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Living with Psoriatic Arthritis (PsA)

Stomach and flank pain?

About three weeks ago, I was about to go to bed and had a stabbing pain in my right side (about level with the naval, but to the right). Panic set in when it didn’t shift, with me worrying about appendicitis, but it seemed like too high up. After about two days of the stabbing, it started to let up, but has left me with nagging feeling in that area that feels rather like a stitch that you used to get when you were a kid and had run too far. I don’t run now, so never had it as an adult. But it’s that kind of pulling sensation. It’s not there all the time. Some days it’s there more than others. I’ll go hours without feeling it. I can’t say it’s particularly painful, but it’s there. I saw the doc last week and he thought it might be a muscle strain, but I’m not convinced in all honesty - although perhaps that would fit with the stitch feeling. Food doesn’t affect it, neither does going to the loo.

So along comes the big question: arthritis related? I ask that because I’ve also got general back ache at the moment too, and sometimes a pain at the top of my right hip (on the side). No UTI, etc. I have IBS, and it’s normally one thing I don’t worry about healthwise because when it plays up it at least repeats what it had done before. Even IBS has a kind of routine or predictability. I’d like to put this down to it, but it’s going on too long, I think, at two and a half weeks or so. My mind always thinks the worst - but I doubt a stitch like pain with no other symptoms is a sign of anything particularly sinister either.

Anyone else have a similar thing. PsA does seem to have a habit of throwing surprises at us, so I thought it might be worth asking.

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Two weeks ago I was doing some light yard work and a bit of chainsaw cutting and I was hit with the exact pain as you describe. I too started poking, prodding and twisting etc to see what is causing it. It was so sharp I had to stop moving until it subsided. I also thought appendicitis. But it would go as fast as it came. I also had inguinal hernia surgery a few years ago on that side so I thought maybe the mesh had moved. It was kind of a stab and release slowly. But its been 10 days and no recurrence.,even with swinging an axe splitting firewood. Considering that I get PSA induced random stabbing pain everywhere else, I am assuming this too is PSA related coming from a tender tendon in the top of the hip joint?

It could be a kidney stone. Mine started feeling like a uti for several weeks, then sharp knowing pain in groan one day, and one or two days on my right side on my left side, then sharp pain in back. I’m not sure if it was moving around. I finally had CAT scan and it showed two small stones. Eventually passed after one day I felt like I was in labor for 8 hrs and ended up at ER both times. It eventually passed

Thanks for the replies. This has all been very odd. I first had this happen about nine months ago - stabbing pain for two days and then a kind of residual ache after for about a week. This time the residual ache has gone on much longer - about three weeks now. The doc is convinced its a muscle strain of some kind. I confess I’m not convinced for some reason - but then I’m a worry-gut. I’m always worried that something is growing somewhere! That said, if that were the case I’m sure that it wouldn’t have started last year and then disappear completely for nine months! Or get better (albeit very slowly). And I’d have other symptoms too.

Just to add to matters, I now have shingles not far from where this is happening, and so have got to leave off all arthritis meds. Already feeling the effect of that. It never rains!

Well, back to the docs on Friday as I’m still getting the odd twinge from this. I should stop worrying, I guess, as they really are just twinges, but I don’t like things that are left unexplained. The shingles is taking longer to leave my body than Theresa May has taken to leave 10 Downing Street, despite nearly as much encouragement to do so. There are other “odd” things going on too - like the twinge most often comes at the exact moment I burp! I guess that in itself means it’s probably more mechanical than anything awful.

I wonder if its just “one of those things.” I’m having back pain more than before, and I wonder if the the PsA has decided to shift itself there for awhile. I suppose the flank pain is probably a muscle (as the doc said originally) or maybe a trapped nerve. But I hate not knowing, even if it’s nothing like what it was when I had the sharp pain for the first few days. But with no other obvious symptoms, and with my stomach behaving surprisingly well lately, I’m not sure what can be done.

