Psoriatic arthritis medication dose
I was diagnosed with psoriatic arthritis about a year ago and I was doing really well on 15mg of methotrexate a week and felt so much better apart from the odd day here and there. Over the last month, I’ve started to feel much worse and my hands are starting to stiffen up overnight again affecting my sleep and causing me pain. I work full time using my hands a lot and have two small children. I am starting to feel extra tired and generally unwell again. I am scared it’s all starting up again. Is it normal to have to increase your dose after such a small length of time? My rheumatology nurse is suggesting going up to 20mg. Dows anyone have any other coping strategies? I try wax baths and hot baths but the relief is short lived. I also hate that no one can really see how I’m feeling- I don’t always have visible inflammation to show people and I feel like people think I’m just complaining for nothing sometimes. Hoping for some advice as I’m starting to feel miserable. Thank you in advance.
I hate to hear you're going through this tough time. It sounds incredibly challenging, especially with the demands of work and caring for young children. It's understandable to feel anxious about your symptoms worsening again. It can be normal for the effectiveness of a medication like Methotrexate to change over time. Your body might adapt, or the progression of the disease might require adjustments in your treatment plan. So increasing the dose, as your rheumatology nurse suggested, is a common next step and might help manage your symptoms better. However, to make sure you are comfortable with that change, I would encourage you to discuss any concerns or side effects with your healthcare provider. I want to share an article with you that gives some tips on the stiffness you're experiencing with your fingers. You can access it here- https://rheumatoidarthritis.net/living/tips-for-hand-pain. Also, if you're not a member of our PsA community already, there are articles there that speak on how to manage hand stiffness as well. I'll link those here- https://psoriatic-arthritis.com/search?s=hand%20stiff. Dealing with a chronic illness is never easy, especially when it's invisible and others don't understand what you're going through. I know the days seem hard but I am hopeful things will turn around soon! Hang in there and I hope this helps! Kindly, Latoya (Team Member) 
Hi
. You concerns about potentially having to alter your treatment plan already is certainly understandable. It is not rare in early diagnosis period for treatments to have to be altered. I want to let you know that, besides increasing the methotrexate (which is certainly an option), there are other treatment options or combination treatment options you can discuss with your rheumatologist. As Latoya mentioned, we have a sister-site for psoriatic arthritis, so I want to share their treatment pages, as treatments are often similar to RA, but can be different. This article discusses treatment options, including combination therapy: https://psoriatic-arthritis.com/treatment and this one discusses medications, with links to more specifics: https://psoriatic-arthritis.com/medications. I hope this information is helpful as you move forward to get your PsA under control. Also, while you are certainly welcome here, know that the PsA site offers the same level of support and information. Wishing you the best. Richard (RheumatoidArthritis.net Team)
