Chronic Pain and Psoriasis Arthritus

Saw the pain clinic again after all the tests and diagnosis of psoriasis arthritis.

The short of it is that the recommendation is to focus on quality of life and what I can achieve even. It was explained that as the lumbar, thoratic and cervical are all affected by osteophytes, disc degeneration and nerve impingement he would advise against spinal surgery as it will cause me more problems and pain longer term due to the additional stress on the other joints. The only time he would advise operating is if and when the spinal cord is potentially at risk of permanent damage.

Thoughts from anyone in similar.

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  • frogmorton
    frogmorton Member Posts: 27,670

    I have inflammatory arthritis and also prior to that back issues from probably late teens/early 20s onwards

    I saw many a doctor over the years with regards to my back none suggested surgery I was even referred to an orthopaedic surgeon after maybe 10 years who reckoned surgery wasn't the best idea. I was in fairly constant pain and had bouts of being unable to move at all when my back would spasm for weeks and then 'recover' to an extent. Many times I got stuck in my car, in the bath or at my desk at work, but that wasn't enough.

    Finally one day I turned over in bed (In Florida on holiday!) and there was an excruciating click and my foot started buzzing....this travelled upwards until I 'lost' that leg completely. It didn't work anymore, wouldn't take my weight or move and I could have put a knife in it without feeling it.

    I was dashed off to hospital there and returned home in a wheelchair the next day armed with some super strong meds. I saw a Dr here who advised surgery ASAP. I had to wait a few weeks for some inflammation to settle then it was done. I had a fracture in there as well as degenerated discs (herniated 70%) and worn vertebra I can't remember what else. The recovery was extremely painful I can't deny that, but I could feel almost all of that leg again and it works ok. Being a single parent at the time I was back at work in 9 weeks, but the recovery painwise from it all took a year I would say. I now have neck issues - cervical spond' - but really do hope I don't need surgery again I did not enjoy it at all.

    I tend to think looking back that it was maybe right to have waited for my surgery. I do have some permanent damage I can't feel some parts of that legs, but not enough to trouble me.

    In your case I would want to be monitored carefully and i would make sure you have and do physiotherapy exercises to strengthen your core and keep your spine as strong as possible. That really is the best thing I do mine now daily and walk to daily even if not too far. My spine appreciates it.

    Take care

    Toni

  • jamieA
    jamieA Member Posts: 273

    Hi @alexander1

    Back in 2015/16 - well before I had any issues that turned out to be PsA - I had back problems. I was getting pins and needles down my right arm and hand and sciatica down my legs and I couldn't sit for any length of time. I had MRI scans and saw a consultant orthopaedic surgeon. He was a young Irish guy with a wry turn of phrase - so young in fact I actually asked him if he was sure he was a consultant! He was taken with a new toy he had - what looked like a very large computer monitor on which he displayed a full colour 3D image of my spine. He talked me through the whole length of my spine - I had 2 lumbar bulging discs (which then became 4) and 6 cervical bulging discs. He then said in his soft southern Irish tone 'I could put you under the knife but I'm concerned I could do you more harm than good'. We left it at that and since then I've managed with physio, Ibuprofen rubs and if necessary painkillers when needed and the realisation I can't do things I previously could. I've always walked a lot and this was recommended. I had an MRI of my lower back last July and my new rheumatologist has said it now shows stenosis of the spine and referred me to a physio. I had a telephone consultation earlier this week with the physio and he has suggested adding swimming and cycling (or even an exercise bike) to my walking.

    I was prescribed Ralvo lidocaine patches last year, initially for my shoulder and then my knee. I've found that if my lower back is causing me issues if I put a patch at the base of my spine overnight whilst sleeping it works wonders.

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