Thankfully, I have yet to find any deadly disease on Google with a symptom of “slight twinge a couple of times a day that feels like a stitch, most often when burping.”

About the only thing that can hurt in that area is a muscle. You can get inflamation but that in and of itself doesn’t hurt but the results, even a bit of gas, can make you feel like you want to die…

Try some phayzyme or something with up to 500mg Simethicone. That followed up with a couple doses of Mira lax (polyethelyene glycol) and it should clear up, Your bowels may be moving okay but chances are the stools are a bit smaller in diameter than usual - clear sign of inflammation

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are you saying the muscle is inflamed?

Is it roughly where the bottom of the ribcage is by any chance? I get a similar pain there to what you describe, sort of ache a bit like a stitch that comes and goes.

I’ve had several tests for that, including a colonoscopy and they’ve always been clear. However I recently went back after leaving it for about 3/4 years and they sent me for a repeat ultrasound and found that I had a fatty liver. I was advised to make some lifestyle changes and funnily enough, if I behave myself food / drink wise then after couple days the pain disappears. If I start misbehaving again then after a few days it comes back and so on.

Possibly something similar?

In the comprehensive metabolic panel that is run every few months look at the anion gap, or albumin levels and the historic results to see if they are slightly low or trending down. And in your Blood count if you are just a bit anemic. or trending down That can be an explanation for the “fatty liver” or pain. Believe it or not it can be as simple as too low a dose of folic acid if you are on MTX

Wow glad I’m not the only one, recently diagnosed with Psa, but have been having these kidney area pains on my right side for 18 months. Eventually went to a doc and had a kidney stone, so had it removed 8 weeks ago, still have the pain and it’s getting worse. Went back to the doc and had another CT scan, kidney is blear and very healthy so don’t have a clue what’s going on, but the pain is getting me down. Any clues or help will be gratefully received…Simon in the UK

Hi Simon,

I’m in the UK too. Just some thoughts. They have checked your gallbladder too haven’t they? And pancreas? In the CT scan? And obviously your liver?

Err nope haven’t had any of those checks, are they important

Well with right side abdominal pain which you know now is not your kidney, they would need to exclude any issues with gall bladder, pancreas and liver. Issues with any of them can also give you right side abdominal pain. So too can PsA problems in your right hip. But making sure you all your other internal organs are OK would narrow things down more, wouldn’t it?

Right side abdominal pain is actually VERY common with PsA. They will scan you till the cows come home or you get cancer from radiation trying to prove what you don’t have and send your way indicating the pain in your gut is really in your head…STAY OUT OF THE ER or IMMEDIATE CARE, WALKINS etc. These guys will alway go through the emergency Gut Pain Protocol Over an Over Again. Not to find an answer but simply to eliminate emergent situations.

The other thing I have found that helps is Miralax a couple times a week. Minor inflammation in the gut causes a constant battle of going “too little” and “going to much” either one raise havoc becuase you arent getting enough hydration where it matters. Miralax compensates as it is osmotic (its not a laxitive). It works by causing water to be retained with the stool. Once this occurs things are more normal making the gut work less, lowering pain levels and allowing you large intestine which encircle the areae to function more normally

There are a number of reasons for this pain. Just a wee bit of inflammation can cause all manner of trouble. So can diet, reaction to NSAIDS, etc etc. Many of us have found that diet has a huge effect on that pain (others not so much) Others as POO mentioned have it as “referred pan” caused by spinal inflammation, hip issues (especially hip issues)

Once all the organs are eliminated that’s enough for scans. There isn’t anything critical in that area that won’t show up in blood work but show up in scans if it is haywire.

FWIW I have finally gotten some control of this type of pain from, of all things, PT. I have a hip and messed up L 4-5. When either of those things flare up I find mysel listing a bit to the right and the gut pain goes through the roof. Some PT that helps me keep me straight up and down and avoid the listing has all but eliminated the pain (That and GF and some substantial weight loss)