Do you suffer with back pain? Did it come before or after your PsA diagnosis?

General
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Morning all,
Well it’s yet another sunny morning here in the UK and although we’re experiencing a beautiful spell of weather, I am pretty sure those of you living in the UK like me have been suffering with increase joint pain, swelling, stiffness and fatigue. It’s not the norm for us to have such long spells of dry weather so it can be tricky to manage when it occurs.
Alongside the regular aches and pains, and old friend has returned with a vengeance, ‘back pain’. I have been a back pain sufferer for most of my adult life. My options for treatment are now surgery (a triple fusion) or medication management. The odds of surgery being successful isn’t great, so it’s been medication and lifestyle management for the past 10 years and this has kept me going until now. It was during one of my prolapse discs episodes that I had my first PsA flare up. I didn’t even consider it was anything autoimmune back then, my entire body was in pain and I just wanted it to stop. Three years later and boy has things progressed rapidly and I’m now on biologic number one (for those of you following my Cosentyx post, no changes yet).
I am interested to know how those of you who also suffer with back pain manage this with you PsA. Do you see it as separate conditions or as one? What combinations of medication, lifestyle changes and dietary changes do you use? Is there anything you have either introduced or removed from your life to help with your pain management?
I think I need to review what I’m currently doing in my life health wise. My conditions are not being dealt with appropriately and they seem to be incontrol at the moment, not the other way around. So I’m interested to know what your experiences with your illnesses has thought you along the way and how do you manage with your back pain alongside your other ailments.

Nicole x

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Back pain, hmm, what an interesting one. So over my life (and I’m only 43 :joy:) I’ve had significant back pain I can connect to multiple causes - period pain (bear with me - it was years ago, but there is a reason I mention it), genuine back trauma (lifting a fridge onto the back of a Ute by myself, after an entire day moving house mostly by myself), odd -not-really-trauma but a response to twisting with a very light weight, clear PsA inflammation, and inflammation in my bowel (which feels uncannily like the period pain), and back pain related to stress, fear, or anxiety.

So; for me, if it feel like period pain (which the inflammation in my bowel almost always does, and the PsA sometimes does), then I go for a combination of anti-inflammatories and heat, either on my back or tummy, and they are generally effective.

For PsA only, DMARDs are the go, keep trying till you get the right one, even though I know it can be a long hard road❤️.

Mechanical stuff will be alleviated by physio and gentle exercise.

Stress, fear , anxiety, take longer to treat, but once you do, it tends to minimise the other problems. Pacing, meditation, relaxation, massage, and removing any truly negative people, if you have them in your life.

Meanwhile, remember the little things are multipliers, not additive. The plants you like growing, your pets, your favourite herbal tea. I know it sounds corny, and it takes time to work, but it does :blush:

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Hi Jen,
Thanks for replying. You really cheered me up with ‘the little comfort things’. It’s funny you should mention menstral pains, I haven’t had a period in over 2 years, long story, but my current meds and new biologics must have have triggered it to start again. It’s been incessant since Saturday and made me feel ill 2 years ago and still does now. I just made a 10-15 mins round trip on foot to my GPs, pharmacy and back and I am absolutely knackered now. My ankles and knees are throbbing. My lower back’s pounding and my tummy churning. The heat doesn’t help one bit, so I’ve just sat down with a large glass of ice cold water, looking out to my garden, listening to the birds. This made me smile along with your post. So I do agree, it during times like these that the little things make a difference.

N x

P.S. when it comes to back pain you name it I’ve probably tried it, both medical and alternative therapies.

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My back pain was unrelated. I actually had an l4-l5 laminectomy/diskectomy in my mid twenties. Since that extended recovery I’ve been good. I wasn’t diagnosed with psoriatic arthritis until about 10 years later.

Since diagnosis the only back type pain I’ve had is my SI joints.

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My PsA will get into my Sacrum and low back sometimes. It can be an issue. Thankfully, it doesn’t flare in my back too often. Mostly knees and shoulders.

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Well yes, lower back pain is part of the PsA picture for a lot of people. I’ve only just recently started having back pain and morning back stiffness. (Recently? Well at my age hehehehe that’s in the last couple of years.) But mine was more like sciatic pain. My rheumie said it was nothing to do with my PsA. My PCP said I needed physio. (More! ugh) Then my surgeon took an x-ray (to see how my hip was doing) and wouldn’t you know, my spine’s 10 degrees off vertical. (And that’s in addition to my being a few fries short of a Happy meal!) I also have a nice mess of facet joint problems in the lumbar spine. This is all since 2014, when x-rays showed my spine as being fine.
I see my rheumie next week. It’ll be interesting to get her take on the back problem now. In October I go to the PsA clinic, which should prove interesting.
So yes, this is since my diagnosis, and since my starting on biologics. What’s going on, I don’t know.

