Just diagnosed.

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I've just been diagnosed with RA and prescribed Methotrexate, 10mgs to start, increasing to 20mgs over two weeks.   I'm currently also on Prednisone (16mgs) as my GP thought it was PMR so I have to taper the Prednisone and wean myself off that.   I took my first 10mg dose of Methotrexate Monday last but the pain seems to have gotten worse which I've read is common when starting on Methotrexate.   The RA affects my wrists, forearms, elbows, upper arms and neck but the wrists are affected the most, I'm basically unable to use my hands without suffering severe pain, particularly late at night and in the mornings.   Question:   will the Methotrexate lessen the wrist pain and allow me to function or is the wrist pain going to be a permanent fixture?   I've also noticed severe cramps in my trapezoid muscles when rising from rest, is this common?

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  • Posted

    Tony - Yes its good stuff, as long as you liver copes with the MTX, the way your posting reads worries me, I am only on MTX once a week, hopefully the same, and stepping up to 20mg when you haven't been tested to see if your liver is coping with 10mg ughhhhh. again worried for you.

    Also have they given you folic acid, I hope they have given it to you, the MTX writes off one of your Vitamins, and the Folic Acid replaces..

    I always get a kick back the following day after my MTX, I take mine via injection as specialist got the point of saying why is it not working, and she had me tested to see just how much I was taking up, nowhere near the dosage.

    IAny questions fire away, I have been on MTX for years now.

    I have been there and done almost the entire chemist shop and for me the MTX has the best result. 

    I am also on 10mg leflunomide or Arava (brand name) the combination is really really rough, and alot of people can't cope with it, but it seems I can.

    Specialist did have me on 20mg of leflunomide but I spiked dangerously high blood pressure, and had to be taken off immediately, side efffects are for me, diareahea first thing in the morning, have learnt to cope with that, but if you can cope with side effects it seems to smash RA, and farily quickly.

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  • Posted

    Has the Dr also got you on odorless fish oil, that acts as anti immflamtory.

    I take 6 x 1000 mg a day, two for breakfast, two for lunch, and two for dinner, with food. otherwise you may get reflux. side effects, none except for reflux, and greasy skin and hair, like Dr said to me, most of your spider lines will dissapear.

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  • Posted

    When Methotrexate works, it works well but you need very regular blood tests (each fortnight) to check for kidney and liver damage. If its the drug for you, and properly administered, it can put your RA into remission. And yes, you MUST take folic acid. I was taking 15mg and all was well until my kidneys got upset. It sorted out the RA though.

    As for the cramping muscles, they will be pulled tight because you are in pain. Try having a massage. I find that helps when I'm having a flare up.

    By the way, best to avoid alcohol with methotrexate. Your liver will be busy enough.

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  • Posted

    Something else I forgot to mention - it takes time for the level to build up in your blood so you wont get results immediately. Discuss with your doctor about weaning off prednisone at the moment. It may be better to wait until the methotrexate is having a full effect. One of the withdrawal symptoms for prednisone is aching joints, and you have enough of that already.
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  • Posted

    Tony - mine affects my hands, wrists, shoulders, was frozen some years ago, could not lift my arms, could not bend my wrists, hands looked as though I was wearing boxing gloves, I believe I came very close to losing the use of my hands completely, mine is negative RA, also negative Psoratic arthritis, but specialist tells me there is no question I have maybe my own unique verision of RA, as she is at a loss to name what i have. Could no longer drive. My hips are also affected, have now had double hip replacement, crazy that I had a complete remission after coming off pain killers for hips, unfortunatley only for about 6 months before having another major flare. I have worked with swimming, in a heated pool, has brought me back, including shoulders, to normal, or as close to normal as you can be, I tread water, and dog paddle letting the water wash over my hands and fingers definately seems to help. I go swimming for 1 to 1+1/2 hours three times a week, I would not be moving about as well as I do without the swimming. agree with gail re massge, it does help.
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  • Posted

    All common metho will help but i still take regular pain killers after 24 years my friend is lucky she hardly ever takes pain relief its early days for you so take pain killers as well but ask dr whats best for you good luck
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  • Posted

