Riders with PsA/ RA? Dealing with the pain.

[Halt_and_Salute]

I’m new here, recently joined because of the amount of support in this particular forum. I was diagnosed with PsA about 4 months ago. (Psoriatic Arthritis) I’d been dealing with the pain for a few years, seeing a chiro thinking I had back problems. Finally got myself in for a MRI with a spine specialist, lots of blood work, and a referral over to a rheumatologist.

So we started down the road of finding the right meds. The first month Meloxicam gave me great relief. So along with that, on the second month, I started Plaquenil. I know it takes up to three months for Plaquenil to kick in, but I feel like the Meloxicam isn’t working as well now. I’ve had two flares since I’ve started on it. Can Meloxi stop working?

So, to tie this into riding, I have a 13 year old Morgan Mare. I bought her in April after leasing a TB for awhile. I ride through the flares, and sometimes it even helps alleviate the spine pain, but the knuckle pain I just work through. I own so many bridles so that I never have to change out a bit. It’s a little embarrassing when other boarders ask why on earth I need so many bridles, I think many of them think I’m trying to show off. Anyways, we’re going to our first breed show next month. Which worries me. I am praying I dont get a flare right before the show, this show has come to mean everything to me!

Anyone else with PsA? (Or those with RA as well, it’s somewhat similar) What meds are working best, how do you get through the pain of flares and still ride?

[_Teddy]

Loop rein

check out freedomrider.com

[Halt_and_Salute]

Thanks, thats a cool site. I’m able to hold my reins without issues, and I ride with double reins which is challenging when my hands are sore. It’s really when I need strength in my fingers to do things like unbuckling bits and reins. I really need to buy a bridle for schooling with those clips that are easy to change in and out.

Oh and tightening the girth is really hard for me, every time.

[_Teddy]

That is where having a helper is important for me. Sometimes i just cant do things like girthing up. Also vetwrap on reins is helpful tooo

[Satchel85]

Meloxicam didn’t do it at all for me. My rheumatologist started me on low dose Nortriptyline for neuropathy (15mg) and it’s been awesome. I still have breakthrough pain, especially when I’m stressed, but have had many many more good days compared to bad days since starting it. One caveat though, make sure you order your refills in advance! If you miss a couple days you go through withdrawal symptoms which include really painful muscle cramping and severe nausea in my case. (I get my refills in the mail, and they usually get here in 1-2 days, but it took a week one time. It was miserable. I had to take a week off from work.)

[Halt_and_Salute]

Satchel - How great you’ve found something that works for you! Those side affects sound a little scary though. Supposedly the Plaquenil I’m on will eliminate the need for the Meloxi…still waiting to see if that will be the case. In the meantime I think I may call my Dr and see if there’s something stronger than Meloxi (have tried high dose Naproxen, and OMG the stomach pain was unbearable)

Forgot to mention, I’m going to school to be a Equine Massage Therapist, so I’ve got to get this pain under control soon or my new career is never going to get off the ground. My knuckles were so achy today I changed out bridles in the middle of my ride so that I only had deal with one set of reins.

[_Teddy]

Melocicam is the strongest, it isnt meant as a pain med. I am oh so lucky no nsaids because i get severe reactions like bleeding under my skin and hand veins bursting?

Breakthough pain for me tylenol 3

[Satchel85]

They aren’t actual side effects, that happened from withdrawal, if you were to go off of the med, your doctor would titrate you off so that you don’t experience withdrawal. The only side effect I’ve experienced from this med is dry mouth. Can’t do NSAIDs because of the stomach pain anymore either!

[Astro598]

Hello, I have RA and I am a dressage rider. I was diagnosed about a year ago, but have had symptoms for a few years. I already have permanent damage to joints in both hands. I was first started on Plaquenil and also took Naproxen for a NAISAD. My Doc was conservative in his approach. We have been adding medications as I have still been having pain. I now take in addition to the plaquenil, Methotrexate, 10mg once a week, and an injection of Embrel every week. I also take a muscle relaxant at night to help with sleep, and also take an antidepressant - Wellbutrin. I am starting to feel better - the Enbrel is beginning to work. Sometimes it takes trying different medications as not everyone responds to the same treatment. I encourage folks to be very proactive in their RA care - I had to push my doc to understand that I wanted to be agressive in the treatment. I finally brought some competition photos of me and my horses to an appointment and told him I didn’t want this disease to keep me from doing what I love. It got his attention!

[myvanya]

I have RA…

I am on 20mg injection weekly of Methotrexate, max dose of Remicade (infusion) every 5 weeks, Folic Acid, 50mg Tramadol (pain med) up to three times a day, and lots of tylenol. (a few other things as well but I think they are somewhat specific to my comorbidities).

The Tramadol is relatively effective but it makes me a bit tired and dizzy. I usually take tylenol several times a day and the Tramadol at night so I can sleep.

In general an aggressive treatment is better if you can work with your doctor on it. I was diagnosed a few years ago and finding the right combination can be hard (especially if you are allergic to any of the drugs as I was…hopefully not the case for you).

I ride with much thicker, floppier reins than other people I know. I am stubbornly trying to avoid needing a dispensation (i ride dressage and jump) so I am trying to avoid the loop reins etc.

[Derby_Lyn_Farms]

I wanted to mention that the Wintec bridles are really easy to move the buckles on. I have issues with my hands and I love these bridles for that purpose. They don’t get stiff like the leather ones, and I can switch a bit pretty fast on them.

