Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group pain management - supplement

Hi everyone,

Many people undergo pain management for AS. Some of them are Radio frequency ablation, TENS etc., Do these pain management techniques while reducing the pain, will they reduce inflammation?. If not, because of reduction in pain, people tend to strain more which lead to more inflammation?. I am not clear about the role of pain management and their relation to the reduction in inflammation.

I would like to get this cleared. Put up your thoughts.

Regards.

JAY

RFA does not reduce inflammation. It only reduces the pain. Very effectively on SI pain for me, though.

Epidural injections reduce inflammation at the level injected (and in the general area within the epidural space). Immediately around the spinal nerve itself. For me, works great when sciatica is flaring up too long.

TENS only interferes with the pain signals reaching the brain...sort of scrambles the signal or creates a bit of 'white noise' to muddy the waters, so to speak. It works better for some pains than for others.

I use these merely as improvements to my life. Keeps me able to work, more enjoyment of activities. As long as I am having no adverse effects, I'll keep doing it. I have a cautious pain doc and trust her, but if I have questions about something, she is willing to answer and to listen to my concerns.

It is a quality of life decision as Rumble says. My pain management dr. always injects steroids also to help temporarily with inflammation.

I see what you are saying: if you mask the pain, will you overuse it and make it more inflamed?

I think as the others have said, when it gets unbearable, you do whatever you have to to be able to function.

I use ultrasound; I get the impression that does reduce the inflammation. Seems to.

And ice definitely not only reduces the pain, but the inflammation too....but sometimes it impractical to continually ice oneself....hard to go anywhere that way......

I have my pain pump for pain and I get my infusions with a start of Methylprednisone before each dose for my inflammation. The Dr.s want me to stay active to the point where you know you are overdoing it. For me my feet hurt too much from walking right now and I will address this with my Rheumatologist. I can barely walk a large grocery store before I feel like I'm walking on my bones so now I go to a smaller store and have to plan out my trips better. You know your body better then anyone and know it's limits. Never push it way to over the limit.

Like Pea says, you have to learn about where your limits are.

For me, limits at work are toughest because I don't have total control over what happens. Since it's at work--given that it's hospital work and I have a duty to the patients whose blood I'm testing, I push myself a little too far. Most of the time it's the difference between a 5 to a 6 on pain scale--not terrible. When I just can't stop it (short handed or have instrument issues, I end up going from a 6 to a 7 or 8 and go home in tears. But I do everything in my power to keep it from getting to that point. This situation, home at an 8, only happened twice in last 4 months. Pretty rare to have it happen otherwise....my life just isn't that exciting.

In the immediate aftermath of a pain procedure, I'm even more careful. Epidurals sometimes cause some spasms. RFAs just cause lots more pain for the first week, then it starts wearing off as the nerves die. Having done it several times, I learned to take it easier afterwards. Even so, I walked around my neighborhood on Sunday evening, a leisurely mile. Very leisurely. Have to have good shoes and insoles for this walking, too.

Hi Rumble,
Thankk you.
I think you got my point. I am on Remicade and have been within my limits. But recently little extra strain has caused me problem and it is yet to settle down even after 4 weeks of Remicade infusion. This has given me a question mark, that I have to be extra vigil to be within the limits.

Though it appears my point is understood by you from my post, I have not got explicit answer. When we are on pain management which does not reduce inflammation and be within our limits, will it cause more inflammation?. I am not really mentioning about a short raise in pain level and subsiding in a day.

Jay

Hi Possi,
Thank you. Yes. I fully agree, it is the quality of life that matters. I am presently on Remicade, SSZ and MTZ. Practice exercise and do swimming. I am not supplementing on any other pain management technique. I am thinking of one of them after study.

Jay

Hi Sue,
You got my point at one shot.
Yes. I agree in doing whatever possible to be able to function. Should one select a pain management technique that reduces the pain and also reduces the inflammation in the process of overuse and make it more inflamed.
Alternatively, select a pain management technique and also use other process (other than regular medication be it biological or medicine) to check the inflmmation under control.

Jay

Hi Pea,
I know that you have pain pump implanted. How it is doing it's function?. How about refilling frequency?. I am sorry to hear about your problem with feet. Hope your rheumy will help.

Jay