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Suggest Treatment For Severe Back Pain Followed By Neck Pain When Diagnosed With Ancholytic Spondalytis
Question: I have been suffering from severe back pain followed by the pain in my neck. Under the advice of doctor, I have undergone MRI and RE Blood Test. The Rheumatologist have diagnosed it to be Ancholytic Spondalytis and suggested Immuno Supplesant medicines. I want to know, Is it safe to take Immuno Supplesant Medicines or can you suggest other alternative?
Brief Answer:
Immunosupressant drugs can lower immunity and other side effects
Detailed Answer:
Hi,
I have reviewed your new and old prescription and I could not find any immunosupressant medicine in it. If you are taking any immunospuressant please tell me the name in the followup, so that I am better able to help you.
The treatment is usually Conservative that includes exercise. You must be in continuous consultation with physical therapist. It is good to know that ayurveda is working for you.
Medicines are given to control the pain and stiffness. NSAIDs are first line treatment and are being given to you. Etogesic MR is the one. Adiza 10 mg is for gastric acidity that may arise due to continuous use of pain killers.
Tumor necrosis factor (TNF) inhibitors are used in patients who do not respond to conservative and NSAID treatment. Medications include adalimumab and etanercept. These can also have side effects. As a rule these are employed first and immunosupressant (methotrexate) is used later in axial disease like yours.
Hope it answers your query. Let me know if I can assist you further.
Dr Vaishalee
Immunosupressant drugs can lower immunity and other side effects
Detailed Answer:
Hi,
I have reviewed your new and old prescription and I could not find any immunosupressant medicine in it. If you are taking any immunospuressant please tell me the name in the followup, so that I am better able to help you.
The treatment is usually Conservative that includes exercise. You must be in continuous consultation with physical therapist. It is good to know that ayurveda is working for you.
Medicines are given to control the pain and stiffness. NSAIDs are first line treatment and are being given to you. Etogesic MR is the one. Adiza 10 mg is for gastric acidity that may arise due to continuous use of pain killers.
Tumor necrosis factor (TNF) inhibitors are used in patients who do not respond to conservative and NSAID treatment. Medications include adalimumab and etanercept. These can also have side effects. As a rule these are employed first and immunosupressant (methotrexate) is used later in axial disease like yours.
Hope it answers your query. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Good Morning Doctor,
Thanks for your Advice. The Orthopedic surgeon recently prescribed 3 injections of Solu-Medrol 40 mg (Intravenous), for immediate relief of stiffness and Neck pain. I have also been prescribed Setolac-300 ER, Saaz DS, Protera 40mg, Folitrax 15mg & Cholecaciferos granles- sachets.
The above medicines have been prescribed by a local orthopedic surgeon as an alternative for the immuno supplesant medicines and has advised to do swiming and other exercise for all the joints.
Hope the above medicines are safe. After taking the injections, at present I don't have stiffness and pain in my neck.
Regards
XXXX
Thanks for your Advice. The Orthopedic surgeon recently prescribed 3 injections of Solu-Medrol 40 mg (Intravenous), for immediate relief of stiffness and Neck pain. I have also been prescribed Setolac-300 ER, Saaz DS, Protera 40mg, Folitrax 15mg & Cholecaciferos granles- sachets.
The above medicines have been prescribed by a local orthopedic surgeon as an alternative for the immuno supplesant medicines and has advised to do swiming and other exercise for all the joints.
Hope the above medicines are safe. After taking the injections, at present I don't have stiffness and pain in my neck.
Regards
XXXX
Brief Answer:
Solu-medrol is steroid
Detailed Answer:
Hi again
Thanks for following up.
Solu-medrol is methyl prednisone. Its a steroid. It has reduced the stiffness by acting as anti-inflammatory and immuno-suppressant. There are many facts about this medicine that should be kept in mind.
Firstly about side effects: It does not only cause immunosupression but has an array of other side effects like HPA suppression, Cushing habitus, fragile skin, high blood sugar, muscle weakness, delayed wound healing, peptic ulcer, weak bones, cataract, glaucoma and mental illness.
Secondly about its dosing: Most of these side effects happen after prolonged treatment. prednisolone >5mg/day for more than 2-3 weeks, warrants a slow withdrawal of dose while stopping the medicine. If an infection happens while on steroids, the steroids should not be stopped abruptly. Dose should be lowest possible, shortest duration, entire daily dose to be given in morning, alternate day dose (i.e after 48 hr) is better.
Setolac is etodolac and is pain killer
Saaz ds is sulphasalazine and is anti-inflammatory. Its an immunosuppressant.
Protera is pantoprazole. Its for stomach acidity.
