Suggest treatment for severe back pain

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Posted on Mon, 11 Jul 2016 in Lupus
Question: Hello XXXXXXX

I have a severe back pain since 6 months. but it is intermittent for past several months and now it became consistent. so I have admitted to the Apollo hospital and gone through all the required tests suggested by the Spine surgeon. and he referred another rhumeutologist and based on reports he suggested medicine for next 2 years.
I have attached all my reports here. could you please help me in understanding the exact situation and severity of this problem.
doctor
Answered by Dr. Shruti Rijhwani 38 minutes later
Brief Answer:
Please attach prescription .

Detailed Answer:
Dear XXXXXXX ,

Thank you for posting your query on HCM.

Your doctor has diagnosed you with spondyloarthritis or Ankylosing spondylitis . Your genetic marker HLAB 27 is positive which further supports the diagnosis . It's a kind of arthritis that affects young males . One thing more, please attach your bone scan report , you have attached the film . Also has your MRI Sacroilliac joint scan been done which is very important for this disease? . Also I need to see what medicines they have prescribed to you . Any other query please ask.

Take care.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Shruti Rijhwani 15 hours later
Hi XXXXXXX

Thanks for the information. I have attached few other reports of mine.

Currently I am using all the 3 medicines prescribed by the Doctor. and one other report, which is missing from my scanned copies It says "CRP" as 4.45.
Vitamin Tablet weekly once, and the remaining 2 tables I'm consuming twice daily after breakfast & dinner.

I have noticed in the Bone scan report, just below the right ribs there is little orange one, what's that about?

Thank you so much for your time and support in this case.

added my reports.
doctor
Answered by Dr. Shruti Rijhwani 23 minutes later
Brief Answer:
Follows.

Detailed Answer:
Dear XXXXXXX ,

Thank you for reverting back.

I have seen your prescription and the treatment you have been prescribed which I feel is fine and you should continue with the same . I have also seen the reports that you have attached , crp is not that raised so its fine . Probably they will increase dose of sulphasalazine later seeing the response you show with the medicines. In bone scan you can get multiple active focus but it's not that all of them are significant so the one you are talking about doesn't seem relevant to disease . Also physiotherapy is as important as taking medicine in this disease plus it will be advisable to stop smoking and drinking alcohol in case you take it .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Shruti Rijhwani 6 hours later
Hi Shruthi,

I'll use this medicine without fail and the doctor asked me to come back after a month with blood reports to check whether is there any side effects due to this medicine. I don't have drinking or smoking habits.
I have 2 questions running in my mind.

1) How did I get this injury in the first place?
2) Can I walk properly without any pain like I used to walk before?
The reason why I'm more worried about this problem is due to my parents are looking a bride for me. Is it going to cause any problem in married life or Shall I postpone my marriage till this problem got resolved.
Please advise me.

once again Thank you so much for your time and advise.
doctor
Answered by Dr. Shruti Rijhwani 2 hours later
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thank you for reverting back.

Well you don't have any injury , it's a genetic arthritis that you are suffering from which presents in young males . See , it's not going to get cured it can be controlled only with medicines . But different people have different severity levels so it's not mandatory that you will have severe disease , some people have very mild disease also . This only time will tell . Regarding marriage , you can go ahead with it once disease is controlled . Yes you will be able to walk again properly once sacroillitis is reversed . One thing more , you have been prescribed Dolo 650 mg but we generally give NSAIDS like etoricoxib as they are the drug of choice . So I would suggest you to consult Nizams institute as you stay in XXXXXXX , they have a full rheumatology department there so will able to guide you more properly .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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