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Living with Psoriatic Arthritis (PsA)

Elbows


#1

I figure we just had a post here titled "Knees" so I might as well go with elbows. My elbows started bothering me in the spring. Stiff when I woke up, catching and painful when fully extended. My range of motion is good. I have had tendonitis in the right elbow in the past, but this is not the same. It's very localized to the joint itself, more to the inside, but it doesn't leave the joint. No visible swelling, but I carry some extra pounds, so it may be slightly swollen without my noticing.

I seem to be having a bit of a flare since I had to go off Enbrel for a few weeks at the end of August/beginning of September for trigger finger surgery on my thumb. I had a brief solid flare after missing two shots, but things seemed to have quieted down a bit. But now I'm back to high fatigue levels, slightly sick feeling, and many joints hurting. Only some visible inflammation.

So I'm icing and using NSAIDs, which I'm not really happy to be going back on right now. The question is at what point do I call the doctor, and what are some treatment possibilities? Start with films and go from there? Anyone have experience with elbows?


#2

Thanks Sybil. I did put myself back on NSAIDs temporarily, and have gotten relief from the pain, but not fatigue. I will likely call the doctor within the next week, once I see how I do on a solid week of NSAIDs.


#3

I had that exact same problem with my elbow before starting Enbrel. It didn’t swell, either, and I could move it, but with pain. I’ve been noticing, too, that I didn’t realize I had quite a bit of swelling, because now since taking Enbrel for 3.5 months my feet and hands are skinnier. My rings are almost falling off!



sybil said:

It’s difficult to compare but I have a tender right elbow. It doesn’t swell, range of motion is fine too and the soreness / tenderness is very localised within the joint. It doesn’t bother me much but it is always there.

My elbow alone wouldn’t send me to the doctor but feeling nauseous plus fatigue plus extensive joint pain would if it lasted more than a couple of weeks. I don’t know what they’d be able to do but what you describe adds up to ‘ill’ in my book. I suppose the break from Enbrel / the stress of surgery / factors unknown may have thrown you off course temporarily, but seeking a professional opinion seems fair enough in the circumstances.


#4

Ah, Elbows. Mine PsA actually started as an isolated “gee if I wasn’t only 35 I’d swear I had arthritis” in my left elbow. But my Rhuemy steadfastly believes damage will always show in the hands first, so I have no experience of X-rays etc for my elbow - he only bothered to do my hand once, at my insistence.

However - my experience is that there are a STACK of tendons connecting to your elbow - and pt and exercise has helped those enormously for me.

I pushed for early biologics (I mean really pushed, Aus is a hard place to get them quickly), so I don’t know if its early biologics or genetic luck, but even in that very first elbow, there’s no functional evidence of damage (when there is no inflammation, my joints work like an athletes!)


#5

Hi Stoney,

like Jen, my elbows were the primary target of initial PSA--both the tendons and the joints. Once the tendons (which were visibly swollen in my forearms but not at the joint) were taken care of, the elbow itself felt much better.

Seems like the NSAID regimen is a great start to get some relief. Sounds, too, like the breaks in your biologics have really thrown things for a loop. Do you tolerate short courses of steroids? I know they are no one's favorite way to go, but they might help you get through to that more stable place where your biologics have kicked back in and your body has settled down more. Also, Voltaren Gel has been an absolute godsend for me on my elbows. Works like a charm to calm things down and get the pain in check. Good luck, friend.


#6

Jane- I tried the voltaren before going to the oral NSAIDs. It works really well on my hands and wrists, but barely touched my elbow pain. Thankfully I'm in a slightly better spot today. If my elbows were hot, I would have already made the appointment to go in, and probably do a steroid dose pack.

I'm glad to hear that I'm not the only one. Like Jen, I haven't had imaging done on my elbows. They just became an issue in the last year. I'll be seeing the OT next week for my thumb, so I may ask her if there are any good exercises that I should be doing to strengthen up the joint.

My joints like to do me the favor of hurting symmetrically, proving that it's inflammatory in nature.


#7

Oh My!! I know this is an Old Thread. I came here to Ask If Anyone Has Had Problems With Your Elbows.I was pleasantly surprised to find some Information. I have experienced pain and swelling in both Elbows. MY Right Elbow Seems Better pain Wise My Left Seems to be the worst right now. I have brought it to GP and Rheumy’s attention it just doesn’t seem Important to them. Putting 2 n 2 together the pain I experience in My Elbows. Is the same pain I feel in My Ankles n now The Nodules on My fingers Coincidence? Or My thought Psoriatic Arthritis. Would be helpful knowing what you’ve experienced and how to deal with this.


#8

I replied over two years ago after having been on Enbrel for 3.5 months and my elbows are still good–no stiffness or pain to speak of. They never appeared swollen when they were painful, but I had noticed after starting Enbrel certain places looked “skinnier”, so there was some swelling. The biologics are great stuff when they work!