    Yes folic acid and fish oil as well.   Pain seems to be getting worse, I can't get my hands anywhere near my face, neck or back and the right aches all the time.   Makes it difficult to scratch as I also have Urticaria.   Not supposed to take NSAIDs when on Prednisone, but I do ocassionally when the pain gets too bad.  The Methotrexate better kick in soon the pain is starting to get unbearable, starting to think I may have lived past my use by date.
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  • Posted

    Hi Tony

    As others have commented, it is all about getting the right treatment for you.  Please do not despair though.  My heart goes out to you; I have been in the position where I feel unable to move, unable to pick anything up and almost ready to give up.  Methotrexate never worked for me.  I was on and off it for a long time (off because my white cell count kept going too low).  My joints never felt better on it.  Eventually I gave up on it and there was a lengthy period of time before I was allowed to have anti-TNF treatment.  This has worked wonders for my joints. I really hope methotrexate works for you, and it seems it does for many.  Persevere!  Wishing you some relief very soon. 

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  • Posted

    MTX is really a last resort drug.   Has your Dr tried Plaquinel or Enbrel?  I save Prednisone for flares but try to stay off it as much as possible. MTX caused me to have Interstitial Cystitis.  I was taken off it when I got it but it had done its damage to my bladder.  I have had it for 11 years and still suffer, but it isn't as bad as in the beginining and wouldn't wish it on anyone.  I had an aggressive Dr in the beginning but switched to one who is more careful.  Remember, some damage can't be undone.
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    • Posted

      CathyK - now you have scared me, Cystitis, have just had an attack, for no reason it seems. I cannot take some of the Biologicals because I have already had cancer, and the one I can take, apparently if you have a positive blood test for Tuberculosis you can't take that either, guess what positive, so I am left with MTX and leflunomide, which I know isn't good for me, but the RA and pain will cripple me without, damned if you do and damned if you don't.  Dr did tell me something new maybe coming soon, in the land of RA drugs, and she has been thinking she might try this with me. She has been my specilaist for over 10 years now, and we have a good relationship, she can be very honest with me and I can do likewise. She was very disappointed that leflunomide, was the new drug of choice a few years ago, and I had a good response, but the blood pressure was going to kill me, so had to be taken off it, back to 10mg dose now, under supervision by GP.
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  • Posted

    HiTony - be careful combining MTX with NSAIDS. Its hard on your kidneys. Panadol is a better combination.
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  • Posted

    I'm on about 20 meds a day, with the exception of the fish oil all have detrimental effects on your liver, kidneys, whatever.   I'll be on MTX or something similar probably for the rest of my life so it's not really a matter of if the meds stuff me up, it's a matter of when.   I live on Panadol these days only taking NSAIDS ocassionally when the Panadol simply aren't strong enough - like last night..
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  • Posted

    Tony - still don't know why, and Dr says no, but I am not going to let it go. Panadol seems to make me worse, noticed when I had Total Hip Replacment, and with first I was on Morphine, makes me vomit, and second Fentanol, which is a morphine like tablet but I don't vomit on it. My RA settled completely, noticed the difference within hours, to days. Sent me home with Endone, so I continued on with them even though they make me stoned, yes i was a little drunk, (or so my son says), and tried to avoid taking panadol. Got to the point of not having to take anything at all, then because of problem with hip, GP started me on Panadol again, and what happened I had a major flare of my RA. Would like yours or others opinion on possibility some of us have problems with Panadol which is making us worse, rather than better.
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  • Posted

    Sounds like something in the Panadol doesn't agree with you.  Did you have this problem with Panadol before RA?
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  • Posted

    Hardly ever took any tablets at all, so coudn't tell you, didn't go to GP for about 5 years, previous to aching hand and wrists, GP started by asking me if I had a virus, yes was my answer, and he said post viral, but it didn't improve. About 6 sixs later hands like boxing gloves,no movement in wrists as so swollen, coudn;t even brush hair as couldn't lift my arms, taking panadol as GP prescibed, I tripped and fell in the house, and coudn't get up off the floor, coudn't push through hands, wrists and shoulders, I just kept passing out when I tried, found about an hour later by husband, he called ambulance. Taken to local hospital, where Dr sent away blood tests for ESR and CRP, came back very high, 77 and 46, if I remember. Specialist saw me three weeks later in hospital clinic, have continued to see her ever since.
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