Flare question

[Lam123]

Hi Everyone!
So, I'm in the middle of a flare, started this time last week, I went to emery and I'm pretty sure I had a partial blockage, I'm on prednisone and told to rest. I feel much better but like my usual flares it moves to my knees and it takes awhile for those to calm down. The weird thing this time is my knees are actually pretty good all day but have started to bother me at night. Two nights ago it bothered me all night and I couldn't sleep, last night it started bothering me maybe half hour before I got up. Once I get up and walk around the pain goes away. Anyone else experience this? Anything I can do in bed to help?

 

[Ozboz]

I use a magnesium supplement for this seems to help

 

[my little penguin]

Do you use volteran gel for your knees ?

Ds does and it makes a big difference

 

[Lam123]

Voltrane gel, I will get some. I would apply it before bed?

 

[Walt]

Good Day Lam,
sorry you are suffering.

I recently bought a tube of regular Voltaran.
I find it does little to nothing?
I strongly suggest you buy the stronger version!
Both are over-the-counter in Ontario, Canada.
good luck to you,
w

ps
I find my digestive symptoms vary from my joint troubles.
Like they are unrelated flares & problems...
: D

 

[Lam123]

Hi Walt,

Thanks for the heads up. I typically don't have joint issues, unless I am in a flare. When I am in a flare, it takes awhile for the joint inflammation to get under control. I did take my humira injection this morning aswell.

 

[my little penguin]

In the US volteran gel is by prescription
Ds was told by his doctors to apply it twice a day
For his juvenile spondyloarthritis

 

[Lam123]

Ok, here in Canada I have seen it on the shelf. I find it strange that usually in the past my knees don't hurt but feel swollen, this time they don't feel swollen but feel painful. They mainly feel painful when I'm sleeping or sitting for a long time. I have never experienced this. Anyone know what the change is? Anyone experience this change?

 

[Lam123]

Do you use volteran gel for your knees ?

Ds does and it makes a big difference

Does he use it all the time or just when his knees bother him?

 

[Lam123]

My little penguin, do you find the gel helps?

 

[my little penguin]

Ds arthritis tends to be the bigger issue than ibd at the moment
He uses volteran gel everyday twice a day on
His heels/Achilles tendons , hands and knees
Occasionally on his shoulders and neck
It really works for ds and helps a lot
When he forgets to put it on
He can tell the difference

He is also on high dose /frequency of humira every 5 days plus mtx

Hope it helps

 

[Lam123]

My little penguin, thanks for the info. I find during the day the pain is manageable, but in bed at night it gets bad. My GI and I spoke a few years ago about adding mtx to humira but the joints seem to get better so we didn't bother. The joints always act up for me during a flare with the crohns, once my gut feels better the joints always seem to take longer. And it's always my knees.

 

[my little penguin]

Other things that help in different combinations
Swimming
Heated mattress pad
Body pillow
And memory foam pad for the bed

 

[Lam123]

My little penguin, is there such thing to have arthritis only when the crohns flares up?
I'm on prednisone right now and weekly humira, I start tapering the prednisone this weekend.

 

[my little penguin]

There are two types of spondyloarthritis
One flares with GI flares and is very common with ibd
Particularly the lower joints
The other type flares independently of GI flares
Ds unfortunately has the kind that flares independently

These should help

http://www.ccfa.org/assets/pdfs/arthritiscomplications.pdf

http://www.spondylitis.org/Enteropathic-Arthritis

Tagging maya142 in case she has anything to add

 

[Maya142]

I like CCFA's explanation that MLP linked - there are several types of arthritis associated with IBD. Typically peripheral arthritis (involving joints other than the spine) occurs with an IBD flare and goes away when IBD is under control.

Knee involvement is VERY common.

That's not to say that it's not painful - if you're allowed Voltaren gel, that should help. My daughter uses it a lot on her knees.

With regard to swelling and pain, we've found that sometimes they correlate, and other times she has significant swelling, but very little pain or lots of pain and NO swelling!

Pain that increases with rest (sleeping/sitting) is typical of arthritis.

If the arthritis persists, then adding MTX seems like a reasonable option. Also, if you need something additional to control your IBD (besides the weekly Humira, since Pred isn't long-term), MTX would work for that too.

We use a lot of the stuff MLP said - swimming or even being in water helps. A hot shower, ice, heating pad. My daughter has used a knee brace for extra support, especially while playing sports or walking a lot (or even wrapping her knee with an ace bandage).

Good luck!

 

[cmack]

My Chiropractor recommended Magnesium Bisglyscinate by made by Metagenics. It says on the bottle that it "Helps to maintain proper muscle and tissue formation."

