Joint pain with crohns?

[littlevick07]

Just curious how many of yall have joint pain with crohns? Ive had crohn's for 2 years. i'm on remicade every 8 weeks and have been since the beginning of this year. i started out on apriso, but that wasn't helping so i went to remicade. i recently started having horrible joint pain in my wrists. they weren't swollen and i was just having pain in the outer wrists. i went to my primary care and talked through my concerns(wondering if it was related to the crohn's), was i getting arthritis? his response was no and i'm on remicade so that should help with inflammation.i just continued to take advil and hope it would get better. fast forward 2 weeks, i was standing in my kitchen and had horrible knee pain. it felt like someone had taken a baseball bat to my knee cap. i was in tears from the pain. long story short, went back to my pcp who had me go for an mri and that showed that i have bursitis. i'm now seeing an ortho doctor for my knee, going to therapy, and on mobic for the inflammation. my knee is still quite swollen. my questions is could this all be related to the Crohn's? my gi doctor doesn't know anything about my knee or wrists. i have an appointment already scheduled for the 2nd week of august, so i was just waiting on that to talk to him. i wondered if that wise? or if anyone had any thoughts/advice/or experience? thanks!

 

[Maya142]

It certainly could be related to your Crohn's. CCFA has a great guide about the various kinds of arthritis associated with Crohn's. Peripheral arthritis that involves the large joints (knees, ankles etc.) tends to flare when the Crohn's flares. If it involves the small joints (fingers) or the spine, then it tends to be independent and needs to be treated independently - such as with Methotrexate, Sulfasalazine or by increasing Remicade.

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

Seeing a rheumatologist is a good idea. They can figure out what kind of arthritis it is and what kind of treatment you need. Mobic will certainly help your joints but it is an NSAID, so it might make your Crohn's flare. My daughter has Ankylosing Spondylitis and Crohn's and is allowed to be on an NSAID since her AS is so much worse than her Crohn's, but I thought I'd flag that to you.

It might be a good idea to check with your GI to see if he is ok with the Mobic. Voltaren gel might be a better option since it's still an NSAID but it's not really absorbed systemically so it shouldn't affect your gut.

Typically, morning stiffness, pain that gets better with movement and worse with rest and nocturnal pain are all common with inflammatory arthritis. SpA often starts with lower back or SI joint pain, but really any joint can be involved.

Good luck!

 

[my little penguin]

Fwiw Ds was on humira and still developed arthritis ( juvenile spondyloarthritis -JSpA) as a secondary condition related to crohns
His joints -hands and knees /hips /heels and neck are Independant of his Gi flares
The Rheumo added Mtx since mobic caused Gi bleeding
We have since increased Mtx and humira twice due to arthritis
Good luck


http://www.spondylitis.org/Learn-About-Spondylitis/Enteropathic-Arthritis

 

[littlevick07]

thanks for the advice guys-maya that link was super helpful. im going to call my gi doctor tomorrow. i love my doctor, but really dislike his nurse so i'm not sure how much she will help me, but i'm glad i have an appointment with him in the next 2 weeks. i'm supposed to have a mri next week to see how the Remicadee is helping with my inflammation so that should be helpful too.

 

[jmiller]

I'm a pharmacist and my advice would be to focus on trying to control the inflammation
in the colon. Your colon represents up to 70% of your immune system. When your
colon is inflamed your immune system may not work properly and that's why Crohn's
disease is linked to things like joint pain, back pain, eye inflammation, and skin rashes.
Once the inflammation it the colon is under control, these other issues should go away.
My wife was once diagnosed with ankylosing spondylitis, but it turned out to be just
a complication of a Crohn's flare. When her colon inflammation became under control
her back pain went away. The general recommendations are to avoid NSAIDS in
Crohn's patients. Voltaren gel is systemic in action. An NSAID does not have to pass
through your GI tract to still have a negative affect on it.

 

[eleanor_rigby]

My joint pain preceded my Crohn's symptoms. I have joint ache and they crack loudly and often. But no inflammation and I have never had them x-rayed or anything.

 

[Malice67]

I'm a pharmacist and my advice would be to focus on trying to control the inflammation

The general recommendations are to avoid NSAIDS in Crohn's patients. Voltaren gel is systemic in action. An NSAID does not have to pass through your GI tract to still have a negative affect on it.

hummmm -- so using NSAID patches on the afflicted joint is bad? I'm not ever supposed to take them, as they were suspected to have caused a bad GI bleed in the past. But no one ever said I couldn't use a topical NSAID... guess I better fess up to the use when I go in next month to treat my anemia

 

[eleanor_rigby]

hummmm -- so using NSAID patches on the afflicted joint is bad? I'm not ever supposed to take them, as they were suspected to have caused a bad GI bleed in the past. But no one ever said I couldn't use a topical NSAID... guess I better fess up to the use when I go in next month to treat my anemia

Check what your GI recommends before following medical advice here

 

[my little penguin]

Second that !!!
Ds is in volteran gel which is a NSAID with his Gi blessing
His arthritis is far worse than his crohns though
At least at the moment
Please check with your own doctor who knows your particular case

 

[Malice67]

Will be talking with GI at next appointment (in three weeks)... just will avoid use as much as possible until then, just in case. Thanks!

 

[Maya142]

It is certainly true that you can have side effects with Voltaren gel, even though it does not pass through your gut. But the risk is significantly lower than with a regular NSAID.

As everyone has said, every person with IBD is different. For my younger daughter, her AS is MUCH worse than her Crohn's and she is allowed to take an oral NSAID daily.

It really depends.

 

[Brad P]

I get back pain during flareups. It's a direct correlation but may be a nerve thing versus inflammation. But bowel disease is a disease of inflammation, so it arthritis which I have a touch of at 41.

 

[Clash]

Not all Extra Intestinal Manifestations (EIMs) of Crohn's disease flare concurrently with active Crohns inflammation. EIMs of CD can involve skin, joints, eyes, etc.

My son has episcleritis(an eye condition) that is an EIM of CD. It tends to flare concurrently with his active inflammation. He also has peripheral arthritis that flare concurrently with active CD. Lastly, he has axial JSpA it is also an EIM of CD but tends to flare independently of active CD.

That's why it is helpful to see a rheumatologist if experiencing joint pain.

Some extra-intestinal manifestations, such as erythema nodusum and peripheral arthropathy, will wax and wane in keeping with bowel inflammation. The more severe cutaneous ulcerations, uveitis, and axial arthropathy may precede bowel disease or persist after it subsides.

Source

Sometimes, remicade and other biologics can cause joint pain. So if you don't find relief you may want to have your GI or rheumatologist check into that.

My son also sees a dermatologist once annually since he is on remicade and methotrexate as well.

We also see ano ophthalmologist annually as well since he has episcleritis and due to the fact that having one EIM of CD increases your odds of having another.

C's knee pain has caused him to be hospitalized in the past. He says it is some of the worst pain he's experienced, which includes his axial arthropathy, severe CD flares and small bowel resection. So I can totally believe that the knee pain you experienced was excruciating.

In hospital, they used heat and cold on his knees in 30 minute intervals. He isn't allowed NSAIDs due to the severity of his CD.

I hope you find some answers and relief soon.

 

[Sharkgirl]

I have had horrible joint pain flare ups when I have Crohn's flares. It even got so bad that I had to move from an upstairs apartment to a downstairs apartment because my knees were so bad I couldn't climb the stairs. Fish oil helped me a lot but I've heard from others it didn't helped them.