Intense Lower Back/SI Pain

Hi! Haven’t been around in a while - just been on the struggle buss with meds as usual, but wanted to see if any of y’all have any input on a recent symptom I’ve been experiencing.

I’ve always had SI and spinal involvement, but recently (last few months or so) I’ve been experiencing very intense pain that builds up when doing chores like cooking, dishes, laundry, sweeping, vacuuming, really anything that makes me need to bend slightly. I once ignored it and pushed through to finish up what I was working on and it got bad enough my knees buckled. (Let’s be honest, I still push farther than I should but if I didn’t nothing would get done).

Interestingly if I sit down or squat for a while it’ll back off enough to let me get to a comfortable place and after a spot of a rest I can get back to it (but not for long and the time between hurts and dropping gets shorter).

It’s getting worse too. I just did some plant watering while making coffee and I’m sitting here in my office chair and my lower back is twinging with pain. It seems to set of my back muscles into spasms :woman_facepalming:.

Idk if this is PsA, my shit posture and being extra sedentary due to pandemic times and my pain being horribly controlled, or what, but I’m definitely chatting with my Rheum about it when I see her in a few weeks (even though that will likely mean yet another med change :sob:) but curious if any of y’all have experienced it or have some tips maybe (other than don’t push it :sweat_smile:).

I go through bouts of lower back pain. I wouldn’t call it intense but I would call it annoying. What shifts it is walking, moving about and being a fidgit.

Oddly after I sit after a walk with my dog, it starts again. I work from home. So I sit all morning. Go for a walk with my dog at lunchtime and of course sit again in the afternoon. Often getting up from that session of sitting is worse than lunchtime. So I do all my household chores at the end of my working day which I’m now strict about being around 4.30pm or 5pm which of course means walking about again some, before sadly I might sit again in the evening. Very much so in winter or when Covid numbers are high as there’s no point is doing anything else. However in the evening I’m on a sofa, so I can sit back, lie down, sit up etc as it pleases me.

Any sort of static slightly bending over stuff (most gardening) kills my back now. As does standing for too long. Sweeping doesn’t as that sort of movement is great for it. Vacuuming my house is a no no too, stupid vacuum is a pull along one instead of an upright, it’s really hard to buy an upright vacuum that does a decent job in the UK now which means I have to bend over too much with my present one. Cleaning a bath etc also a no no. I don’t have issues doing laundry or the dishwasher, cleaning down counter tops etc. Or mopping a hard floor. I do employ a cleaner in case you though I live in a tip of a house. :grinning: However the house is a tip carpet wise just before her due day. My dog is a black lab and I stupidly have cream carpets.

However the more I just walk about the better for me. Too long in bed is also a no no.

Very often heat and ice works a treat for a while, Frozen soft ice pack and a hot water bottle. Alternating between the two every 5 mins whilst sitting and working. Have you tried that? And upping the amount of anti-inflammatories I take too can ease things if they’re particularly bad.

Also changing the height of my work chair often helps too. Having my feet up when I’m on the phone for example and leaning the back of the chair back. Keeping my feet in the same place and swivilling my work chair from side to side also helps. I do have a proper office chair for working.

As you can see I’m constantly sort of moving around some. Hope I’ve given you some ideas which might help. However I rarely push through physical things to get them done. Other than walking as I have to get back!!! :laughing:

I don’t know which has more…various reasons for back issues or treatments for back issues. I have lived with up to 3 herniated discs for 35 years…all were self induced over-lifting caused. I mention it because even a slight bulge in a disc is reason for much pressure type pain. A disc can become “ruptured” from the slightest event like a sneeze…it doesn’t take anything catastrophic to cause one and many live with it long term. Sorry for the big pre-amble but I would suggest that if you haven’t, do whatever is necessary to find the cause so that proper treatment is explored. And, while chiropractic treatment is helpful for some things, they cannot fix a disc herniation…it isn’t possible through manipulation and will likely make things worse. Depending which way a disc protrudes, I have found that bending doesn’t hurt, its in the straitening back up that the pain occurs. When bent over, even slightly, the vertebrae above and below the disc open up and take the pressure off the disc bulge, which feels good…but then the disc protrudes more and when trying to straiten up, the prolapsed disc is now squeezed even more. A classic example: when I had some of my worst back pain close to the SI joint, I found that sleeping on my side in a sort of fetal position felt much better so I could sleep. But oh man, I couldn’t straiten out of that position in the morning. I have found some pretty good relief by using ice/heat like @Poo_therapy suggested and moderate use of an inversion table. Muscle spasm also are caused by disc herniation as the body tries to make a “splint” out of your muscles to stop further activity that causes pain…and then the muscles become a source of pain causing a vicious cycle that we all know quite well. Now the good news…if it is a disc issue, we tend to age out of it. The discs change with age from being soft and pliable to more leather-like and thus stabilize with age. I’m 62 and have far less disc caused back pain than 5 years ago. Even with PsA, we can get better with age…like fine whine! Or is it *wine? *
But I could just be blowing smoke and @SubliminalFlicker your pain could have everything to do with PsA. I hope you get to the root cause and find the relief that allows a better quality of life! An MRI would quickly give a good picture of your lower back and likely the cause.

