I get my pain meds from my family doctor, that I have seen for 15 years.I usually just use Vicodin 5/500, but if I need something stronger, all I have to do is call her. Getting to know a doctor and have a good relationship, is a blessing. My rheumatologist just prescribes the PsA meds. Adirondack life said:
I have SI pain and inflammation I have to be honest I have suffered in pain and went to a chiro but since being diagnosed with osteoporosis ans possible fractures I am afraid to go back. I a currently having a lot if pain in my tail bone. I resist going to dr for pai issues because a lot of them act as if you are looking for drugs so I just suffer with it. I hope you get relief from your pain.
I had an injection to my piriformis Monday. It seems to have worked. It was my first piriformis injection. Have had several si injections, prolotherapy, and a nerve block. Was in pain management at one time. Not on narcotics now and am doing well pain wise. I wonder how safe these drugs are longterm but I will have to take them or live in misery. I am 42 and before I got on treatment felt much older. I'm gonna have to take care of my health and rest when I need to. This rheumatologist measured my buttock and did the injection. It seems to have relieved the huge pain in the butt I have had for so long. It was terrible 24/7 pain. Like demonstrated in the above picture my nerve runs through the piriformis.
mom5: I had several injections for S I joint and piriformis, they worked great, but the side effects were horrible. I haven't had prolotherapy, or a nerve block. Can you please tell me a little about them and how well they work? When I see my ortho doctor on Monday, I would like to know something about my options. I took a Flexeril, Celebrex, and a Vicodin, and the pain has subsided some. I took Neurotin for nerve pain before I had back surgery, and it didn't help much and it mad me lethargic. It's almost like a toothache at times. In addition to PsA, My diagnosis is SI Joint Dysfunction, Failed Lumbar Laminectomy, and Bursitis. mom5 said:
I had asked my docs about muscle relaxers but they all said no. They didn't know I had piriformis.
I've never heard of an S I belt before, I'll ask my doc on Monday, maybe insurance will cover it. Thanks.
HoneyBunny said:
I have a S I belt that helps when I am suffering. It is worn low on the hips and supports enough to reduce the load on the joint.
I bought it online and I use it along with the other basic treatments. I also mentioned in another post that I have Lidocaine patches I use to numb certain areas.
Laura E D I have had a hip replacement on my left, but I put it off for many years, my left leg was over an inch shorter than my right; which damaged my right side and my lower spine. I've had surgery, physical therapy, and injections. I thought I would post this question and get some more options, it's great having others, with the same problems, to ask for advice. Thanks. Laura E D said:
Hi Andy,
I'm really sorry to hear that you are suffering with this. In the past I found that Pilates with a Physio helped alongside standard Rheumy drugs.
As I became unwell and my body can't take the drugs anymore, my fitness levels have deteriorated as has the stability of my lower spine-pelvis-hip joints. Not content to hobble with an aching bum for the rest of my days, and unfit for the lowest of the Pilates classes, I'll be starting physiotherapy to work on this as well as a few other issues soon.
I should mention that I've nothing against taking plenty of pain killers prior to any movement therapy.
Wishing you lots of relief by any and all means necessary
I was diagnosed with si dysfunction but it turned out to be piriformis. The prolotherapy is expensive and somewhat painful. Had three series of it. It may have strengthened my ligaments. The arthritis meds are helping me a lot. The piriformis injection helped a great deal but they would have to know it is the piriformis. The si belt didn't help me because it wasn't really the si hurting me. Prolotherapy is not usually covered with insurance. While I was having it done I did not know I had inflammatory arthritis so it wasn't necessarily good in my case. A moist heat pack has helped my piriformis. I tend to tighten my muscle around it.
Thought I'd share some stretches that may help elevate some pain, some can be done while in bed. I only stretch until I feel a slight stretch and release and never stretch when there is increased inflammation as it may aggravate the area, rest is best during that time.
I would absolutely agree Laura, in fact if one was to have hip replacements I would hope part of their treatment would include physical therapy. Many of these can be modified, some are more challenging and I would say don't do them at all. Just slight stretching is helpful, even the use of bands to help hold the weight of the joint would be helpful..I was in the hot tub this morning and did some stretches in there.
Laura E D said:
I've got a nagging feeling from a half remembered conversation a few years ago that it may be possible that some of the stretches need to be modified if you've had a hip replacement operation so that the prosthesis doesn't dislocate...as in possibly the piriformis stretch may need to be modified.
