JOINT PAIN
Antiphospholipid Syndrome has been recognised as an inflammatory disorder as well as a clotting disorder; this can result in inflammation throughout the body affecting organs and joints. It is joint pain we will be discussing here. Not all patients with APS experience joint pain.
Joint pain in APS can be debilitating, causing extreme pain and stiffness. The joints affected can be anywhere and everywhere. The pain can become exhausting to experience, sometimes not much swelling is noticeable, and so family can be less than understanding! I have heard many stories of doctors who fail to recognise the pain and distress of joint pain in APS.
Sometimes the pain can spread throughout the joints in the body, making walking extremely difficult. If severe and widespread, it can cause everyday life to become a nightmare for the sufferer. The patients CRP (C reactive protein) levels are frequently elevated. The CRP levels are not necessarily indicative of the severity of the pain.
Your doctor will need to treat you on an individual basis. Your treatment will depend on the amount and type of pain you are experiencing and your current treatment regime.
Please discuss the following with your specialist:-
Anti malarial therapy is considered a mild disease modifying therapy in the management of inflammatory arthritis, in particular for Rheumatoid arthritis and joint, skin and fatigue symptoms in Lupus. It has also been found to be very effective in the management of general symptoms such as rash, fatigue and pain in APS.
The drug is available in several forms.
Chloroquine sulphate - Nivaquine / plasmoquine
Chloroquine phosphate - Chloroquine
Hydroxychloroquine - Plaquenil
The decision regarding usage is based on need for treatment of the actual immune process rather than just treatment of symptoms of pain. The response is seen only after 6 weeks - 2 months, but response may take as long as 6 months to begin to be effective. The drug may be used alone or in combination with other disease modifying drugs - in particular methotrexate. Interestingly, combination with methotrexate seems to reduce side effects of the methotrexate. Methotrexate is considered only if the immune response dictates a need.
There are also other treatments used to control the immune process and therefore the symptoms that are experienced by the patient.
Anti-inflammatory drugs and other pain relief must be carefully prescribed by a knowledgeable specialist as these drugs can affect the anti-platelet and anti-coagulant therapy you may be taking. Some drugs can also in fact cause the immune response of APS to increase and cause you more problems. So, be careful to ensure you don’t take over the counter medication without the advice of a doctor with a good knowledge of APS.
I have had many positive stories of patients prescribed Lyrica. I personally had a very good response to this drug. It also has its side affects and these must be carefully weighed up by both you and your doctor.
ALWAYS GET YOUR DOCTOR TO OK ANY MEDICATION. ALWAYS KEEP HIM/HER INFORMED OF ALL YOUR MEDICATION.
Do not despair, a good specialist and a tailored treatment programme should help you achieve a good quality of life.
You are always welcome to contact myself or Wendy on our contact numbers if you wish to ask any advice on these matters.
* A false positive test for syphilis is characteristic of the antiphospholipid antibody syndrome. Patients with this false positive test do not have syphilis, and the illness has nothing to do with infection by syphilis.