Exercise options with PsA

Hi Jenny I was diagnosed with PsA 18 months ago and was seen by a Rhumatologist and. I was having pain in my elbow hips, knees and a swollen finger. I managed to do exercise and run but with a naproxen but finally succumbed to taking methotrexate starting at 10 mg a week but now on 20 mg a week. I have no side effects and am able to run and exercise without naproxen. my finger is still a bit swollen but improving .I am 54 and am able to do most exercises and run albeit very slow. I know how it feels to feel 88 especially after being static!! hopefully this gives you hope. good luck!

I was diagnosed with PsA about 13 years ago (so about the same age you are now). I was decently fit at the time, would go running most mornings, did a fair bit of cycling and would do the odd triathlon. Once it was under reasonable control I was able to go back to running, but for me one of the problems is that my PsA seems quite sensitive to diet and stress. Every now and again it flares up and running becomes out of the question. Some people manage to keep it under control all the time, but not everyone, so I'd recommend trying to get into something low impact (swimming, cycling, that sort of thing). That way you are able to maintain a certain level of activity even when your PsA is flaring up (if it does).

Thanks so much for replying guys. That really does make me feel much more positive about my outlook. I get to see my Rheum. next week, so hoping that he'll put me on the road to recovery with the right medication. On another note....... When you have flares, do either of you have really numbers finger tips?... on both my hands I have very numb thumb, fore and index fingers, at night is worse with the pins and needles. the steroid injection has all but worn off now, but my hands were never effected by it, and havel aways been numb since this whole thing started?...... Thanks so much, sorry for all the questions!

Hi Jenny I have only one finger affected . It’s my ring finger and it swells up and sometimes can be painful. I’ve had steroid injections in it and it gets it down but I foi lu lasted about 4 weeks. Now I’m on the 20mg methotrexate it’s got a bit better . I can use it more . I’ve never had numbness in it .my other hand tingles sometimes but if I move the fingers around it goes away . Not sure if this is related to PsA .

Numbness/Pins and Needles in fingers or toes has never been one of my symptoms. Different people find different treatments effective, so it may take a while to find the right one for you. There are plenty of options, so make sure you give regular feedback to your Rheumatologist. The biggest problem is that most seem to take 2-3 months before you know whether they are going to work for you. I've been on Sulfasalazine nearly the whole time since I was diagnosed 13 years ago and found it really effective. My rheumatologist put me on Methotraxate two years ago because she was concerned about the high dose (6x500mg/day) I was on. It did not agree with me and my PsA was terrible after about three months on Methotrexate. After six months I switched back to a lower dose of Sulfasalazine with the intention of going on a Biologic treatment. I was approved for that in February last year, but that got put on hold because of Covid.

Hi Jenny, Can't really speak much from my own experience as a bit of a couch potato and running hurt my knees long before I ever got sick, but I do know of several people with PsA/RA that literally went on to do Iron-man triathlons! I guess it depends on your individual case and what is eventually safe/comfortable for you. I found a bit of cycling is fine for me. Swimming is supposed to be excellent. It does depend on your circumstances though - for example my rheumatologist said don't have resistance on the exercise bike (I'm within the first year of severe PsA and haven't got the optimum treatment sorted yet so still pretty swollen). So do be careful and get specific advice from your rheum first! They also said to me doing nothing at all is the worst for PsA so they do recommend you do some form of exercise. Being able to walk 3 miles already seems an excellent start - I still struggle to walk across the clinic's car park. As for the numbness, I do recall having something like this but only mildly so it doesn't really sound like the same thing. I think mine came from an impingement in my inflamed shoulder. Definitely something to mention to your doc anyway. Hope you're feeling better about everything x

Hi Jenny. Don't really know about the running, i suppose it's one of them things only you can answer. As for exercise, i think it's really important, i like the bike and swimming, though some day's i can only do a few min on the static bike every hour or two when in a flare up. Hard to beat the real bike though ;). Good luck.