It helped me with back and joint pains. It is labeled on the bottle as Mag Glycinate and has 120 tablets per bottle.

hope this helps,

P.S. My Chiropractor and GP both agree almost all of us are deficient. This type of magnesium is the most easily absorbed by our bodies.

your bud,

cmack

 

[cmack]

By the way Magnesium regulates Calcium which may be building up in your joints and causing pain. I had a rather large calcification on my wrist(had it for a decade if not two) and it disappeared after about a month of this supplement. I was totally amazed.

cmack

 

[Maya142]

Please consult with your doctor before taking any sort of supplement or medication (including the Voltaren gel!).

 

[cmack]

Yes, as Maya142 said, always consult a medical professional before trying any new supplements. Always good to be on the safe side.

 

[Lam123]

Maya142,

Thank you for all the useful info, I more then appreciate it. A few questions, I don't see my GI till April, should I put in a call to ask about the gel? Or just go ahead and try it? Why may I not possibly be able to use it? One other question, how do I know when to use hot to cold on my knees? In the past I have had quite a bit of swelling, so I have always used cold, but this time, its swollen a bit, but more painful.

CMACK, thank you for your info. How would I know how much magnesium to take?

 

[cmack]

I would call the Doc. I took it as directed on the bottle 1-3 100mg tablets a day. I took 2 per day then after I felt better I maintained one 100mg tablet per day. I also made sure not to take it within an hour of anything else (prescription meds) except vitamins as my Chiropractor told me this was OK.


cmack

 

[cmack]

As for your knees heat brings blood to the area and helps speed up healing as there is more good stuff flowing that way. You can alternate heat and ice too if it really hurts. I had to do that with my lower back.:ybiggrin:

cmack

 

[Lam123]

my little penguin, I will also try swimming. Do you know how do I know to apply heat or cold? In the past I have used cold due to swelling, but this time its a little bit of swelling and mainly pain.

 

[Maya142]

A few questions, I don't see my GI till April, should I put in a call to ask about the gel? Or just go ahead and try it? Why may I not possibly be able to use it? One other question, how do I know when to use hot to cold on my knees? In the past I have had quite a bit of swelling, so I have always used cold, but this time, its swollen a bit, but more painful.

I would call and ask. It is an NSAID but since it's topical, very little is absorbed. Different GIs have different rules when it comes to NSAIDs (even topical ones) and of course, it also depends on your history.

In the US it is by prescription only, so we would have to ask.

In terms of heat and ice, every single rheumatologist we have seen has said to use what feels better. You can also alternate them, like cmack said - my daughter does that sometimes.

I have one kiddo who prefers ice most of the time and the other prefers heat most of the time. Both have arthritis. Use what helps you more.

 

[Maya142]

I don't know if you get Theramacare wraps in Canada, but in the US they're available OTC. If you like heat, they might really help. They're surprisingly warm and stay warm for quite a while.

My daughter wears them when her knees are really bothering her - they fit under her jeans and no one at school has to know.

 

[Lam123]

Maya 142, Ok, I bought the gel today at my pharmacist, you don't need a prescription here, but I will put a call into my dr and ask before using it. I will also try some ice since that has helped in the past.

 

[Lam123]

Maya 142, ok, I will try ice first, in the past I have found heat makes it worse. I once went in a hot tub when I was in a flare with crohns and knees were mildly swollen and found the heat made it much worse. So, I will try ice first.

 

[cmack]

Icy Hot patches work really well and last quite a while. they have helped me in the past. OTC. Hey pro athletes use them I'm down with that!

 

[Lam123]

CMACK, whats an icy hot patch? is it cold or hot?

 

[cmack]

Lam,

They are things that stick on like bandages, but help relieve some symptoms, like moderate pain and muscle stiffness
I think it has a menthol type effect. First it feels cold but then becomes warm and cozy.
I really can't explain it but to say it is worth a try. all you do is wash the skin. Dry the skin, apply patch to affected area and enjoy for several hours.

cmack

 

[Lam123]

I might first try icing and the gel. I'm a little nervous to apply heat since in the past heat has always made me worse. I iced just now, so I will see what it's like when I'm sleeping tonight.

 

[cmack]

You know your body better than anyone else.

cmack

 

[Lam123]

So, last night my knee pain woke me at about 2am, I switched positions, massaged and elevated it, it calmed down a bit but still pretty sore. I put a call into my GI this morning. I'm thinking he will add methotrexate to my humira med. I have never taken methotrexate, but was on imuran for many years before humira. What are the differences between methotrexate and imuran? Also, is there any difference between methotrexate shots vs pills?