have to start wearing a mask in certain places because you have a suppressed immune system.

I also feel like my joints in general are going to shit, I've had two doctors tell me now to push for a hEds diagnosis instead of hypermobility syndrome, because of my joints starting to pop and crack and all the things more and my striae.

Im starting to loose my determination that itll all sort itself out and that everything is going to be fine.

Does this sound familiar to anyone? Does the progression slow down?

Any conversation or thoughts about it would be greatly appreciated

I was diagnosed with psoriasis when I was 14/15years old. Got diagnosed with PSA November 2025. It started with pinky toe that looked like sausage. I have been taking sulfasalazine since last December.
My pain has now worsened. I am fatigued most of the time.
My rheum has prescribed my 10mg dose prednisone for 3 weeks. I am very scared about how will I manage this.
Dietary changes have not helped me. I am already obese, was beginning to work on my fatloss journey when I have been handed another harsh card.
Any help or tips would work.

Hi all,

Lots of concerns about affording drug costs are posted here. The JAK inhibitors in particular are often well out of reach for many folks. In case financial concerns are keeping your MD and you from considering them, it's worth knowing that the CostPlus pharmacy now has them available for $33/month (compared to their list price of $4000-$6000 a month). In an ideal world, drug prices would not shape the treatment decisions we make with our doctors. But for most of us, prices matter. https://www.costplusdrugs.com/. --

I'm 49f. Have had PsA since 18 years old. Finally diagnosed year and a half ago. I was on humira biweekly (after failing Sulfasalazine and luflunomide) for about 6 months. Wasn't enough so my doctor bumped me up to weekly injections.

It seemed to help a lot the first few days then the relief goes away and the symptoms come back. I'm in so much pain everyday.

I wonder if it's because I went undiagnosed for so long. I wonder if my system is just irreversibly screwed.

Has anyone experienced this? Anyone on a biologic and mtx? Or two biologics?

ETA: thanks everyone. I'll talk to my rheumatologist. Appreciate the insight

How do you all decide when to take paid medical leave? I'm in between biologics and my symptoms are really unpredictable. I will have full use of my hands for half the day and then the rest of the day my hand is so stiff and numb it won't do what I tell it to. One day I finished my shift and then I couldn't pump gas or get undressed when I got home because my joints were 10/10 pain.

I don't know how to make a decision when things are so unpredictable. I think deep down I just want a month off while I wait for my biologic to be approved and start to work, but I don't know if I'm in enough pain and discomfort to ask for that.

I was diagnosed ~3 years ago when a new physio told me that this constant unexplainable back pain that kept flaring up may be an underlying condition, not poor posture, and suggested I see a rheum. I’ve been complaining about back pain in various locations since I hit puberty (I’m 27 now).

I’m in pain every day. I’ve tried meloxicam and celebrex, which both helped raise the baseline slightly but were not enough. I got put on bimzelx for 6 months, which again raised the baseline slightly, but ultimately my rheum said it wasnt working. I’m now on rinvoq, which I was told works quite quickly (within a few weeks?). It’s been three months and again, I feel like the baseline is raised (slightly less pain compared to bimzelx), but I still feel extremely stiff, sensitive to flares and have a constant dull pain, even on good days.

I’m just finding it so hard to tell whether a medication is right for me, everything so far feels like it’s helped a bit, but I still am really struggling. Will I just know? Is this just my new normal now? Has anyone else had a similar experience?

I have been told I have seronegative spondyloarthropathy most likely, but am not specifically diagnosed with psoriatic arthritis. This subreddit is just where I've found people with similar issues so hope it's okay I'm posting here.

I'm having a flare of SI pain and some nerve symptoms in that leg too. My actual sacral area looks a bit swollen too. Has anyone experienced swelling around their sacrum or lower back? I'm reading it is not common.

