u/oncepersephone

I was hoping to get some insight from others with RA on prednisone and methotrexate.

Background info: I (31F) started experiencing symptoms the first of January, I was put on 20 mg of prednisone in April after my MRI results until my rheumatology appointment, and I was diagnosed with seronegative RA the first week of May. I started methotrexate in May at 12.5 mg while tapering off the prednisone. I was then increased to 17.5 mg near the end of the taper when my symptoms started to come back but I can't tell a difference with it yet.

My next appointment isn't until mid September, but my symptoms are getting worse weekly since fully stopping the prednisone a month ago. In January, I could not fully bend my fingers/make a fist with either hand, I had almost no grip strength and could not pick up glasses/my phone/turn door knobs/etc., and I had a lot of hand soreness/sensitivity with even minor use. All of that went away with the prednisone except for some mild stiffness still. Currently, all of my previous symptoms are coming back. However, I started having pain/stiffness in my toes a month and a half ago that's now hitting my wrists and ankles as of the past week or so.

I already messaged my rheumatologist in the portal to ask if I need to go back on prednisone in the meantime, but has anyone else had their symptoms come back fully when getting off prednisone? Has anyone had methotrexate kick in after this long and start actually working or did you have to start adding in something else to get relief?

Sorry if this is a huge ramble, I've just been pretty disheartened since the symptoms started coming back so I was looking for others' experiences + a little hope that my quality of life can get back to normal eventually!

Hey everyone,

I (31F) was diagnosed with seronegative RA a week ago and I start 12.5mg methotrexate next week. I had excision surgery for endometriosis this past Monday so my rheumatologist said to wait a week into recovery.

As some background info, my symptoms all started in early January seemingly overnight: I woke up with terrible pain/sensitivity in both hands and they were so stiff it felt like they were encased in concrete. I couldn't make a fist with either hand and my hands hurt so bad it felt like they were bruised down to the bones so I essentially couldn't use them. (Side note: I noticed during Thanksgiving while baking/cooking that my hands were getting "stuck" in positions, like when using a piping bag, so my rheumatologist said it was probably already starting to express and I just didn't know.)

I waited a month to see if it would improve on its own in case I did something to cause it that I wasn't aware of and my sports medicine doctor essentially has been running cover for me since February. I saw the quickest rheumatologist I could get into in March (with a 6 hour drive total) who seemed puzzled and kept saying "20% of healthy people have a positive ANA" as only a 1:160 ANA showed on the bloodwork I brought. He ordered an MRI of my left hand, but canceled my follow-up appointment and sent me a portal message dismissing me before the MRI was even performed.

My MRI came back with "nonspecific tenosynovitis of the fourth extensor compartment" with the radiologist noting to follow up about possible RA, so I went back to my sports medicine doctor, who broke out her textbooks from school and ordered all the extra labs she thought I would need while I waited to see a different rheumatologist in a month. She also put me on 20mg of prednisone, which basically gave me my quality of life back now that I'm 40+ days in (but I'm super puffy in my face and my self esteem has taken a hit lol). My hands have been relatively normal unless I overdo things and they swell some in the evenings but other than not being able to make a full fist with my left hand, I have finally been care for myself instead of depending on my spouse for basically everything.

However, now that I'm a few days out of surgery, I'm noticing my hands are getting a lot more painful like they were before the prednisone. The stiffness is a little longer in the mornings now (it went from a few hours to about 45 minutes after the prednisone kicked in, now it's back up to about 2 hours until I can make a fist with my right hand) and I'm having pain/difficulty with opening things, picking my phone up, etc. My prednisone amount hasn't changed and other than alternating Tylenol + Advil for 3 days like my surgeon said (I didn't want to use the oxycodone or muscle relaxers), the only other thing that stood out that I was really given was the stress steroids during the surgery because of the prednisone. I did have to use my hands a good bit to pull myself out of chairs for the first day but after that, I've just been bracing with a pillow + my spouse lifts me in/out of bed. So I'm not quite sure what triggered it.

My rheumatologist wants to start tapering the prednisone at the same time I start the methotrexate and, while I'm excited to come off of it so I can lose the puffiness, I'm so scared of losing function of my hands again now that they're somewhat messing up from surgery. I don't go back in for my follow-up until June 16th, but my rheumatologist did give me the go ahead to wait an extra week if I wanted to start the methotrexate and start tapering.

Has anyone else kind of flared worse from surgery? And if so, did you kind of bounce back after a bit or did it last?

And does anyone remember how fast methotrexate kicked in for them when they first started?