Question for those with CD and arthritis

I injured my right hand 3 years ago in a car accident (partially tore a ligament between my index and middle fingers), and have been getting steroid injections in it to control the pain. At first, the shots helped and I had up to 6 months of pain relief, but now the shots are only lessening the pain for a month, but I still have pain when using my hand. There is no surgical fix for my hand at this point, and the orthopedic brought up the possibility of RA or crohn's related arthritis because there is still inflammation in the area. He gave me a referral to a rheumy, but I can't get in for 4 months and I don't know what insurance I'll have then, so it's on hold.

He said that he suspects I would have more joint problems if I weren't on Humira, and that he feels that's keeping my joints in check, but he thinks that a rheumy would want to add meds to help my hand. What meds do you take in addition to crohn's meds to control RA or arthritis? Or do you just take pain meds when necessary and deal with the pain?

I do have pain meds and take them sometimes (especially after working with my hand a lot) but I don't like the idea of taking pain meds more than necessary.

Thanks for any suggestions you might have. I know it might sound silly, it's just my hand, (and a lot of you have far worse joint issues than I do) but it's my dominant hand and working with it at all causes a lot of swelling and pain. Also, my back bothers me almost daily, and I wonder if this might be arthritis as well since xrays have always been completely normal.

Also, I might ask my PCP to run bloodwork when I see him next to rule out any other AI diseases as well, but don't know which ones to ask for.

ps. and it's not "just" your hand. You use your hands all the time - hand pain is terrible, hurts, and is incredibly disabling :-(.

Much sympathy - Ivy.

Yep. It makes perfect sense to me. The more I use it, the worse it gets, and the pain spreads right up to my shoulder and back and it goes stiff and I can hardly use it at all. It's miserable, and I feel for you.

I'm another with arthritis issues and see a Rheumatolgist...I'm taking sulfasalazine, which works a bit for me...not sure if testing per se would help(like a blood test), but a Rheumy can figure out which joints are tender, and pinpoint it a bit better (ie, is it joint or tendon issue? is it more OA or InflammatoryArthritis? Injury or disease?)

Crohn's related arthritis does not tend to show up on x-rays' as it tends to NOT destroy the joint...not to mention, there is more likely to be involvement of the ligaments and tendons...this doesn't mean the pain is any less...

Where on your back? More towards your shoulder joint? or is it more sacral area?
Good luck.

The ortho I see is a hand specialist, and he says even when it happened, nothing could have been done surgically. I partially tore the ligament (on the MRI they couldn't even see the tear, but because of the swelling, fluid, and joint being separated it indicated a partial tear) between my index and middle fingers. The joint is stable but was separated a little when it was hurt. Now it's just swelling around that area and toward my ring finger.

I injured my back (at work) 5 or so years ago. I had xrays which were normal, but it's never been the same either. At the time I saw an othopedist about that and it was ruled as a back strain...from overuse, rather than a specific injury. Though I will add that most xray techs have back problems from lifting/pushing, etc. Oh, and it's my lower back and SI joints that are causing the back pain, more on the right side and sometimes down my right leg.

I have muscle relaxers to take for my back, so I just deal with that and try to be careful how I do things like working in the yard or cleaning.

My insurance runs out at the end of Nov, so I'd like to see a rheumy, but I can't get an appointment by then, and I don't know what insurance will be like after that. I am applying for a state insurance program (it's my ONLY option at this point) so once I hear about that, I may try to make an appointment with a rheumy and really figure out what's going on.

I do have another question for you all though. IF it is crohn's related arthritis, would it be better when my crohn's isn't active, or could it still be affected regardless of how the crohn's is? Right now my crohn's isn't active, so that makes me wonder. Is there usually a correlation between the 2 or not?

I use sulfasalazine also to manage hand pain, and it's working well.

I've also heard that the arthritis shouldn't be flaring if the Crohn's is under control, but that hasn't been the case for me.  My Crohn's is in remission but I've been in a constant arthritis flare for almost two years now.  There are a lot of other meds that a rheumy can try...sulfasalazine, salsalate, methotrexate, plaquenil, leflunomide, just to name some of the ones we've tried.  I will warn you that a lot of these can aggrevate your stomach, so it takes trial and error to find something that works.  The only thing that worked for me caused my liver enzymes to elevate and I had to stop it.  We are now in the process of trying to get my GI to agree to stopping Humira and switching to Enbrel (which does nothing for Crohn's) just because we have exhausted all other options and we're to the point that I will end up in a wheelchair in the next year or so if it continues to progress as is has been (and I'm 29).