I have been seeing a rhuematologist for my pain. Nothing really pin pointed yet. He says fibromyalgia and sjogrens. I really feel like it is something else. I have terrible knuckle pain, in my feet and hands. Feels like I jammed a finger and have bad flare ups, but I can’t ever think of when I would have injured myself. My blood work comes back abnormal, but when tested for RA or lupus it doesn’t show anything. I am only 30 and very active. This pain is really holding me back, and I have a hard time at work. Wish I could figure it out. I try to work through it most days, but some days are just killer and I can’t even get out of the house.

[Halt_and_Salute]

Wow thanks everyone for your posts, very helpful. Its also comforting to know there are others riding through this pain.

I do realize Meloxi isnt a painkiler but a strong NSAID, but as soon as I started taking it my pain diminished…but sadly has come back, though I am now thinking I am having a lomger flare than normal right now. I called my rheumy and they wont change my Rx over the phone, I have to wait until my Mid august appt. Lovely since I have two shows next month.

Derby- is it a possibility you have the markers for PsA? Your story is so similar to mine. Im 38 and had back pain for two years, I thought I had an injury, turns out I have spondylitis psoriatic arthritis which means it started in my spine. So 6 months ago I hurt my finger picking up my dog, was so strange like it was jammed, and has hurt ever since. My xrays tell me it wasnt from picking up the dog, it was my arthritis moving into my hands. Its now in my knuckles, wrists, ankles and toes.

I rode today, which always makes me feel wonderful, flare ups or not. A big hug around that warm neck and I know I can get through the pain as long as I have my mare

[Halt_and_Salute]

Oh, and does anyone bruise really easily? My legs look like I play some contact sport and I cant figure out why!

[Satchel85]

Ugh, yes! I always feel like a domestic abuse victim when I go out and I feel bad for my DH because he gets some nasty stares sometimes!

[Halt_and_Salute]

[QUOTE=Satchel85;6445930]
Ugh, yes! I always feel like a domestic abuse victim when I go out and I feel bad for my DH because he gets some nasty stares sometimes![/QUOTE]

Exactly! Why is that? Is it the meds or the arthritis that does it? Thank goodness breeches and show coats cover it all, it really looks bad sometimes.

[RMJacobs]

I was diagnosed with RA in early 1998 after a year of intense symptoms. So I guess I’m getting to be an old hand at this. Too bad my old hands hurt so much! Bad pun, I know.

I’m currently on the equivalent of 20 mg of methotrexate injected weekly, weekly Humira, meloxicam and a host of other stuff to counter the methotrexate and meloxicam side effects. I function pretty darned well considering I have a pretty severe case. I still bike (nowhere near as far as I used too, and soooo slooooowly), and I drive my pony.

I agree with what the others said about being aggressive in treatment. The reason I can still work a high stress job and do all the other stuff I do is because I have a great rheumy who was always willing to be aggressive in my treatment. I have minimal joint damage. Darn, why do they look so good when they hurt so much, anyway?

For those of you who are bruising so much, are you on prednisone? That would do it. It’s a drug I personally avoid as it makes me psychotic. I’m intense enough without it.

Rebecca

[tuttifruitti]

PSA

I was diagnosed with psoriatic arthritis last year at Duke. One thing that I want to say is my Docs said this disease does not have the high markers in blood tests like you expect for RA…usually normal or low sedentary rates. Also, the most encouraging news about having to take medicine(which we all hate to do) which has bad side effects like methotrexate is: without it, immune system thats gone awry and untreated can lead to infections,sickness,diseased organs, heart/liver problems and of course, deformed joints. That really put it in to perspective for me.
I really, really feel for you youngsters with it. Please keep up with your meds!

[Halt_and_Salute]

Wow I’m really surprised to find someone else with PsA! And you’re right, the inflammatory markers for it sometimes don’t even show up. I have an appt with my rheumy in another couple weeks, can’t wait to get to that appt so they can adjust these meds, I have had worse flareups with them than without!

My SI pain though is now non existent, BUT, we’ll see as the weather changes in the fall if it comes back. In the past week more joints in my hands have started to hurt, if the Plaquenil is supposed to stop joint damage, how can new joints be starting to hurt? I know they want to start conservative with my treatment, but I don’t think the Plaquenil is actually doing anything for me.

RMJacobs - I’m not on pred, that stuff makes me bonkers, cleaning my house at 1 am! Maybe the Meloxicam makes me bruise easily?

tuttifrutti - does your P flare more often on the meds? My actual P has been pretty bad considering it’s summer time which usually calms it down. My skin is a mess right now.

[_Teddy]

Yeah id say its the meloxicam making you bruise, made my hands bruise like the veins were leaking

[tuttifruitti]

I don’t know the drug meloxicam(is it a biologic?) but I am bruising easily, too. I was on prednisone for 4 months and it helped me immediately - like by lunch time! Docs said that was one of the markers for PA - that pred. works fast. Anyway, I hated being on it that long but it did help, for sure.
I am getting new pains in my heels. I couldn’t figure what in the world I’d done to make them soooo tender but I went straight to the store and bought some great Merrills with heel cushions and voila, helped tremendously. Then, Doc told me that PA can make the soft tissues in the heels become very inflammed…oh, yeah.
My psoriasis is not much and hasn’t ever been. A couple/three times a year for the past 5 I would get it on my let palm and I always thought it was from dunking hay or glove allergies or something. I finally went to a Dermatologist in 09 and she said it was psoriasis but nothing further.
I’m sorry it took me so long to respond but I couldn’t log in for some reason??