How do I explain PsA pain to my family at age 25?

Question

Hello doctor,

I was diagnosed with PsA. Some days, my fingers are so swollen and stiff that I cannot hold a cup properly in the morning.

But when I try to explain it to my parents, they just say, You are too young to have joint problems," and suggest I exercise more. How do I explain PsA pain to my family at age 25 when they do not believe it is as serious as it actually is?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

This might indicate that your psoriasis might be active in your joints, which is a serious concern, as psoriatic arthritis is an erosive disease that can cause joint erosions and destruction in the long term.

Unfortunately, joint problems are usually underdiagnosed and undervalued despite their grave importance due to their long-term impact on the patient's quality of life and ability to perform different activities of daily living. Try to talk with your parents and show them some reports about how dangerous psoriatic arthritis can become if it is not treated well, and hopefully, they will understand your issues.

In the meantime, I suggest adding Methotrexate to your treatment regimen to control joint pain, and if there is still no improvement after two or three months, consider shifting to biological therapy immediately.

The investigations to be done include:

CBC (complete blood count).
ESR (erythrocyte sedimentation rate).
CRP (c-reactive protein).
ALT (alanine aminotransferase).
AST (aspartate aminotransferase).
Sr Creatinine (serum creatinine).
HCV Ab (hepatitis C virus antibody).
HBsAg (hepatitis B surface antigen).

The treatment plan includes:

Methotrexate 25 mg weekly.
Folic Acid 5 mg weekly.

Follow up after three months of Methotrexate to evaluate the response and the possibility of needing biological therapy.

Preventive measures include:

Rest.
Physical therapy.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.