Hi Jenny, It seems I am following the path well trodden. Just been diagnosed with PsA. With psoriasis in my family (my brother and I both have it) About 4 months ago I started getting plantar fasciitis pain in one foot and heel pain (like spurs). I put this down to not exercising due to COVID lockdown. But then one toe swelled and just would not go down. Fast forward 5 weeks and it’s seems it’s PsA. So had a steroid shot which is an instant relief (aside the bum pain). Walking normally made me laugh. It’s weird what you get used too.. I am about to go on MtX and really very apprehensive both the side effects and also my ability to return to normal. Like you I am a high energy person!! I used to pre COVID do a daily commute to work on bike (100k a week) 3/4 gym and weights sessions. Super interested to see how your getting on. What works for you and hope your symptoms reduce. Talking to my doctor he seems to be of the view that Covid and work just tipped me over. I really hope I can tip it back to where I was and you can too. Let me know how you are! nice to share to be honest as families can’t always appreciate the impact and effect this has. James

Hi James! thanks for your message. I cant tell you how much this forum has helped me, and it really helps to know we are all in this together. So, I have very positive news regarding the methotrexate. I was exactly like you, and had heard all the scary stories of hair loss, dodgy tummies, ulcers, headaches and the lot. I was so apprehensive about taking it too. I bit the bullet and 4 weeks ago started on a 15mg course once a week (dont forget to take that all important folic acid 2 days prior!!... it really does help with dealing with any side effects you might have!...) So, week 1, I decided I was going to take them at 5.30pm in the evening (mid week) with a meal (V important! have a full stomach!..) and I get to sleep off most of the side effects. for me, I just have just felt a bit tired the next day, loss of appetite, and indigestion every time I ate (peppermint tea has helped greatly here!...) By day 3 I feel back to normal. Ive not has any of the other side effects, so am really chuffed (lost a quite a few pounds Id put on too, from not exercising!..) Regarding the effectiveness on my Arthritis, ive yet to see. Like you I had cortisone injections. I had on on NYE and then another beginning of Feb. That has seemed to see me through. I have carpel tunnel in both my hands, so numb fingers due to the PsA, and its a bit painful at night, but nowhere near the agony I was in, in December at night time. My legs are still ever so slightly swollen behind the knees so I know running is not an option quite yet (but never say never!...) As Methrx takes upto 3 months to work, I cant really tell if its workign yet, however I have high hopes of being able to get back to some normality soon. The things I can do so far ........ I can mountain bike, I can walk a good 3-5 miles. Im hoping to start sea swimming in April, as Im lucky enough to live on the coast. In April im hoping to start back with some gentle weight training and resistance training, just to get my strength back in my legs and arms. Its very strange to go form feeling so strong to not even being able to pick up my daughter. But thats all a temporary thing, and I have no doubt I will get back there again. I have read other stories on here about people getting back to normality too, so lets hope! So, in Summary, I say bite the bullet and take the Methx, if it does'nt suit you, you can always change your meds, but its the best on the market for PsA and just might help you get the better of this disease. I have also recently bought some CBD gummy sweets (very new age, I know!..), as I hear good thing about them too. Ive only taken those for 3 days so far, so again, yet to see if they have an effect on what inflammation I have left. Sorry for the long reply, I just wanted to get across that my 'journey' has actually turned into a positive one so far, and I wanted to assure you, that its fine to be apprehensive, but just give it a go, and you might be surprised. let me know how you get on! all the Best of luck, Jenny

Hi Jenny Glad you are feeling ok with methotrexate. I’ve recently outed my dose to 20 mg a week and feel great . My finger is nearly back to normal and I can do all the activities I used to do . So for me 10 months of methotrexate upping the dose gradually has worked.. So far so good . It took me a while to decide to go down that route but don’t regret it . As a lot of people say : fear the illness not the treatment. It does take a few weeks to kick in so hang in there . Wishing the very best with your treatment ! 😃😃

Thats so great to hear! I cant wait to have the feeling back in my fingers... thanks for letting me know. Its so nice to hear of positive news and how it all works. It gives me a great sense of what is to come, fingers crossed! X

