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Suggest Treatment For Persistent Pain In Hip
Question: diagnosed with bilateral sacroilitis before 2 years after pain in hip for one month
Male/31yrs/ht 176 cm/wt 105kg
Normal X-ray
MRI shows bilateral sacroilitis l>r
Hlab27 +
CRP 5
ESR 15
Met rheumatologist prescribed Naprosyn 500 1-0-1
Ultracet 1-0-1
For 15 days
Pain subsided but comes back often
Sometimes had diclofinec instead of Naprosyn
Now after 2 years
MRI and X-ray reports are same
MRI shows r> l
CRP < 3
ESR 15
Wt is 83kg now
Now having pain constantly for 45 days some days even on Naprosyn ... Is there any other treatment is available
Male/31yrs/ht 176 cm/wt 105kg
Normal X-ray
MRI shows bilateral sacroilitis l>r
Hlab27 +
CRP 5
ESR 15
Met rheumatologist prescribed Naprosyn 500 1-0-1
Ultracet 1-0-1
For 15 days
Pain subsided but comes back often
Sometimes had diclofinec instead of Naprosyn
Now after 2 years
MRI and X-ray reports are same
MRI shows r> l
CRP < 3
ESR 15
Wt is 83kg now
Now having pain constantly for 45 days some days even on Naprosyn ... Is there any other treatment is available
Brief Answer:
Spondyloarthopathy treatment
Detailed Answer:
good evening
thank you for writing on health care magic
Well your diagnosis of spondyloarthopathy (anykylosing spondylolitis) looks confirmed. Since you are not getting much relief from Naprosyn we can step up the drugs. there are 2 options from here...since it only affects the spine we can try:
1. Sulphasalazine.. it has shown good benefit in the XXXXXXX patients . UK recommendation do show good result in spine involvement as well.
2. other is Biological drugs..the latest developments have been in that field only..they ate much better versions of sazo and pain killers and do halt the disease and will improve quality of life . Only.problem is cost and fear of tuberculosis. TB we normally evaluate prior to starting the therapy
do let me know your locality so I can guide you to a different rheumatologist...but too much of painkillers aint a good option..
hope the information was useful. do let me know for more queries
regards
dr naval
Spondyloarthopathy treatment
Detailed Answer:
good evening
thank you for writing on health care magic
Well your diagnosis of spondyloarthopathy (anykylosing spondylolitis) looks confirmed. Since you are not getting much relief from Naprosyn we can step up the drugs. there are 2 options from here...since it only affects the spine we can try:
1. Sulphasalazine.. it has shown good benefit in the XXXXXXX patients . UK recommendation do show good result in spine involvement as well.
2. other is Biological drugs..the latest developments have been in that field only..they ate much better versions of sazo and pain killers and do halt the disease and will improve quality of life . Only.problem is cost and fear of tuberculosis. TB we normally evaluate prior to starting the therapy
do let me know your locality so I can guide you to a different rheumatologist...but too much of painkillers aint a good option..
hope the information was useful. do let me know for more queries
regards
dr naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I stay in XXXXXXX can u recommend any good rheumatologist who is expert in treating AS
AND can u tell me about the prognosis of this disease I'm really worried
AND can u tell me about the prognosis of this disease I'm really worried
Brief Answer:
Management of ankylosing spondylitis
Detailed Answer:
Good evening
Well, you can consult Dr XXXXXXX in XXXXXXX XXXXXXX ..OR if you happen to visit XXXXXXX we can look into your case as well
As for the prognosis..It depends on a few things, for which I will need more details
1. X rays of your spine will be helpful to see if any bridging is happening or not. If the syndesmophytes are appearing, it is an indication to attack the disease hard
2. Any extra articular symptoms like eye involvement, bowel involvement and other joints of the body. If none are involved, it is a good sign
3. As your CRP has been normal so far(I am not sure about the units it has been checked in), it is again a good sign
Bt never the less, main thing is the decreased requirement of your pain killers before anything else. SO if we go off it..and you do good with exercises and other drugs like saaz, it is a good sign
HOpe the information was useful
Do let me know for more queries
REgards
Dr Naval
Management of ankylosing spondylitis
Detailed Answer:
Good evening
Well, you can consult Dr XXXXXXX in XXXXXXX XXXXXXX ..OR if you happen to visit XXXXXXX we can look into your case as well
As for the prognosis..It depends on a few things, for which I will need more details
1. X rays of your spine will be helpful to see if any bridging is happening or not. If the syndesmophytes are appearing, it is an indication to attack the disease hard
2. Any extra articular symptoms like eye involvement, bowel involvement and other joints of the body. If none are involved, it is a good sign
3. As your CRP has been normal so far(I am not sure about the units it has been checked in), it is again a good sign
Bt never the less, main thing is the decreased requirement of your pain killers before anything else. SO if we go off it..and you do good with exercises and other drugs like saaz, it is a good sign
HOpe the information was useful
Do let me know for more queries
REgards
Dr Naval
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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