I had a hip replacement 3 years ago. At first I had to be careful not to cross my legs. But after a few months it was ok. Some may need to be careful, but I can move however I want. I only wish my other hip moved half as well!
Thank you, for the illustration, I wish I knew about all this years ago I had 4 hip surgeries on my illiosoas due to tightness and pain and guess what I still have the tightness and pain. Thank you and I have had many steroid injections and injections under fluoroscopy.
TaraLynn said:
Thought I would share this picture. As you see the piritormis muscle runs along the sciatic nerve. Some times the sciatic nerve can also run through the piriformis muscle. Any increased inflammation in the area could also increase pain levels as the sciatic nerve also is in that area. Sitting, lying down, and getting up after resting all can cause increased pain. I found the best relief just standing in one area. Going to the bathroom, getting into bed and walking all required assistance when the inflammation was bad. The key is to stop the inflammation. Hope this helps anyone suffering with SI pain understand.
I would advise anyone who has had joint replacement surgery to get a PT referral before doing any stretching activities. there’s a lot of risk for injury depending on how far out you are from surgery.
Also, prolotherapy won’t be covered by insurance as there is very little evidence showing it to be effective. It is believed to be ineffective as a monotherapy. So, if tried it should be coupled with PT
Unfortunately, there isn’t a whole lot to be done for SI pain other than what has already been discussed: NSAIDs, PT, posture, steroid injections, oral steroids, surgery, and topical pain control such as lidoderm or SalonPas patches. It’s frustrating. Hopefully, finding out where the pain is actually originating from can help narrow down the appropriate treatments. Good luck!
I didn't get to see my ortho doctor today, his wife went into labor; but I saw a resident. He said other than the injections, there's nothing that I can do except physical therapy. So I'm giving it another try. My pain is at about an 8, so I have to do something!
I'm so sorry to hear you are in so much pain today It's always very frustrating when we don't get quit the appointment we thought we were going to have. Sometimes it leaves you feeling frustrated. Look at it this way, today your pain was put on hold for a while to bring a new life into this world. Think of it as your contribution to that child's life force if you are of a mind. It might make you feel a little better :) Holding you in my thoughts and sending you hugs...XXXXXXXXX
Finally feeling a little better, after soaking in a warm bath, then using my tens unit, heating pad, methetrexate, Celebrex, mineral ice, and an ice pack in my recliner. My pain is now at a 6 and no longer throbbing like a toothache. ~Thanks everyone for your suggestions and words of kindness and encouragement. (smiling)
Well, it's been about a month since I posted this discussion. I didn't get to see my ortho doctor because his wife went into labor. I saw a resident and he sent me to physical therapy. I've been going 3 days a week for almost 3 weeks. The low back pain is easing up a little, but the SI, piriformis, hip...is worse. My family doc has increased my pain meds twice, they wore off after about 2 hours, so today she prescribed a Fentanyl patch for about 10 days. If I am not better I will HAVE to get an injection. But I will only get one this time, so hopefully I won't have the side effects.
The pharmacy said my insurance requires that I try either oxmorphone er or morphine er; I have never taken any of these drugs.HAS ANYONE TAKEN ANY OF THESE 3 DRUGS? Is the Fentanyl patch better for controlling pain than oxymorphone er or morphine er? PT says my leg is shorter on the painful leg. WOULD A HIP REPLACEMENT STOP MY PAIN? WHEN I HAD MY LEFT HIP REPLACED, THEY LENGTHENED IT; BUT NOW MY RIGHT SIDE IS SHORTER !##%!!...excuse my language.
I have frozen shoulder pain too, and my hands are getting numb. I am in for a painful sleepless night.My physical therapist believes the numbness is most likely from my neck instead of my shoulder. HOWEVER, MY CHOLESTEROL AND KIDNEY FUNCTION WERE GREAT. I am wondering if I want to keep trying to take care of my health so I can live longer--if I will be living with this much pain.
I have not taken any of them. I must have had morphine following an accident and surgery but I do not remember it. I would not take any of them for PsA pain. I would take high doses of NASID and perhaps prednisone and i never take prednisone. It sounds like you are heading into some sort of pain syndrome and pirformis stretches and hot water should be your new best friends. I was taught by PT to do piriformis stretches everyday to help prevent a piriformis spasm. But I do not think you want to start the hard narcotics. It can be a slippery slope with huge pain every day.
I don't know what meds you are on. Is your PsA under good control? If not I would look at bios and prednisone but this is just my opinion. I will keep you in my thoughts and prayers while you get this challenge under control.
it’s so difficult to cure