Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group enthesitis

Before Humira, I treated my enthesitises just like anyone would treat tendon / ligament "injuries"....PT, ice, contrast baths, ultrasound (I now have a home unit), soft tissue work.

I found that bracing of any kind only made the inflammation infinitely worse. But I did try braces for my wrists and orthotics for my feet, including the expensive custom made (a mold created to my foot), and with a podiatrist, slowly tried to get accustomed to them, the way you are supposed to, but always, they made my feet worse.

I've found that being barefoot as much as possible, but standing on a soft rubber kneeling mat, like when in the kitchen, or wearing flat flat shoes, but again standing on a soft rubber kneeling mat, like when in the lab, or rubber flip flops in the shower, and avoiding standing as much as possible, and avoiding walking too much on hard man-made surfaces.

Stretching the calves, which stretches the plantar fascia. Right now I have a bit of shin splints...the other morning they really acted up when I tried to stand in the kitchen, for a bit, after a day of too much shopping...I caused them by sitting on my knees/legs to grade for hours on end at the end of the semester. So now, I ice, stretch, avoid standing too much.

And that morning, probably because of the shin splints, my foot locked up and I could barely walk, but I was off to the chiro and he unlocked it...all the little bones on the top of the foot locked up due to inflammation in there.

When my wrists were very bad, I've had a well placed cortisone shot, once in the thumb side and once in the ulnar side, but that was only once there was so much inflammation that barely moving it would set up new rounds of inflammation and more and more scar tissue and nothing was preventing that, even the PT and ultrasound. So I use cortisone but only as a last resort when necessary.

Once I was able to start low dose naltrexone (LDN), my enthesitis got better. I still had tendonitis, etc, but I no longer seemed to tear tendons and ligaments like I did before LDN. But LDN didn't seem to help my other symptoms enough, so I went on Humira, and that has helped even more. I still do have some enthesitis, seems like these days its my upper arms (not the shoulders but more where the bicep tendons attach at the front of the shoulder) and elbows, I think its due to trying to carry too much in and out of my building at work for too far of a distance....I tried pulling a cart long ago, but tore my bicep tendon pretty badly. So part of enthesitis is trying not to injure ourselves....as you attested to first off in your post.