Hi OP, I have PSA, which started suddenly almost immediately after giving birth. Mine started similarly to yours, with pain in my feet and fatigue but no outwardly observable features if you see what I mean, like swelling or blood markers. I did have a history of psoriasis- the arthritis started around 10 years after my first psoriasis attack, which I think is pretty common. I was initially diagnosed with plantar fasciitis, PMT and slight fatness 😆
A couple of years later my symptoms suddenly worsened, with significant swelling around my knuckles. My knuckles get red and hot when they swell and I feel like I have flu. I was diagnosed very quickly once the swelling and redness started. Funnily enough, my feet really don’t trouble me much any more despite being my first symptom, it’s my hands that are the biggest problem now although my shoulders/knees/wrists are not great either. Supportive shoes have really helped my feet, I could barely walk for 2-3 hours in the morning before but proper arch support (including around the house) were a real turning point.
I take sulphasalazine to manage it, which works quite well in that I feel well far more than I feel ill, although I still struggle with flares. The flares are less frequent and shorter than they were before I started the medication. My rheumatologist wanted me on methotrexate but I ended up on sulphasalazine because I want to have another baby at some point- I didn’t really experience any side effects on it after the first day.
I highly recommend keeping a diary of your symptoms along with what you’ve eaten, whether you’re stressed, how much sleep you’ve had, how much exercise you’ve done, whether you’re on your period etc etc. Often, flares have a specific trigger and once you know what that is, you can try to mitigate it. My symptoms are 100% predictable because they start 3-4 days before my period and ease a few days after it starts. Obviously I can’t avoid periods (although I’m hopeful the pill might help once I’m no longer TTC) but knowing the trigger still helps loads, because it’s comforting to know when I can expect relief.
I was overweight when I was diagnosed and was told to lose weight, but I really struggled because I just didn’t have the bandwidth with managing work, small child and my condition. But, I finally lost 2 stone this year and the difference in how I feel is DRAMATIC. So, if this is a factor for you, it could be worth considering.
Keeping active as much as you can is quite important. My PSA can make me just want to flop on the sofa, but I’ve found that I can get deconditioned very quickly which leads to a vicious cycle of feeling worse, sitting more, and so on. I don’t do ‘workouts’ per se because intense exercise triggers my flare, but I make sure I do plenty of walking each day to stop my joints stiffening. If I’m really feeling too bad to exercise, I still make sure I get up very frequently just to stretch and move around, which has also made a big difference.
Best of luck OP, it is an unpleasant disease but there are plenty of things you can do to live well with it. For me, a combination of lifestyle changes and medication have really made things better, and at least I know when to expect flares so I can manage them better. If you have PSA, your flare triggers may well be totally different, so I really encourage you to keep track of symptoms and lifestyle factors to help you figure out which changes will be helpful.