NSAIDs in inflammatory back pain.

ajtaylor
ajtaylor Member Posts: 6
edited 1. Sep 2009, 06:08 in Living with Arthritis archive
My first post here, just looking for some information / moral support.
I have recently been diagnosed with inflammatory back pain and the rheumatologist has prescribed 3 week blocks of 3 different NSAIDs. I guess this is normal? Any way I'm on the last now, Naproxen 1000mg per day. Has anyone else had this three weeks of three different drugs type prescription, and if so how long do NSAIDs take to build up and work, is it normal to have a drop off between each drug, i.e. about 5 days into the new drug feeling much worse again until the new drug builds up?
Also my GP snorted at the the rheumatologists IBP diagnosis saying "thats not a diagnosis". All my blood tests were normal, I'm hla b27 negative, mri has no significant abnormalities but I have debilitating pelvic and spinal pain - deep, diffuse burning pain - which is worse during and after inactivity, but better during and after activity. It started slowly 9 months ago spreading up my spine and into my neck. I was happy with the IBP label (just to have any kind of diagnosis seems to help understand things), but now my GP has made me think its not a "real" diagnosis, despite the ever present and real pain I feel. So what is IBP and what does it mean?

Comments

  • frogmorton
    frogmorton Member Posts: 29,336
    edited 30. Nov -1, 00:00
    Hello AJ
    Nice to meet you and welcome to the forums.
    I would guess that inflmatory back pain is that you have pain in your back which is causing inflamation.
    If the GP doesn't value the opinion of the rheumy you have to wonder why he sent you eh!
    It may well be a vague diagnosis, but I have heard similar before when bloods are negative, but you are prseenting with real pain.
    I have only ever tied NSAIDs one at a time. Maybe the rheumy wants to see which is best for you? Did you notice one made a bigger diference than the others? I would keep a note of the effects to take to rehumy If I was you.
    You take care
    Hope you feel a bit better soon.
    Toni x
  • ajtaylor
    ajtaylor Member Posts: 6
    edited 30. Nov -1, 00:00
    frogmorton wrote:
    Hello AJ
    Nice to meet you and welcome to the forums.
    I would guess that inflmatory back pain is that you have pain in your back which is causing inflamation.
    If the GP doesn't value the opinion of the rheumy you have to wonder why he sent you eh!
    It may well be a vague diagnosis, but I have heard similar before when bloods are negative, but you are prseenting with real pain.
    I have only ever tied NSAIDs one at a time. Maybe the rheumy wants to see which is best for you? Did you notice one made a bigger diference than the others? I would keep a note of the effects to take to rehumy If I was you.
    You take care
    Hope you feel a bit better soon.
    Toni x

    Hi Toni, and thanks. Been meaning to write things down - I'll start now.
    Anyone know any dietary things that may help? Oh and the GP sent me cos the spinal surgeon he sent me to told him his diagnosis of disk damage was wrong. He's struggling with his ego and I'm still in pain! hey ho!
    AJ
  • woodbon
    woodbon Member Posts: 4,969
    edited 30. Nov -1, 00:00
    Hello, Just to welcome you to the forum - I hope you find it useful :) I do, its nice to talk to people who've been through the same things. It can sometimes take a while to get a diagnosis and it helps to talk. Love Sue
  • skezier
    skezier Member Posts: 11,333
    edited 30. Nov -1, 00:00
    Hi AJ,

    I think I would take the rumo's diagnosis over the gp's to be honest. You clearly have something going on and you rumo is quite rightly treating you accordingly. I guess they are doing the change each week to see what will give you the best relief? I also think it is a real diagnosis and if you have a look at the types of arthritis I think it is mentioned in there somewhere.

    I can't really help you with what it is except its inflamation and the base cause as yet hasn't revealed its self maybe? You could ask the helpline team if they have any ideas either by email, through the helpline forum or by phoning the number at the top of the page. I really hope it will get sorted for you and Hi as well. take care Cris
  • valval
    valval Member Posts: 14,911
    edited 30. Nov -1, 00:00
    there is booklet on here about foods as well look under living with arthritis think it under there good luck hope u get sorted pain is pian what ever they call it so hope u getting releif from it did they give u pain killers as well
    val
  • ajtaylor
    ajtaylor Member Posts: 6
    edited 30. Nov -1, 00:00
    valval wrote:
    there is booklet on here about foods as well look under living with arthritis think it under there good luck hope u get sorted pain is pian what ever they call it so hope u getting releif from it did they give u pain killers as well

    Hi Valval and thanks - I'll check the booklet out. Got tramadol, but it doesn't really do that much, well not enough anyway. I had a bad reaction when I was taking a higher dose of tram' so I'm a bit anxious about taking more than I am. (4 x 50mg per day)
  • valval
    valval Member Posts: 14,911
    edited 30. Nov -1, 00:00
    know what u mean take naproxen for inflimation and co-codamol for the pain the lowest but things r getting bad so might have to get something stronger but do not want to
    e020.gif
    mind u if it means i can do this again will be worth it
    val
  • ajtaylor
    ajtaylor Member Posts: 6
    edited 30. Nov -1, 00:00
    skezier wrote:
    Hi AJ,

    I think I would take the rumo's diagnosis over the gp's to be honest. You clearly have something going on and you rumo is quite rightly treating you accordingly. I guess they are doing the change each week to see what will give you the best relief? I also think it is a real diagnosis and if you have a look at the types of arthritis I think it is mentioned in there somewhere.

    I can't really help you with what it is except its inflamation and the base cause as yet hasn't revealed its self maybe? You could ask the helpline team if they have any ideas either by email, through the helpline forum or by phoning the number at the top of the page. I really hope it will get sorted for you and Hi as well. take care Cris
    Hi cris, i've had three weeks on each drug, 1st diclofenac, 2nd meloxicam 3rd (now) naproxen. just wondered how long they take to build up to full strength, and how effective to expect them to be. Reading the forums you hear people say they started a new drug and got instant relief. Just wondered if that was normal, or a slow improvement like I seem to be getting?
  • ajtaylor
    ajtaylor Member Posts: 6
    edited 30. Nov -1, 00:00
    valval wrote:
    know what u mean take naproxen for inflimation and co-codamol for the pain the lowest but things r getting bad so might have to get something stronger but do not want to
    e020.gif
    mind u if it means i can do this again will be worth it
    Tramadol much more effective than coc-coda for me, but my GP started me on quite a high dose and scared the living daylights out of me - sweating, racing heart, dizy, vomiting, panic....... its strong stuff.
  • woodbon
    woodbon Member Posts: 4,969
    edited 30. Nov -1, 00:00
    I think, maybe, your reummy was unsure of the exact cause of the back pain, it can, as I know from experience, take some time for a doctor to be sure of the basic cause of the pain. Inflammitory back pain does sound more like a symptom, but that may well be all they are certain of at the moment. I have back pain and its still not 100% certain of the cause after several years. They know that their is OA in the spine,but their could be other things making it worse. The I think you need to discuss all this with the rheummy. Do you have another appointment?

    As for the anti inflammatories, its often hard to find the best drug for the patient, first time and I think the consoltant is trying to hurry things along. But again I'm no medic and could well be totally wrong, so you do need further advice. If you can't or would rather not discuss this with your consultant, it sounds as if your GP has views, :wink: so talk to him. Hes also got the power to re-refer you if hes not satisfied. That happened to me once and worked out well in the end, but thats another long story!!! :D

    Best wishes and love Sue