Worsening Discomfort in the Sacroiliac Joint
Hello everyone, I’m a 20-year-old female from Australia, and I’ve been dealing with persistent lower back discomfort for as long as I can remember. Lately, over the past two months, the intensity has significantly increased. It has become so severe that I find myself contemplating leaving work early due to the agony, which is not an option for me financially. Earlier this year, my rheumatologist diagnosed me with inflammatory spondyloarthritis. However, I was informed that treatment for ankylosing spondylitis isn’t possible since my scans only showed signs of inflammation on the right side of my sacroiliac joint. I was prescribed a daily dose of 20mg meloxicam, but its effectiveness seems to have diminished. Now, the pain has escalated. In addition to my lower back, I also experience discomfort in areas such as my ribcage, neck, shoulders, wrists, and ankles, extending down my legs. Standing for more than ten minutes is excruciating, and sitting doesn’t provide much relief either. The pain disrupts my sleep, waking me up at night, and I often wake up already in pain. Unfortunately, over-the-counter pain relief has ceased to be effective for me. The only time I feel slight relief is when I’m lying down, but that never lasts long. According to my physiotherapist, my pelvis is misaligned, resulting in my left leg being longer than my right. This misalignment could be exacerbating my discomfort. Additionally, I have a history of being pigeon-toed, which subjected me to bullying in the past; my hips and ankles also roll inward. At this point, I’m uncertain about what steps to take next for relief. I have another rheumatologist appointment scheduled, but it’s still over a month away, and I need to find a way to balance work and study amid this pain. I’ll share my x-rays in the comments; I think I notice some differences between the right and left sides, but I’m no expert. I’m reaching out for advice on how to manage this situation. If the pain worsens to a level where I cannot work, should I seek immediate care? Is it better to wait for my upcoming appointment, or are there alternative measures I can pursue without a doctor's visit?
Answers (1)
3/26/2025, 9:50:43 AM
OpenHealth AI
I'm sorry to hear about the intense discomfort you’re experiencing; it's understandable to feel overwhelmed when pain disrupts daily life and work. Your condition, particularly the inflammatory spondyloarthritis and its impact on your sacroiliac joint, can be quite challenging. Here’s a structured approach to manage your symptoms while you await your rheumatologist appointment.
Main Points:
- Monitor Symptoms and Pain Levels: Keep track of your pain patterns and any changes.
- Adjust Pain Management Strategies: Explore additional at-home strategies and physical adjustments.
- Consider Immediate Action if Necessary: Know when to seek urgent care if your condition deteriorates.
Explanation:
Your lower back pain, intensified by inflammatory spondyloarthritis, can lead to discomfort that factors in various areas of your body, as you’ve noted. The misalignment of your pelvis, along with uneven leg lengths, may be contributing to your pain. Since meloxicam’s effectiveness seems to be waning, it's crucial to look for complementary strategies while waiting for further medical guidance.
Next Steps:
-
Pain Management:
- Heat Therapy: Apply a heating pad or take warm baths to relax stiff muscles and reduce discomfort.
- Gentle Stretching & Strengthening: Work on gentle stretches focusing on the lower back, hips, and pelvis. Physical therapy routines that emphasize alignment and flexibility can help.
-
Posture and Body Mechanics:
- When sitting, use lumbar support to maintain a healthy posture. Consider a cushion or rolled towel behind your lower back.
- Take frequent breaks to stand or walk around, even for a few minutes, to avoid stiffness.
-
Activity Modification:
- Try to alternate between standing and sitting. If work allows, consider using a sit-stand desk or taking brief walking breaks every 30 minutes.
- Practice movements slowly to avoid sudden pain triggers.
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Mindfulness and Relaxation Techniques: Consider engaging in mindfulness or relaxation techniques, such as breathing exercises or meditation, to help manage pain perception and reduce stress levels.
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Immediate Care:
- If your pain worsens to the point where you can’t complete daily activities or if you experience severe symptoms like sudden swelling, numbness, or significant mobility loss, don’t hesitate to seek immediate medical attention. This ensures you're safe and can receive urgent support.
As you navigate this challenging time, remember you're not alone; many find themselves in similar situations. Your upcoming appointment with the rheumatologist is important for reviewing your treatment plan, particularly if your symptoms continue to escalate or new symptoms arise. Keep a detailed note of your experiences for this visit to help guide the conversation.
Take care, and don't hesitate to reach out with any further questions or concerns as you work through this.
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