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Thanks for the info. I definitely have morning stiffness in my lower back, usually sitting down after standing is the worst and the first morning sit is quite painful. Will definitely have a chat with my Rheum soon and see what she thinks we should do.

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Well a chat with the doctor last week at my appointment resulted in a switch to Tremfya. If the back pain doesn’t improve we’ll do imaging :woman_shrugging:

Also got a steroid taper that I’m avoiding picking up bc they always make me feel :face_with_symbols_over_mouth:. I keep trying to talk myself into going and getting them and then not doing it :joy:

I also got a bit of the “diet changes and supplements” talk that I might have been a tad upset about (why is it my fault for not eating the “right” foods and not that the meds don’t forking work?), but I’m trying to see it as “nothing else is working might as well try” rather than “clearly your doing something wrong to make this worse” it felt like at the time.

Oddly enough my inflammation markers are almost normal! But I swear I’ve been in more pain when they were 3 or more times normal :roll_eyes:

Here we go again! Lol.

All my rheumy says about food is that biologics work better if you’re not overweight. There’s zero research on diet (other than low carb and low sugar) doing anything for us. There’s also no evidence that supplements (other than B12 and Vit D being optimal) help either. We could stuff things like tumeric into every oriface washed down with cider apple vinegar and sadly nothing would change much.

PsA is classed as seronegative so it’s very normal for many of us to have nothing showing up inflammation wise on blood tests despite feeling perfectly horrible and in considerable pain.

I get you on the steroids. I now won’t take them anymore - no point in feeling murderous to everyone around me, plus I’ve got steroid induced osteoporosis which is being medicated anyway.

I do hope the Tremfya does the job for you. But why wait on the imaging? All biologics take a year to reach full efficacy so why wait to see what’s going there?

Yeah after that report came out at the latest Rheum conference or whatever about the Mediterranean diet being “the best diet” I swear she’s talked about it every time I’ve seen her. Last time was “nightshades, gluten, and red meat and processed foods” might be making things worse (she includes the “doesn’t work for everyone” to cut these out :roll_eyes:) and to take vitamin D, something about ginger too (I’m allergic so :woman_shrugging:) and tumeric and green tea. Honestly, I know I’m fat, but I’m lucky to have the energy to eat these days so it’s just not going to happen because IMO fed is best even for adults and I don’t have anyone who’s going to prepare vegetarian meals for me all day every day. (Why is it always the healthiest food for you requires so much preparation and/or money? :thinking:) In addition I’m simply not convinced that restricting random food/food groups from my diet helps anything other than feed my old eating disorder (which I’ve been well recovered from for over decade, tyvm). So yeah the diet changes can go stuff themselves in a closet. Lol.

No idea why we’re waiting on imaging. :face_exhaling: :woman_shrugging:

Anyway, thanks for letting me whine and for your comforting comment @Poo_therapy :relaxed:

Oh you make me giggle over the first coffee of the day. The market is presently making a lot out of the vegan/vegetarian political fad presently. Hence the expense and indeed the energy required. Apparently instagram requires to you post pictures of the effort of making the latest ‘in dish’ which can’t take up most of the remaining ‘space’ on your cell phone. Sunflower oil is anyway in short supply thanks to Russia’s present tantrum so very sadly. There’s nowt wrong with decent plain good food and lots of fruit and vegetables.

My poor bowel hates anything spicy and given my Crohn’s issues I’m a bit fed up of the decor in my bathroom anyway but certainly no energy or funds to change it. And consequently don’t want to spend anymore time than necessary there.So spice remains out of my diet.

However on a more serious note I do have concerns about your rheumy sending you off on some sort of self flaggelating exercises of excluding groups of food. Why is there this notion more in the USA than anywhere else that the reason you’re sick and have an autoimmune disease is somehow your fault?

I do know loads of people including researchers into our disease do find cutting carbs and especially sugar do feel better. However I find if I don’t have some gluten at least daily I’m back in my bathroom again. Anyway I’m Irish and we have a thing about ‘bread’ so it’s also quite an emotional attachment for me too. And apparently biologics do in fact work better when you’re not overweight. Thankfully mine works just fine despite being overweight considerably so I’ll leave that just there.

Push on getting that imaging done now, whilst you’re in between biologics. Then when assessing Tremfya down the line they can redo the imaging and see if it arrested things somewhat. Great chance to actually get ‘evidence’ rather than pandering to some more flaggelation notions isn’t it? :roll_eyes:

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Last year I had what is called the minute man. It’s a little jack that is put in to relieve the compressed disk. I have not had any more pain in my lower back. Mine was caused by a fall that crushed the sciatica nerve and caused break in my lower spine. I have lots of Hardware in my back. Love my Doctor he saved me.

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Oh wow! Glad it’s helped!

I had a 10 day steroid taper. Got to feel like a normal human for about a week, and noticed my lower back pain pretty much vanished so I’m hoping that indicates it is just inflammation right now and not damage (yet). I had thought it was my constant SI pain, but apparently my lower/sacral spine was inflamed at my appointment (determined by her poking all my tender joints :roll_eyes::sweat_smile:) so that may be the cause. The pain has all returned now that the steroids are done. But I only have 10 days until I start my new medication (Tremfya) and hopefully that will provide relief.