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I’ve been a hairstylist for 15 years just recently not working anymore. My back always hurt everyday. In the last year though just very recently being diagnosed with PsA I found I have mild scoliosis and osteoarthritis in my mid/low back. Being on my first round of prednisone completely took away my pain but on my last pill of only 5 MG I’m feeling the stiffness starting… dr just upped my dosage starting tomorrow of prednisone. Yoga stretching and hot
Showers are the only other things that help me. I’m 34. Typically when I bend over I wonder if I’m going to be able to get back up again. It’s crazy!

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Hi Nicole,

I’d have to say my back problems started way before I was diagnosed with PsA, but about 15 years after my psoriasis started…
I was around 35 the first time I had p.t., and it followed a stretch of hard physical labor (building our house) and having a baby at 31. I was told I had a bulging disc at that time…after several months of p.t., etc., all was well with my back for many years. However, my neck gave me trouble around the age of 40, but I think that was from whiplash—long story and I’m sure I told it somewhere along the line!

I guess I feel kind of ‘delicate’ or wimpy, especially because I like to think I’m tough, but it sure doesn’t seem to take much to get my back or neck acting up! Then again, I’ve done a lot of “men’s work” over the years and probably too much for a woman’s back (and feet, I should add)…I’m sure sorry about it now!

Around the time I was diagnosed with PsA I had all sorts of various back aches and pains—radiating to my butt, down my leg, electric shock pain in lower lumbar area, the sensation of one leg feeling shorter than the other — can anyone else tell me if they’ve ever had that? And, of course, terrible stiffness until I started Enbrel. Most of my pain disappeared shortly (within days) after starting Enbrel—I was on top of the world. That all came crashing down when my back went out 7 weeks into Enbrel! Pretty much the worst pain I’ve ever had! It all settled down after awhile, but since then (almost 4 years now) I’ve had to be very cautious about lifting, etc., and my legs are weak—pretty sure from damage to my spine.

So, I’d say - in conclusion - my back had been smoldering for many years before PsA diagnosis—just like most of my other PsA symptoms.
I’m an ongoing mess!

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I had pulled a muscle before PsA but that was the only back pain I had.

After PsA, I’m bone on bone between C1-C2, C2-C3, C5-C6, C6-C7 and now with throacic and some lumbar involvement. It’s all bound up in my shoulder issues (rotator cuff on both sides).

I keep it at a dull roar by taking 4 mg Tizanidine at night and at other times. I’ve had multiple cervical epidurals and will have another one in September. I just had my second thoracic epidural on Tuesday.

All that being said, I’m a criminal defense lawyer who writes appeals for a living. I bang on the keyboard A LOT. Even with treatment, there are days when my fingers go numb. I stop typing, do a little massage and wait. I start typing again until I can’t any more. If I’ve had multiple days of doing that (I filed five major pleadings in the last three weeks. I’m transcribing my newest trial now), then the numbness comes more often during the day.

I’m working with Dragon Naturally Speaking but that’s slow going. My mind works faster than the software.

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I have had back pain from ruptured discs but had epidural injections that helped since surgery wasn’t an option. I did develop pain between my shoulder blades in The thoracic spine since PSA started. I try to stretch daily but when it flares that doesn’t help. Heating pad and warm baths. I see a chiropractor and that sometimes helps. No good answer I’m afraid.

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Hi, Nicole2017,

I had pain for 37 years and a misdiagnosis of fibromyalgia before being diagnosed with PsA in 2012. My pain was often in my neck and shoulders, but it was a painful sacroiliac joint that actually led to my second referral to a rheumatologist (after decades) and eventually to a diagnosis.

About 18 months ago the back pain flared as a result of a variety of conditions coming together: sitting (in meditation), a cold environment, and no cushions for the chair that I was sitting on. Since then I’ve been struggling.

I see both the neck and should pain and the low back pain as connected to the PsA. It could be more complicated with osteoarthritic changes or other anatomical changes, but they haven’t been diagnosed and I’m not aware of any major injury.

I manage with meds, heat, physical therapy exercises, avoiding too much sitting, too much walking, and too much sugar.