Hi Jenny I have had PA since I was 35 - now 59. I think once the methotrexate works you will be fine with exercise - I am a gym fanatic - 7 days a week - 1.5 - 2.5 hours per session including spinning, Grit (Hiit), Bodypump and weights as well as regular runs on treadmill. Since Covid i've switched to cycling and jogging along with weights at home but looking forward to Gyms re-opening a week today. I have had a flare up for a few months now and my hands are taking the hit with inflamation around the joints and it looks like i will be starting on Adalimumab unless the increase dosage of methotrexate works (15mg to 20mg) but on the excercise front if you were active before and the treatment controls the PA you should be fine. Oh and so far (fingers crossed) after 25 years of methotrexate i haven't had any side effects

Hi Jenny, I read your post with interest as I was diagnosed with PsA a year ago and have had some similar experiences to you as well as being very active doing loads of cycling and yoga. I have been on 15mg of MTX last year which helped to keep the inflammation under control but then in Autumn I didn't take it very regularly and so had a big flare recently. I wondered how you have been since these messages and if you've managed to get back to your exercise? Did you find out what was causing the pins and needles as i started experiencing this a couple of months ago and it seems to keep happening more now? I hope you're doing well and would really appreciate any info you're happy to share.

Hi Sara, thanks for posting. It has been over a year now Ive been on methotrexate. I do take it religiously every week, by way of injection…….. I’m afraid to say it makes me feel pretty crap for a day or so every week, so I’m getting a bit tired of it, and would like to see if I can get onto Biologics…… but I’ve not had any flares since taking methotrexate, so it’s clearly doing the job. As far as exercise goes, tbh I’ve been too scared to start running again, as my RT said it wasn’t a good idea to do high impact sports. I’ve taken to walking 5-7 miles a day instead. But I need to do more low impact cardio, Pilates etc. I’m sure it can be done,, I just need to focus!! Anyway, I’m not sure if that’s answered your question?….. good luck with it all!! X

Hi Sara, Sorry I did t answer your last question! The pins and needles were carpal tunnel syndrome. But the Mtx eventually sorted it 😉

Hi Jenny, Thanks for replying so quickly. I'm glad to hear the methotrexate seems to be keeping things under control for you and that it helped with the carpel tunnel syndrome. I definitely need to get back to taking the methotrexate regularly, but i also feel pretty rubbish the next day or so. Thanks for sharing about what you have been able to do. Winter always seems hardest as motivation to get outside and do things is even more tricky. Low impact cardio sounds like a good idea. It's hard to know how gentle you need to be with the joints and how hard you can work without overstressing the body. I guess it's a constant learning and adjustment process. If i find some good low impact cardio ideas I'll let you know :)

I have recently been diagnosed with Psa after 2 years of being on the GP treadmill of try this try that. I used to run 5k x 5 mornings a week and have completed various half marathons but this condition sure put paid to any further races or morning runs oh and I am unable to do any gardening which I absolutely love. I've now started (last Friday) on 10mg Mtx and folic acid on the other 6 mornings and Rheumatologist wants this increasing to 20mg over 4 weeks. Occasionally I've been a little nauseous through the week but I put that down to not eating due to lack of appetite and unbelievable fatigue in an afternoon. I also suffer with numb, splitting fingertips which started about 2 weeks ago and is pretty distressing when I cant pick small things up or open things :( However, having read this stream and everyones upbeat posts I feel so much optomism and just wanted to thank you all for sharing your positivity xx

I was diagnosed with Psa at 35 - 25 years ago. I've had various treatments over the years but the staple has been methotrexate (was at 20mg bit now at 10). I recently started amgevita as had quite a serious relapse and it's worked miracles up till now. For those of you who enjoy the gym / running etc then once the treatment is right for you it should have little if no impact. I'm still able to train 7 days a week up to 2.5 hours a day. Various stuff including spin/swim/treadmill/weights/HIIT. Getting the treatment levels right for your circumstances is key and if that is working you should be fine.

Swimming would be better than treadmill