Recently diagnosed and waiting on meds, but now I’m feeling better after a cortisone shot..?
So sorry this is long, but bear with me please. I (37f) was just diagnosed with psoriasis by a dermatologist on 5/28 and then PsA by the rheumatologist on 5/29. When my “initial” issues started in mid March, I had just had a small cyst removed from under the skin on my back near my spine. I also had a spot on my spine near there that had been in pain since January that I assumed was a gym injury but it wasn’t getting better. After the cyst removal the GS told me to stay out of the gym for two weeks.
The next week my knees and hips started to ache and it took a bit in the mornings to get moving and not be hobbling around. After about a week of that I contacted my PCP and asked if I could get in for all of that, but primarily that pain from January. That very same night I developed random and abrupt major swelling in both legs from the knees down and my right knee felt much worse and felt unstable or like it was “slipping” or “floating”.
I had an upcoming important family trip so I was in and out of my PCP clinic for the next 2 weeks doing numerous blood draws, ultrasound for blots clots, X-rays on my back and knees and all they could tell me was “looks like you have inflammation”. I dumped all of my symptoms, bloodwork results etc into ChatGPT because I was desperate at that point and it suggested I asked for a prednisone taper.
I got the first taper and started to feel relief in the first 16 hours. The swelling went way down and I could actually walk. While on the vacation the taper ended and a day and a half later I was more swollen, stiff and in pain again. I was able to get another smaller and shorter taper to get me through the rest of the trip and home.
After the 2 prednisone tapers that helped a lot, but did not entirely clear the issues, the swelling went away but I was still in pain in many spots, now newly including my hands, collarbone/shoulder in addition to the knees and hip. For about 4 weeks I have been barely surviving off of constant and daily ibuprofen, icing, knee braces and walking as much as I could when I could.
I finally had the dermatologist appt I had scheduled months prior and she said I definitely have psoriasis, and because I also had it in my pelvic region she felt confident she could fast track approval for a biologic, especially knowing about my other pains. She gave me a new lotion/ solution for my scalp and a lotion for my body to replace the clobetesol my PCP had given me in December for the suspected psoriasis I was dealing with then. Then she started the process for getting me on Taltz.
The very next day I had my first appt with the rheumatologist and he did an ultrasound on my knee finding a lot of fluid. He pulled out 10cc of fluid then gave me a cortisone shot. He agreed that it was PsA and sent me for baseline X-rays on my hands and feet, and scheduled me for an MRI in two weeks. Within about 12 hours not only was my knee feeling better, but all of the other spots have been too! I have slept better (and almost pain free) the last two nights than I have in MONTHS.
I’m so confused though. Isn’t cortisone supposed to be a localized pain relief? How is it that my hands and hips have almost no pain now? And my shoulder /collarbone is like 80% better? I didn’t change anything else, other than I have now been able to take less ibuprofen (like one or two a day instead of 6) and haven’t needed the knee brace or to ice any spots. Now I am questioning if I really need to be going on a serious med like Taltz? I’m not going to lie that going on biologics makes me slightly nervous. Has anyone ever experienced something like this? Am I buying into some sort of false hope?
TL;DR - I’ve been in pain and had swelling since mid March. I had two prednisone tapers in April that helped but after those the swelling went mostly away but pain remained in hip, knees and back. Then hands and collarbone/shoulder also started to hurt. I got diagnosed with psoriasis by derm, and with PsA by rheumatologist the next day. He pulled 10cc of fluid out of my knee and gave me a cortisone shot. Now the pain all over my body also seems to have abruptly stopped?! Derm is trying to get me approved for Taltz, but like do I really need it? Is this false hope I am better? How did a localized pain relief shot helping all over??