Methotrexate helps; no results yet from my first biologic. I take as small a dose of NSAIDs as I can manage, 100 mg 2 x per day.

I use a heating pad at night when I go to sleep. It turns off after an hour. If I wake during the night, I use it again. It seems to help. I take a hot bath sometimes, too.

I have been in physical therapy for 7 months or so and been doing my exercises daily. They do seem to help. Though the path to being pain free is not straight, I am out of extreme pain.

I try not to sit for too long at any one stretch. Instead of energetic 1 hour walks I am taking two shorter 20 minute more casual walks every day, as suggested by my physical therapist.

I already know that too much sugar will cause a flare-up. I once ate too many of my favorite dark chocolate almond clusters and suffered afterwards. The MD told me that they don’t have any evidence for dietary effects…oh, well.

I don’t know if I remembered everything but I’ll add on if I do.

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Hello Laura,

For a very long time I have seen my back pain as a separate condition to my PsA. However over time with medication treatment for my PsA like the introduction of hydroxychloroquine, my back pain appeared to ease off and now only really flares up when my PsA flares up. I think for a very long time I have been misdiagnosed and my back pain is mainly due to arthritis. Don’t get me wrong the prolapse discs I had in the past were real and to some degree there are elements of mechanical failure, but for it to get worse so quickly was a sign that I had something else underlying, which was my PsA.

I was pretty active in the past even with back pain and I spent a lot of time outdoors, my last great outing was climbing Snowdon. Now I have had to slow right down and learn to pace (this took a very long time to learn), so that I can get through the day. I have recently taken up tai chi again, given up meat from my diet and started biologics. I am hoping (or should I say praying) that the biologics work and I hopefully get back to some form of my previous normality. There is still much work to be done, like I want to increase my level of exercise, lose weight and learn another skill like jewellery making. However before any of this can be achieved I think that it’s important that I continue to work on my mental health, stop blaming myself for my loss of abilities, be kinder and more compassionate to myself and most importantly look over the horizon knowing that one day most of this pain and unwanted suffering will go away.

I hope this goes some way to answering your questions.

All the best,
Nicole x

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Thank you for your very thoughtful reply, @Nicole2017. If heat helps you, I have tried a couple of other things that have also helped me.

One of those is the Thermacare product for back pain. You can actually wear it under your clothes and it heats the body for at least 8 hours. This is quite lovely when you have to been out.

Since you are already doing tai chi, you might also enjoy ai chi. These are gentle movements in a heated pool. I try to go at least twice a week. The one pool in town that is heated to about 80 degrees F, I think, has a number of classes, and one of them is sponsored by local MDs and is free. I have also found this helpful.

Have you found that not eating meat has made a difference? How have you tested it?

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Not blaming oneself and being kind towards the bodies that we have are so essential. I am glad that you mentioned them, @Nicole2017. For me it is meditation and process painting that help. Also time in nature, even if it’s only the back yard watching the birds. And time away from the news.

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Thanks for the Thermacare tip. I’ve ordered a couple from Amazon this morning.
The no meat diet was purely coincidental. My other half stopped eating meat because he suffers with diverticulitis and has problems digesting meat, so I gave it a try for about a month then went back to eating meat and could see a marked difference in how I felt. Eating meat makes me feel bloated, sluggish and adds to my fatigue. I also actually now feel healthier in myself and because you have to think about planning your meals there is now a huge increase in the amount of fruit and veg in my diet. I have even gone off chocolate. Anyone that knows me will tell you that I am a self-professed chocoholic :grin:. If there is anyway I can do to reduce my tiredness and it’s safe I’m willing to give it a try.
With regards to my mental health I am still trying to find that right place where my I can feel whole. Pain is my major issue. It makes me irrational, angry and frustrated, not just with everyone else but with myself. If I can learn to find that safe place within me, I am sure that I can learn to control my emotions and behaviour when my pain is at it’s worse. This remains my work in progress.

Nicole x

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I suffer from back pain. It started during my last pregnancy. And got way worse after I had the baby along with tons of other issues and they said pregnancy probably triggered PsA.

I suffered with pain of all sorts about a year before I told a dr.

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I’m having some new areas of back pain. Actually, it’s a spot on my left hip, a spot on the outside of my left knee and a spot on the left side of my left ankle. I need to look up sciatica and see if any of those symptoms fit.

I’m trying to make it until I see my rheumy on 8/8 but it’s tough.

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