Hi Darshin and welcome to the forum

It's good to hear that things are starting to improve for you, but it' still early days and the meds do take a while to take effect.

I've been on methorexate and sulfasalazine combination for a year. I was on just sulf. for 2 years . It worked well for me but then started to become less effective so the consultant added the mtx. I have recently started to get a similar thing in my left knee, usually with pain and it can be difficult to walk. It isn't all the time- it comes and goes . It seems to happen when I have a flare or I have overdone things/ been stressed, and usually improves with rest. I also take an anti inflammatory tablet which helps. I am assuming that it isn't the drugs. Maybe you might find that yours settles down too. Do you have a rheumatology nurse or helpline you can contact if it doesn't improve?

I hope that generally, things continue to improve for you.

Maria

Hi Darshin

I am not an expert but that sounds more like a flare up to me. It may go in a few days. That's one of the problems with this condition. It changes daily. At least we know things can come and go so there is some respite.

Hope it goes soon

Love Sheila x

hi Darshin,

i have a swollen left knee .. but i do have Osteo in both my knee's and to be honest i don't know if RA has hit them yet.

see how you go over the weekend, i trust you have a contact number for your Rheumatology Nurse..? if i don't get hold of mine straight away they always call be back within 24 hours.

hope you begin to see some improvement soon,

Suzanne x

Hi Darshin

i've had a mysteriously swollen knee for months now. It was extremely swollen and in August I had the fluid taken off and some steriod put in (didn't hurt at all). She drew of 3 giant syringes of fluid that time! Since then I've still had a little fluid on the left hand side of the left knee. Steriod tablets (15 mg) did nothing and neither has anything else!! It just makes my knee a bit stiff and I can't bend it completely.

The rheumatology nurse on the phone said they could look at it, but I decided to wait until my next appt in 3 weeks time. SHe said even with all the treatment (I'm on Humira) you can still get some fluid stuck somewhere that never seems to drain. I'll let you know what they say about it. All my other joints have settled down on the Humira. Just that one knee....... and I'm still dropping down the steriod tablets - now on 7 mg a day.

I also take sulphasalzine, declofenic (long acting) and Ranitidine (a stomach protector while I'm on the steriod tablets and declonfenic).

MTX can take 12 weeks to completely work - so it may take longer for you to see all the benefits. Unfortunately MTX didn't like me!! So I've had to go down a different route.

My daughter who has also been diagnosed with RA (aged 22) has not been on MTX 3 weeks, but hasn't seen much benefit yet!

All the best
Anne

Hi Darshin,

It does sound like a flare up, it is common at the start of treatments, do not let it get you down. I do not think your drugs would have caused that. Rest with them up and put ice peas or such like on them. I kept some in the freezer for years as a stand by. I had little flares too at the start, and my fingers were the same on wakening but eased after a short time. keep positive though, you will soon see your consultant.

Take care, thinking about you.

Lorna

Hi Darshin

Unfortunately whilst today's RA drugs are pretty fantastic in what they can achieve they do take time to build up in the system and become fully effective. Until then it is something of a waiting game that may be controlled to some extent by drugs such as Naproxen or prednisolone. Alternatively depo-medrone steroid jabs or methyl prednisolone infusions can help.

It sounds as though the fluid in the knee may need to be aspirated and steroid injected directly into the joint space. These can be very effective when individual joints are very inflamed. Joints which are 'hot and swollen', showing evidence of active disease, should be cooled gradually with a cold compress (frozen peas in a towel) for no more than 10 minutes at a time. If the joint isn't hot but is painful warm wheat bags can be a good comfort and help ease the pain.

It sounds as though, at the moment, it is individual joints that are affected rather than an overall feeling of being unwell which would perhaps suggest a flare; although I do understand how this is getting you down. Do try to stay positive and not let it get the better of you.

RA has a mind of its own that we have to learn to understand. One of the first noticeable symptoms of a flare is lethargy; tiredness and difficulty sleeping. This then moves into a phase of generally feeling unwell perhaps with a temperature and non specific aches and pains. Then arrives the acute pain in the joints, swelling, stiffness, the emotional roller coaster and fatigue. Sometimes it is only when we look back at the progression we realise we are in a ‘flare’. Occasionally a flare can hit dramatically with no build up; one day everything is apparently fine, the next it is a struggle just to function!

A flare almost always affects several joints as it is a breakdown of the immune system rather than inflammation of only specific joints. You feel ill, as though perhaps coming down with something like flu, and quite possibly unable to get out of bed! It can last anything from a week or two to months depending on how quickly the disease can be brought under control again. And that must be the aim. Intervention is the only way forward, be it rest or changed medication. Without it we run the risk of ongoing problems or at worst the possibility of joint damage.

Certainly that knee requires attention and perhaps an increase in naproxen and a steroid jab would help until the combi drugs kick in. When do you see the consultant?

Lyn x

Thanks Lyn for your support and long message. I would say that my flare is either on-going since mid Feb when this all started. Or perhaps I have had about 3 flares since. Don't really know. 2 depo-med injections have brought symptoms down so these kinda confuse me whether its a constant flare or intermittent.

I only take 1 x 200mg naproxen at a time and avoid taking a full days dose (of three). I alternate with paracetamol.

Seeing my consultant on Friday when I shall present the knee.

However I do believe that MTX at 10mg is doing something as my right hand is better - fingers OK.

As mentioned the shoulders, left hand, wrist, right knee are the main worst joints.

Darshin

sara - yes there is the plan to raise the MTX I am expecting to go to 12.5 mg on Friday. However my consultant seems to a bit slower than get it to 15mg in 6 weeks approach. I might ask if I can jump from 10 to 15 assuming blood results are fine.

Regards other pain killers my GP advice is the old-fashioned approach - take unless necessary.

Hi Darshin,

I totally understand how you are feeling at the moment, I have just survived the most dreadful fortnight of pain. I was taking max paikillers - tramadol and codeine and still lots of pain, added paracetamol, no change. It was only the addition of 40mg prednisolone that has settled the pain finally. Have you had any short term course of steroids at all?? I just wondered if it might help you with pain? The swelling is the cause of pain, so reducing that is part of pain relief.

I hope you get some relief soon. It is very draining and depressing to be in so much pain. My hubby kept asking 'how are you today' How could I reply every day that I felt worse than the day before? But I did, I sometimes feel like a right whinger and need to change the record!!

Petra xxxx