? for those with back pain/AS

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immunosci
Regular Member


Date Joined Jun 2006
Total Posts : 326
   Posted 12/5/2007 1:11 PM (GMT -7)   
It's been a while since I've posted. I've been struggling with getting iron defiency anemia under control and terrible SI joint pain. The SI joint pain started a little over a year ago. I saw my primary care doc who sent me for physical therapy. The PT said that my SI joint was locked on the right side. They had me do exercises and used steroid patches on my back. I don't think the exercises helped much, but the steroid patches did a little. As soon as I finished the PT the pain came back, but was manageable. I've mentioned it to my gastro at every appointment, but he doesn't seem to be too concerned. I finally asked him for something to help with the pain, because Tylenol wasn't helping. There were some meds that he suggested, but I couldn't take because of interactions with other meds that I take. We finally settled on 200mg of Celebrex as needed. He didn't want me to take it daily because of possible GI side effects. Well, over the last month the SI joint, as well as my neck on the right side), are killing me. I've been taking the Celebrex daily, but it's not really touching the pain. I've made an appointment for Tuesday to see my primary care doc about a rheumatologist referral. I know this has been asked before, but I didn't know how far back to go to look for the post. What do you do for pain, particularly the back pain? Are there alternatives to Celebrex and narcotics? I'd like to have several suggestions to put forth on Tuesday since my primary care doc is very responsive to patient input. Any help or advice is really appreciated!!!!!

Thanks,
Jen
-Formal diagnosis of Crohn's Disease in ileum in July 2005.
-Experienced what were most likely flares for 12-15 yrs.
-6-MP, protonix, cymbalta, wellbutrin, trazadone, miralax, allegra, celebrex


Clcaj
Regular Member


Date Joined Oct 2007
Total Posts : 82
   Posted 12/5/2007 1:53 PM (GMT -7)   
I'm sorry I can't be of much help since I haven't had problems with my SI joint - only my hips and knees.   I too have been thru physical therapy and didn't get much relief.   Many people in this forum see rheumotoid arthritis doctors - maybe you should consider that.
 
Have you tried aquatic therapy? Just moving around in water on my own helps me more than traditional physical therapy.  Also using heat patches like crazy...
 
You could ask your primary about getting a cortisicoid shot directly into the SI joint - that may do the trick - if you want to avoid pain meds.
 
Good luck to you!  Let us know if find anything that works.
DX: mild to moderate Crohn's for 34 years
Additional benefits: chronic anemia, B12 deficient, peripheral neuropathy, facial mylagsia, joint pain, underactive thyriod
Current meds: Colozal, Nexium, Entocort, Flagyl, steriod cream, monthly B12 injections, Neurontin, Synthroid, Effexor ER, pain meds as needed


immunosci
Regular Member


Date Joined Jun 2006
Total Posts : 326
   Posted 12/5/2007 3:24 PM (GMT -7)   
Thanks for the response, Clcaj. I am going to ask my primary about seeing a rheumatologist. I used to have one here years ago when they thought I had rheumatoid arthritis. It turns out the joint pain then was probably my first signs of Crohn's disease.

I haven't done the water stuff lately. I used water aerobics to rehab my knees after my surgeries. It was helpful then. I do get exercise. I work with a personal trainer twice a week. She always watches me very closely to make sure I do things right so I don't put any strain on my back or neck. She also has me doing a lot of stretching and "core" exercises to keep my abs and lower back muscles strong. Many of the "core" exercises are similar to what I did in PT.

I do use the heat patches while I'm at work or out and about. At home I use a heating pad or a soak in a warm tub. That helps some. I was thinking about the cortisone shot into the SI joint as well. The physical therapist I saw said that might be a possiblilty down the road. I think I've hit that spot in the road. This pain is really beginning to interfere with my life.

Thanks again for the support!

Jen
-Formal diagnosis of Crohn's Disease in ileum in July 2005.
-Experienced what were most likely flares for 12-15 yrs.
-6-MP, protonix, cymbalta, wellbutrin, trazadone, miralax, allegra, celebrex


Clcaj
Regular Member


Date Joined Oct 2007
Total Posts : 82
   Posted Yesterday 7:35 AM (GMT -7)   

It sounds to me like you're doing everything right - a real credit to your personal strength and endurance.  Hopefully, an RA doctor can help you with the 'next step', whatever that may be.  

Keep on keepin' on!!!  I admire your commitment to exercise.  I wish I had your energy and ambition!  :-)


DX: mild to moderate Crohn's for 34 years
Additional benefits: chronic anemia, B12 deficient, peripheral neuropathy, facial mylagsia, joint pain, underactive thyriod
Current meds: Colozal, Nexium, Entocort, Flagyl, steriod cream, monthly B12 injections, Neurontin, Synthroid, Effexor ER, pain meds as needed


Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted Yesterday 12:31 PM (GMT -7)   
Get yourself to a rheumatologist as a good rheumy will evaluate your joint pain and determine what is going on with your SI joint. The therapist's observation that your SI joint is "locked" needs to be relayed to the rheumy. If you have fusion in that SI joint, it is an indication of Ankylosing spondylitis. Sacroiliitis is not always visible on an xray. If your pelvic xrays do not show why indications for the SI pain, insist on a MRI.

Twenty percent of people with CD have arthritis related issues. Spondyloarthropathy associated with Crohn's can cause real painful and damaging problems in the spine and peripheral joints.

I have been taking tramadol for quite sometime to help with the pain of my AS. I have Vicodin for breakthrough flares.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, small fiber peripheral neuropathy, avascular necrosis, diffuse connective tissue disease, Sjogren's Syndrome ?
 


Matthew
Veteran Member


Date Joined Oct 2004
Total Posts : 3932
   Posted Yesterday 1:40 PM (GMT -7)   
I use a portable TENS unit at work, but I also take Tramadol & Celebrex. Plus, I get steroid epidural injections in my spinal cord.
I am not impressed with Celebrex, either..
I am not afraid of narcotics, but they do tend to become less effective over time..

Matthew

immunosci
Regular Member


Date Joined Jun 2006
Total Posts : 326
   Posted Yesterday 1:50 PM (GMT -7)   
Thanks for the replies, Ides and Matthew. I had spinal x-rays a year ago when the pain started, but they didn't show anything. My gastro said it wasn't a big deal since the x-rays were negative. He had also suggested Tramadol, but it can have bad reactions with one of the other meds that I take. I forget which one right now. I've been concerned about anklyosing spondylitis because of its association with CD and my mother had it as well. I hadn't thought about a TENS unit. I have friends that use them to help with migraines. I'm not afraid of narcotics. I've taken them with my knee surgeries. I'm really sensitive to the sedating effects and can't afford to be drowsy with the work that I do. I'll let you know how it goes Tuesday with my primary care. Thanks again for the advice!!

Jen
-Formal diagnosis of Crohn's Disease in ileum in July 2005.
-Experienced what were most likely flares for 12-15 yrs.
-6-MP, protonix, cymbalta, wellbutrin, trazadone, miralax, allegra, celebrex


Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted Yesterday 5:59 PM (GMT -7)   
I forgot to add that I had my right SI joint injected with a cortisone based med in September. It was amazing to discover how much pain the SI generated after the pain was relieved. Still mostly pain free in that SI joint after 3 months. I have also used a TENS unit with good relief in the early stages of the SI problem. However, I then developed an allergy to the glue on the electrode pads...
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, small fiber peripheral neuropathy, avascular necrosis, diffuse connective tissue disease, Sjogren's Syndrome ?
 

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