Non-GI symptom management (joint pain, mostly)

I'm in kind of a weird phase in my disease. My gastrointestinal symptoms are fairly well under control. Dietary changes seemed to help a lot. A recent colonoscopy showed little disease activity. Yet my joint pain is pretty significant, and is beginning to interfere with my ability to sleep and exercise.

We (my doctor and I) increased my Imuran dose by 50 mg but while it helped some with the joint pain, the mental dullness and fatigue was not tolerable.

Having failed on Pentasa, and apparently topped out on what I can tolerate for Imuran, a rheumatologist suggested Humira or Remicaid. But the side effect profile looks awful and its a fairly intense medication to take.

Does anybody else take anything to help with such symptoms? Is it just pain management? What was going on when you had non-GI symptoms but everything else seemed fine? I'm worried something else is going on but I've already been diagnosed as non-rheumatoid. I'm wondering what I can do to get my symptoms back under control.

I saw a rheumatologist who did a bone scan to determine that my joint pain was not osteoarthritis. I'm looking into a pain specialist but hadn't considered physical therapy.

I wish I could get a doctor to do that for me, heatmiser, because Tylenol doesn't do anything for the joint pain. However, when I go in asking for something stronger my experience has been they think you're an addict, rather than somebody who has run out of other reasonable options. If I could just get to sleep at night, I can tolerate the daytime discomfort for the most part.

Aside from pain medication, my rheumy has consistently pushed me to get on stronger meds. He has classified my joint pain as enteritis arthritis. My GI poo pooed the whole thing until one day I showed up with my first pinky joint bright red and swollen. He then prescribed me sulfasalazine, which is an "old" RA med, newly in favor among GIs for effectively treating joint pain in IBD patients. My hand pain is about 95% gone. My knee and shoulder haven't been touched by the sulfasalazine, but they weren't the biggest problems to begin with, my hands were.

If your only med for the Crohn's is currently imuran, have you considered methotrexate? If that's not an option, I'd say your rheumy and mine would agree that the anti-TNF biologics are the logical next step. I think I'd rather take one of those than an opiate pain reliever. The scary side effects are very rare. What concerns me more about those is "using up" my options. I've seen too many posts on this forum about people who have LOVED their remicade but then can no longer tolerate it.

But I'm half a step closer to choosing that than I was a couple of days ago. I just had 3 days of PVCs, a benign but annoying heart arhythmia, every minute of my waking day. Maybe connected to Crohn's maybe not. But my rheumy's comment from a few years ago about getting a better quality of life out of my GI - I'm hearing that message more clearly these days.