Back pain

[gradyjackjacob]

I recently wrote a message stating i,ve got grade 2 spondylolisthesis and facet joint arthrosis in my back,i,ve spoken to my doctor about the awful pain that eases during the day but is really bad in the morning but he said because i,m taking zapain there,s not much else he can give me.Has anyone got the same problems.

[Runrig01]

spondylolisthesis isn’t an inflammatory condition, it is where one vertebrae slips over another. Same with facet joint arthritis is another name for osteoarthritis and again not inflammatory. So neither of these conditions would be eligible for biologics. Although if gradyjackjacob also has rheumatoid arthritis or another inflammatory arthritis, they may be.

Re the spondylolisthesis, it’s usually treated with nsaids, steroid injections and physio. If it doesn’t improve with these treatments some may need surgery to either fuse the offending vertebrae or decompress any nerves or are cruets being compressed by the slipped vertebrae. Hope you can get a good response to non surgical treatment. I have nursed patient’s who had fusion for spondylolisthesis, and they achieved very good results, although often the backpain itself has remained, but tingling, numbness and sciatic type pains settled.

[gradyjackjacob in reply to Runrig01]

Thank you for your usful reply,i have rheumatoid arthritis and the helpline only treats rheumatoid so as this is osteoarthritis they won,t want to know.I,m taking olumient for the rheumatoid which won,t work for osteo,i think i,ll ask my doctor for a steroid injection,and physio.I,m in constant pain but the morning pain is horrendious.

[Runrig01 in reply to gradyjackjacob]

hopefully the physio will help. It’s mainly about strengthening the muscles around the area where your vertebrae has slipped, to support it better. You may find your GP says you need referred for the steroid injection, as GPS tend not to do spinal steroid injections, it’s usually pain management clinics or orthopaedic teams. Hope it becomes manageable for you 🤗

[gradyjackjacob in reply to Runrig01]

Thank you,i was going to ask the doctor if i could have a steroid that they inject into your bottom.Here,s hoping.

[Runrig01 in reply to gradyjackjacob]

ah yes, they should be able to do that 🤞

[gradyjackjacob in reply to Runrig01]

I,d cross my fingers if i could.

[oldtimer2]

It's usually spinal surgeons or radiologists who do the spinal injections under radiological control.

I had one in June last year and found that I couldn't walk for about a week afterwards, but it did get rid of the terrible constant sciatic referred pain. It's left quite a bit of more diffuse pain due to involvement of several facet joints and a couple of healed fractured vertebrae after a fall last December.

The key for me is exercise - I do the exercises from the Royal Osteporosis Society website. The lying down ones I do before I get up in the morning, so that I can stagger to the shower where the hot water helps to get me moving more. Then Zapain, breakfast and the standing and kneeling exercises. I'm doing some gentle circle dancing, often not managing to finish a dance, and frequent mobilisation exercises during the day.

But I do find that it is always a bit better in the first week after I've had the adalumimab (Imraldi) injection, then gets worse again before the next one is due, suggesting that there is some inflammatory process there as well.

So, keep exercising!

[gradyjackjacob in reply to oldtimer2]

I,ll try,thank you.

[Luludean]

i have same problem and was put on biologics, Humira then Benapali, had nasty side effects so offered Methotrexate. I am not taking it ( many reasons) . Mornings are bad but it eases , and, I try to walk everyday. All the best.

[nomoreheels]

I don't have the same problems as you but in addition to Zapain (paracetamol/codeine) my pain relief includes Butec (buprenorphine) transdermal patches. In addition I’m prescribed amitriptyline as a muscle relaxant which in turn eases pain & prednisolone, but I’m on a slow taper hoping to be off it by the end of the summer. I also have pregabalin for nerve pain & Oramorph (liquid morphine) for when needed.

If you feel you're in need of some further help regarding pain maybe asking to be referred to the pain clinic, although I've heard they generally have long waiting lists so personally I'd see if an alternative GP in your Practice can prescribe something for you, even if it's only pro tem. Did your GP go into any depth as to why he won't prescribe anything else? Alternatively, perhaps he'd consider changing the co-codamol & prescribe something else.

[AgedCrone in reply to nomoreheels]

Be very careful if you ever come off Buprenorphine…….I had been on it for a couple of years ….only 10 mg & suddenly it stopped being effective & my GP said I would be fine just stopping……I wasn’t! I had the most awful opiate withdrawal symptoms…..& it took a good three months for them to disappear.

[Mmrr]

I have similar lumbar issues to yourself. I'm on a JAK inhibitor, leflunomide and oral prednisolone, as well as diclofenac acid (voltarol). I do find my morning prednisolone helps loosen up my lumbar issues, even though they are OA.

But not a reason for taking oral steroids - I'm just commenting that they do help.