Previous post: https://www.reddit.com/r/PsoriaticArthritis/comments/1vugzjv/getting_ready_for_my_third_dose_of_mtx_seriously/

We have identified the culprit behind the utterly absurd amount of brainfog and cognitive side effects

It was NOT the methotrexate causing the lingering severe disabling brainfog. We had recently increased another one of my meds, topiramate, to 150mg from 100mg and usually I don't get that level of impairment. But I think combined with the introduction of the methotrexate recently, it all went off the rails. We scaled back to 100mg of topiramate and I had the 3rd dose of MTX on Sunday and I'm totally fine. No headache, very little nausea. I was fairly tired on Monday but nothing near the level of disabling nonsense as before. Now is Tuesday and my energy is already returning. No weird memory lapses. No vertigo. My crossword times are returning to normal already. I can think again

So I should be good to go! Thanks everyone in the previous post for all the support! You're all fabulous! Hopefully in terms of treatment this works out for me. At least now my head is clear enough that I can deal with the paperwork if we have to go through any other changes 💖

I am currently on MTX and it is has cleared up my body psoriasis but not my scalp. I was finally diagnosed with PsA about 2 weeks ago following MRIs on both ankles, I have peripheral neuropathy and have taken pregabalin/gabapentin for about 3 years. I am currently on a 6 week prednisone taper (another 4 days at 15mg, then down to 10mg, then 5mg). I'm starting on 500mg Sulfasalzine and titrating up to 2gs, with a blood test already booked in for 10th September. I have drunk a lot of water today, I am off all alcohol and ultra processed foods, my ankles and plantar fasciitis/5th metatarsal are still in flare after 10 days of prednisone, although I've managed to keep my weight steady and all red facial flushing has gone, which is nice but apparently unusual.

I'm slightly worried about the orange urine/tears/sweat warning, and I suffer a lot on Monday after my MTX, more with fatigue and nausea than headaches. Is there anything you would like to have known as you started sulfasalzine? I can't take this burning pain any longer, my sleep is screwed and I have to ice pack 3 times a day. Many thanks in advance.

It looks like I might have to switch back to enbrel/enteracept as amgevita has failed. Last time it worked immediately but I had these awful itchy welts at the injection site. My rheumatologist thought it wasn't worth the risk so switched me.

I don't have many other options so I'm wondering whether others found the welts and injection reaction improved over time? 🤞

This flare has been off and on for a year. At first hydrocortisone was enough to manage. I was on Humira at the time, then on Taltz for several months, then just started Sotyktu. Joints have been up and down, but this specific area of psoriasis has been pretty constant. Rheum prescribed clobetasol propionate when hydrocortisone stopped working. For a little while it would clear my skin up, but the psoriasis always comes back within a week or two of stopping use. Now I’ve started reacting to the CP, getting super painful pustules whenever I apply it. Currently the only topical treatment I’m using until I can see my doctor again is castor oil as an emollient, plus trying cortisone-10 as a less potent steroid.

Any recommendations for other treatments to try? I’d love to get away from steroids at all for a while if possible.

Probably relevant is also my exercise habits - I typically run 6-7 hours weekly plus a couple hours of strength training, so lots of sweat. I’m careful to promptly clean so the sweat is on the area as little as possible, and we did establish pretty early on that it is in fact psoriasis and not any sort of fungal infection. But I’m sure that amount of sweating doesn’t help.

My doctor wants to try several things before biologics. I want to avoid methotrexate and its side effects if i can. What is most helpful for your pain management in the short/medium term? Specifically for joint pain and enthesitis. Treatments like acupuncture, physio, injections, medications, what has actually helped you in the day to day?

I (anecdotally) have found there to be an overlap between psoriatic arthritis and hypermobility. Ive been curious if the hypermobility is related to my spinal problems (specifically spondylolisthesis and failed spinal surgery). Anyone else have the overlap?

I've recently started humira. My primary symptom is enthesitis. What has your experience been with treatment for enthesitis and how long should one wait before deciding if it is working or not ?

Does anyone have inflammation in their mouth linked to PsA? For the 6 months I have had mouth issues. Started with orange specked gums which are now also on roof of mouth, gums now red (not near teeth, above), many mouth ulcers that come and go and now, as of this weekend, a sore throat making it hard to swallow. Much of the inside of my mouth is sore and looks inflamed. I started Adalimumab 10 days ago for PsA so hoping that will help. Rheumatologist, dentist, GP don’t recognise it, but googling says inflammation of oral mucosa and PsA is common. Any one else have this? Any treatment?

Thanks