Enthesitis

[Allfurcoatandnoknickers]

Does anyone have this? If so what does it feel like and how did you treat it? Any exercises that helped?
I’ve had a number of tendon issues and the latest is insertional achilles tendinitis - it took me 3 years to semi recover from the last Achilles issue and it’s seriously affecting my quality of life as I love hiking and can’t do that at the moment. Standing, going up and downstairs feel like a hot poker in my heel.
I’m seeing a rheumatologist for a second opinion on psoriatic arthritis- the last one I saw totally ignored my tendon issues.
I’m managing to swim and do a gentle gym workout, icing, taking paracetamol and resting it as much as possible. A physio has worked on it and given me some exercises. I threw a hell of a lot of money at the last Achilles tendinitis including shockwave therapy and acupuncture and nothing helped 😟

My first thought on reading you post was to wonder if you have PsA but I see you are already referred to a rheumatologist. What helped me was being put on a biologic. The first one helped a bit, dose was doubled and it helped a bit more. Changed again and the one I'm on now seems to be doing the trick.

When I was diagnosed I had enthesitis, tendonitis, bursitis and dactilytis so hard to determine which was causing what symptom😀

I hope you have a productive appointment and they get to the bottom of it.

I’m thinking it could be PSA but because all
my bloods seem to be ok I need to push for further investigations. Were you started on methotrexate or biologics?

My bloods have always come back normal. I was diagnosed on the basis of the various bits of inflammation (the dactylitis in particular is a marker), a tiny patch of psoriasis on my scalp and nails lifting slightly at the sides.

I went straight on to a biologic, partly because I have axial involvement, but also I'm in Ireland and we don't have the same guidelines as the NHS. I think in the UK you have to fail a couple of treatments before you can get a biologic?

Yes that’s my understanding- looks like a trial
of methotrexate first I think?

It's unfortunate that they can't just prescribe the most appropriate medicine like they do here. But hopefully the methotrexate will work for you.

I know! Wouldn’t it be so much easier?!

But on the plus side you don't have to pay for meds. We pay a maximum of €80 per family per month for meds unless you have a medical card. About ⅓ of the population have a full medical card.

Between myself and dh, we pay €80 pm but we get €30 back on insurance so €50 net. We get tax back too though so I think that's about another tenner.