Newly diagnosed with RA, prescribed methotextrate
I have been recently diagnosed with both RA and osteo. arthritis. I am 48 years old. I occasionally have joint pain, and red swollen hands, but my primary problem is a feeling of muscle aches, and the feeling of muscles being inflamed. Has anyone else had this same problem? I've been prescribed Methotrexate which I started 2 weeks ago. I see no improvement in my symptoms. Does it take awhile for this drug to work? I feel hopelessness that I will never feel any relief.
Hi, welcome to a good website for info. Yes it can take 6-8 weeks to start feeling improvement. I think many with RA feel the same way you do. I find ice packs to feel good after a day of work, some people like heat for a chronic pain. If the pain is debilitating ask the doc for a short term burst of prednisone to work until the MTX kicks in.
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Hi Chris,
From what I've heard (I'm not on MTX) it can take up to 6 weeks for the benefit to be felt. RA can affect muscles, tendons, etc (and internal organs too) although a lot of folks don't know that. You can also have fibromyalgia (FM) on top of the RA, it can be hard to sort out. I've had chronic tendinitis, and eventually had tendon reconstruction. I have a neuroma (inflamed enlarged nerve)in the same foot, along with inflammation of the 5th toe joint and even just along the outside of the foot. My neck has had trouble for 20+ years... even though I wasn't diagnosed with RA then, I have a feeling that the genetics (If we have the genes that pre-dispose to RA that some of us do) would set me up for all of this, even before full-blown RA. Is there anything other than MTX that you can take for pain or inflammation? I was on Celebrex even before the diagnosis, for all kinds of other things, and stayed on it until my stomach just didn't want to handle it anymore. Now I'm trying to decide how to deal without it. Tylenol helps, but it can raise my liver enzymes (even within the guidelines - I have a touchy liver, that's why my rheumu didn't put me on MTX). I would keep a diary of some kind as to how you feel, how long morning stiffness lasts etc, what hurts, and how much, so when you see your doctor, or if you need to call him for help, you have good info available. Do you have both a GP and a rheumatologist? My rheumy basically says, go to your regular doctor for everything else, including osteo pain. So I do! (and I'm heading there in about an hour...)
If the meth doesn't work in a reasonable period of time (and it wouldn't hurt to call the dr. and let him know you're very uncomfortable. They usually do want to know. I'm surprised you weren't told that it might take a while.
How are you sleeping? If you're not getting good sleep, your body is not 'healing' itself (this happens with FM). Lack of sleep can also contribute to mood and depression. There are some meds (low-dose antidepressants) that were originally designed for pain & sleep. Amitriptyline is one of them. I was given 10 mg at bedtime for sleep before I got the definite RA diagnosis. It did help my sleep (a bit too much until I got on it for a week or so) and I took it for several months. Then at the diagnoses, my liver enzymes were high, and I stopped it. I've used it occasionally since, but not always, because sometimes it is too strong. But some people need to take 2 -3 times as much as I did. It's very individual.
I read on the internet (non-mainstream) that guaifenesin can help with FM. I asked my doctor and he said, well it can't hurt you. (It's the ingredient in Robitussin - who would have known?) He gave me a generic Rx (very inexpensive) and I take a 200 mg tablet with food in the morning and evening. It really helped with the energy. For some people, it helps for a while, then it stops. So much is trial and error. Other people swear by vitamin D for those muscle aches. I had mine checked, and it's normal (despite the fact that I have low bone density - go figure!)
Well, that's probably enough to think about for one day - good luck!
Ellen
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Chris
Friday, October 23, 2009 at 04:59 PM
Hi Ellen,
Thanks so much for the information, I appreciate you taking the time to respond to my question. I just feel like this thing hit me overnight!! I am seeing a rheumatologist and also my family doctor. It was my family doctor who initially ordered the bloodwork when I complained of sore muscles all over. That is when they found the RA, and he sent me to a rheumatologist. She is starting me on the MTX, but did not say how long before I found any relief. I think she probably will have to try a couple different things before we find something that works. I am sleeping OK now, but wasn't at first because of worrying about my condition. I did go through depression also before I actually knew what was wrong with me. I also have doubts in the back of my mind whether or not I actually have RA because the doctor said you can sometimes test positive for it, and not have it. I am confused right now. I am getting an ultrasound of my hands next month. I mainly have the muscle aches and burning irritation feeling in my muscles. Sometimes my fingers are hard to bend. I get a lot of numbness in my arms and legs also, but I also have 2 herniated discs in my neck pressing on my spinal cord. I've seen a neurosurgeon who wanted to do surgery which I do not want. I am not certain how much is coming from the RA or the herniated discs. Just feel that I've been healthy all my life, now I get hit with this in the prime of my life! I guess it could always be worse. I appreciate your time, and hope that you are handling this illness better than I am. It's helpful to have these websites to go to for information. Sincerely, Christine
Ellen
Saturday, October 24, 2009 at 07:28 AM
Wow, you do have a lot on your plate. I know what you mean re: depression and hitting overnight. I had the depression beforehand ironically, then I had a colonoscopy (family history) and never got my energy back afterward. That led to blood tests and then when my wrist blew up with fluid, and an MRI, the RA diagnosis.
If you have neck & spinal problems, that could definitely contribute to fibromyalgia - the numbness in your fingerse can come from the herniated discs. I can understand the reluctance for surgery, but sometimes it's necessary to avoid losing function and getting permanent nerve damage or disability. I'm not a medical professional, and would suggest you get more than one opinion. A lot of insurance companies have a Nurse-line or something like that (although I wonder if they always are trying to save money!) But at least get a second opinion. Surgery gets a bit more complicated after you're on RA meds because some of them you may have to then go off for the surgery. I am sorry your life is getting this complicated, I know it's tough! I've had surgery on my foot/ankle - push finally came to shove, but now 1 1/2 years later, I'm very glad I did. Neck & spinal surgery would be scary,but you need to consider what the consequences of doing nothing are, too.
Stay in touch and don't give up! One decision at a time ...
It takes time and patience...patience and time...hang in there and a good rheumy will help you find a helpful solution.
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Chris
Friday, October 23, 2009 at 05:06 PM
Thanks for your comment! I'm not a very patient person, but I guess I will have to learn to be. Been on the meds for 2 weeks now, hopefully it will start to work soon! Thanks for your response! Take care!
Hi Ruth,
I appreciate you taking the time to answer my question. I guess I will have to try and be more patient, I've only been on the MTX for 2 weeks. I did find the prednisone helped, but I think you can only be on that for a short time. The pain is not debilitating, just annoying at this point. However, I think I am still in the early stages. Hopefully it will not get much worse! I hope you are doing well with your condition! Take care! Christine