from the research i've done, synovitis (the swelling of the synovium) causes some of our pain. chemicals related to inflammation are released, and some swelling of nerves may occur as well. anything swollen can hurt, but most of the stuff i've read states that the inflammation alone is not the only cause of pain.

some people are very sensitive to prednisone. i've spoken to people who feel relief from painful swelling within an hour of taking prednisone. if it can work that quick, i'd think it could be very easily noticeable when it wears off.

what causes the damage are those chemicals that are released for various reasons. the chemicals that are part of our immune system, that fight infections and stuff, can wear away cartilage over time. as the synovium swells, it can damage healthy cartilage and bone. so 'inflammation causing the damage' is probably a bit closer to the truth than the other way around.

most people accept the idea that if there is swelling and pain present, there is damage occurring - and the opposite: that if there is no pain or swelling, there is no damage occurring. that's not the case. damage can occur with little or no pain/swelling depending on the person.

because ra is not curable, most rheumys will treat to the symptom, meaning the point of treatment is to keep us symptom free to have a good quality of life. they also want to keep the disease from progressing as much as possible. although damage can be done with little/no pain or swelling, without the swollen synovium, less damage would be occurring. controlling the symptoms that bother us can help control and minimize the damage that is occurring in our bodies - but at this point, it cannot stop it.

Thank you. I will have to read this again tomorrow...my brain just won't process it tonight.
I can feel the swelling but have never had visible swelling. I must be sensitive to prednisone. It goes to work within minutes of taking it....bit lets the pain resurface if I don't take it at the same time each day. It's just so frustrating.

It is frustrating....I have lived with it a very long time and it never ceases to amaze me.....how our own body can attack itself....thinking our joints and tissue of our organs are forign .....like they don't belong ha ha!!! But so important to keep very good care of mind body and soul....ask questions.....read as much as you can....there is a lot you can do besides meds too....hydro therapy is wonderful.....a electric blanket on hi wrapped up in in when I'm hurting helps so much....diet...I do not eat fat.....mainly fish.....brown rice....fruit....green veges.....and it takes a lot of creativity to keep one self together....but I wish for you more good days than bad....Take care and rest is wonderful!!

dd24,

Most theories are under the impression that the inflammatory response continues after it should have stopped. Therefore, the inflammation is what causes the swelling. Then, the swelling causes the pain issues.

Dibbie: My Rheumy really wanted me to begin aqua therapy. So, I joined a local gym and take arthritis classes in a warm pool. I am always the youngest person in the class by 15-30 years. Most of the participants can complete the exercises better than I. But, I do believe it is starting to help and I plan to continue it long term.

Take care,
TheWino

Dd24, when I'm in a flare and on prednisone, I actually have to take it 2-3 times a day. Seems to wear off on me after 8 hours or so. You might talk with Dr about morning & night dosing.

Thewino, ahhhh heated pool therapy! I'm in there 2-3 times per week. Has really helped everything! You'll love it after a while.... It's the primary exercise I do as well, since prednisone made me prone to stress fractures in feet.

All I'm taking right now is Prednisone and have been doing my best to taper. For what its worth personally I can feel every little variance in the dosage and timing, even .5 of a dose with an increase in symptoms and withdrawl side effects. I am at 7 right now, take 5 in the am and 2 in the later afternoon and can feel the rush soon after I take it. Helps with the "energy" in the afternoon but its been a beast to try and regulate. I wonder about the timing you mention-will be interested to see posts following. Sometimes it takes me a day or so to put 2 and 2 together about what could have triggered something change in medication, exercise,etc., I keep a running notebook to keep track.Hope you're feeling better.

The only problem I have with heat is it causes fatigue. For example...when I walk for exercise, when my body warms up, I start feeling like I don't have any muscles in my body-like muscle fatigue. Any excertion in the heat causes that to happen.

I will talk with my rheumy in April about this and maybe he can shed some light on it for me.

For now I just have to remember to take the prednisone at the stroke of 12 or .......

dd, I'm a bit surprised that the instruction you've gotten is to take your first dose prednisone at noon. My instructions have always been to take at least a partial dose no later than 9am to "coordinate" with the body's peak cortisol release.

And, for my 2 cents on the swelling you experienced, this may simply be a flare - or, you may be sensitive to a delay in taking your meds. I generally take my morning meds immediately after breakfast to ensure that I have as little swelling and discomfort as the day progresses as possible. I'm also pretty active in the morning helping three kids get ready for school - packing lunches, making breakfasts, styling hair, helping little ones get dressed and buckled into their car seats, etc. So I really need to hit the ground running asap; for that reason, 70% of the day's meds are taken by 6:30 am. Maybe shifting when you take your meds would help if your swelling and pain continue to be a problem.

trinaunz, I take Synthroid first thing each morning for thyroid problems...on an empty stomach. I take prednisone with my lunch each day. Lunch just seemed a better time because I don't always eat breakfast. Gives a little space between taking the meds.

I "felt" swollen, but I don't actually swell....at least not to my eyes. Sometimes my knuckles get red. I just have no visible signs of RA.

I do have problems at times trying to unbuckle my grandbabies from their car seats. My thumbs just don't want to press that darn button...and trying to pull the buckle apart is not easy either...no strength in my hands at times.