Managing inflammatory back pain

I was diagnosed with Rheumatoid Arthritis in 2009. After a long fight with back pain, thought to be mechanical, it has been confirmed by MRI that I have inflammation in my SI joints. I do have some facet joint problems too but I am not clear whether it is mechanical or not.

Anyway, I have found that gentle exercise really helps my pain levels but my RA is uncontrolled right now. I know my back needs to move but my feet, ankles and knees are swollen and inflamed. I am struggling to balance managing those joints with managing the need for my back to move.

I've found an affordable gym with a warm pool that I plan to join which the spine ortho said would be good for all my joints. That still doesn't solve my day to day need to balance rest with movement.

Any tips would be gratefully received. Thank you.

7 Replies

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  • Check out the self help information on the nass.co.uk website. They have downloadable exercise guides and a "back to action" app, for the stretching exercises that are essential self help for spondyloarthritis (spinal inflammatory arthritis). I can't do all of them, but I just do what I can, and try to push all my joints to their full range of movement every day, and that really helps. What treatment are you on? If its just DMARDs, then maybe you should ask to see an ankylosing spondylitis specialist - DMARDs won't do anything for that inflammatory back pain, which is usually treated first with NSAIDs (at full prescription doses, and taken regularly) and if those fail, with anti-tnfs. You could also ask if a steroid injection or a short course of steroids would help - that would give most folk a bit of relief from inflammatory pain. Unfortunately steroids are not a safe long term treatment, and I find that the effect doesn't last once you stop them. I do use them occasionally though, as it does give me a "pain holiday", that helps me get back on track.

  • Thank you so much, earthwitch. I spent a good couple of hours on the NASS site, particularly looking at the exercise section. I downloaded the app on my iPad and my phone.

    I'm on injected MTX, leflunomide and Humira. I saw my rheum nurse today and she said I need to give the Humira more time to work; it's only been 2 months. I'm on the max dose of celecoxib and loathe to try another anti-inflammatory right now as I'm having other health problems, so don't want to rock the boat while I'm in the diagnosis process.

    I react really badly to oral steroids, so it would have to be a very last resort. I had hoped for a steroid depo but while I'm ill, nurse doesn't think this is a good idea.

    Do you swim? If so, do you find it helpful?

  • I used to go the pool a bit, but not really swimming as such, as some of the strokes can put more stress on parts that hurt. I really just did stretches and moved in the water. I don't go much now as I have quite a lot of damage, including neurological damage, which makes it difficult for me to move my legs properly, and I was finding that swimming, and getting dressed again afterwards, was really wiping me out, and destroying any benefit I got from it. I just do stretches now, and walk as much as I can with crutches.

    I hope the humira works for you, but the nurse is right in that it can take longer than 2 months to kick in.

  • I don't think I can swim properly anymore. But I've been advised to do stretches and walking in the water.

  • I did that and it made it worse i was such pain afterwards

  • Could it be worth you being referred for physio??

    My GP referred me for physio a few weeks back due to back pain I've had for over 6 months and painkillers that I take for OA in my knees and feet don't touch my back pain. After a couple of sessions, I was diagnosed with SI pain and the physio has given me 3 gentle exercises to do a couple of times a day to help strengthen the surrounding muscles (taking into account my limited mobility due to my OA and other conditions). For the last 2 weeks I've also had ultrasound therapy where my SI joints are and had kinseo tape applied to my lower back this morning. To my surprise despite a little light gardening this evening for half an hour after work, I'm in very little pain for the first time! Last week I wasn't convinced the physio was helping but tonight I'm starting to change my mind :)

  • Thanks for the reply. I probably should have mentioned that I am having weekly physio on the NHS including using their gym equipment. I am also seeing a private osteopath. I am seeing some improvement which is good. Glad it is helping you. :)

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