Folitrax is methotrexate. Its an immunosuppressant.
Cholecalciferol is vitamin D.
Solu-medrol, Saaz ds and Folitrax are not alternatives to immunosppressants. These are immunosupressants themselves. These also have other side effects. I can go on and on about their side effects. Keeping in mind the fact that you just started to experience stiffness and your young age, I think you have been prescribed more medicines then you need.
In my opinion, Saaz ds and Methotrexate are not advised initially. It is good to be in remission but also be on minimum medicines. If we start on strong immunosupressants in initial stages, we will not have a back-up when the stiffness is bad.
Yes exercise in consultation with a good physiotherapist will help. Yoga has some nice stretches that can help. Padmasadhna is a set of asanas and is also helpful in back pain. Exercise to be done in moderation. If your back hurts more with a particular exercise then stop that exercise.
I will really suggest that you consult an experienced rheumatologist, who is not in a hurry and gives you adequate time for consultation.
Hope it helps. Let me know if I can assist you further.
Dr Vaishalee
Solu-medrol is steroid
Detailed Answer:
Hi again
Thanks for following up.
Solu-medrol is methyl prednisone. Its a steroid. It has reduced the stiffness by acting as anti-inflammatory and immuno-suppressant. There are many facts about this medicine that should be kept in mind.
Firstly about side effects: It does not only cause immunosupression but has an array of other side effects like HPA suppression, Cushing habitus, fragile skin, high blood sugar, muscle weakness, delayed wound healing, peptic ulcer, weak bones, cataract, glaucoma and mental illness.
Secondly about its dosing: Most of these side effects happen after prolonged treatment. prednisolone >5mg/day for more than 2-3 weeks, warrants a slow withdrawal of dose while stopping the medicine. If an infection happens while on steroids, the steroids should not be stopped abruptly. Dose should be lowest possible, shortest duration, entire daily dose to be given in morning, alternate day dose (i.e after 48 hr) is better.
Setolac is etodolac and is pain killer
Saaz ds is sulphasalazine and is anti-inflammatory. Its an immunosuppressant.
Protera is pantoprazole. Its for stomach acidity.
Folitrax is methotrexate. Its an immunosuppressant.
Cholecalciferol is vitamin D.
Solu-medrol, Saaz ds and Folitrax are not alternatives to immunosppressants. These are immunosupressants themselves. These also have other side effects. I can go on and on about their side effects. Keeping in mind the fact that you just started to experience stiffness and your young age, I think you have been prescribed more medicines then you need.
In my opinion, Saaz ds and Methotrexate are not advised initially. It is good to be in remission but also be on minimum medicines. If we start on strong immunosupressants in initial stages, we will not have a back-up when the stiffness is bad.
Yes exercise in consultation with a good physiotherapist will help. Yoga has some nice stretches that can help. Padmasadhna is a set of asanas and is also helpful in back pain. Exercise to be done in moderation. If your back hurts more with a particular exercise then stop that exercise.
I will really suggest that you consult an experienced rheumatologist, who is not in a hurry and gives you adequate time for consultation.
Hope it helps. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor for the detailed response to all my queries.
I feel much more confident and hope all these information will make me able to take care of my ailment in a better way.
Regards
XXXX
I feel much more confident and hope all these information will make me able to take care of my ailment in a better way.
Regards
XXXX
Brief Answer:
Yes, take charge of your treatment
Detailed Answer:
Hi
Yes, it is important to take charge of one's treatment. Being informed about one's condition and treatment options is vital for correct and safe management of condition.
I may add a few lifestyle advises:
- Lifestyle is very important in managing long term conditions. Drink cleaner water from RO system and hygienic home cooked food to avoid any intestinal infections. Regular exercise important.
- For pain control, adequate pain killer is needed. It must be taken as and when needed, without crossing upper limit of the recommended dose. "You are not this body". Remembering this fact and disconnecting mentally from the body also helps in pain management. Avoid movements that can hurt your back.
Take care. Do get back if you need further assistance.
Dr Vaishalee
Yes, take charge of your treatment
Detailed Answer:
Hi
Yes, it is important to take charge of one's treatment. Being informed about one's condition and treatment options is vital for correct and safe management of condition.
I may add a few lifestyle advises:
- Lifestyle is very important in managing long term conditions. Drink cleaner water from RO system and hygienic home cooked food to avoid any intestinal infections. Regular exercise important.
- For pain control, adequate pain killer is needed. It must be taken as and when needed, without crossing upper limit of the recommended dose. "You are not this body". Remembering this fact and disconnecting mentally from the body also helps in pain management. Avoid movements that can hurt your back.
Take care. Do get back if you need further assistance.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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