Repeated tendonitis

I have joint involvement with my crohn's (and may also have psoriatic and/or rheumatoid arthritis...rheumy won't commit to type).  Over the last 2 years, I keep getting bouts of mostly spontaneous tendonitis (i.e., not precipitated by an injury).  A different tendon seems to be affected every 3 to 6 months -- it's to the point where I'm putting off seeing the orthopedist because I feel like they must think I'm a hypochondriac...those close to me have made comments to the effect that they think I'm overreacting and it's become a joke at work.  After a week of walking around in pain, I finally saw an orthopedist this morning who confirmed tendonitis and prescribed some physical therapy.  After the first few bouts, I mentioned it to my rheumatologist and she said that it could be related to my arthritis.  Just curious if anyone else has a similar experience.  If so, is there anything you do to help prevent it or is it just treating each new case as it comes?

 

Melissa

sry * 1 month and shoulder has improved...

Enthesitis is inflammation of the tendon where it inserts into the bone. This is a somewhat common problem in the family of spondylitis diseases [ankylosing spondylitis, reactive arthritis, undifferentiated spondylitis, psoriatic arthritis, and enteric arthritis]. I have had repeated bouts of enthesitis. During a flare of my AS I once had nine tendons inflamed. It was nearly impossible to move.

I have learned to be careful - I try not to make sudden stressing movements like jerking on a heavy package or over using a joint. I also make sure to stretch prior to physical activities like gardening or briskly walking.

My rheumatologist has been great in trying to combat these flare ups. I have had numerous steroid injections around tendons that did not respond to rest or that are nearly impossible to rest [like fingers]. I was actually started on Remicade because of the joint and tendon involvement. Being on an anti-TNF med has been the best method to keep my problem under control. NSAIDs work but as Crohn's people we are usually told not to take them.

Thanks for the replies -- it's nice to get a dose of reality from others going through the same things. 

MToronto -- do you know if LDN helps prevent injury or treat existing injury?  I'm not that familiar with LDN other than a few posts i've come across on this board.  It sounds like you're seeing good improvement with LDN....I'll keep my fingers crossed that you continue to improve.

Nanners -- It's hard for someone looking in from the outside to understand everything and then it makes you question your own sanity.  My mom recently read a self-help type book by someone with crohn's and after reading she called me up to apologize for not really taking what I told her seriously . . . i just wish there was a way for others to get it.  BTW, I think it was you who told me about SIBO a few weeks ago...my doctor was thinking along the same lines and has me on xifaxan now.

Ides -- thanks for putting a name to it.  I have an appointment with my rheumy for Monday morning and will ask her again, armed with more info this time .   My rheumy and GI tend to manage my case together and they're holding off on trying another anti-TNF on me (one might suggest it, but the other tries adjusting a medication which takes care of the immediate need).  I was on remicade for about 15 months ... at first it helped the crohn's, but then I appeared to be going into a flare and it looked like it wasn't helping.  While we were trying to figure out what was going on, my insurance denied a camera pill.  Once the joint pain started we decided to stop the remicade (too high a risk when all indications were that i developed an immunity to it).  A few months later the pill camera was approved, which showed no signs of crohn's, so in fact it probably had been helping but i had something else going on .  Long story short, because there's no clear answer as to whether I developed an immunity to it or not...as a result, the other anti-TNFs are being held back as a last resort in case either the crohn's or arthritis gets really bad.  NSAIDs don't agree with me so they're out and I had steroid-induced Cushing's from steroids a few years ago, so I try to avoid any form of steroids if at all possible.

ChronieToo - thanks for the reminder on flouroquinolone antibiotics.  I do use them occasionally since they tend to help my flares, but I haven't been using them lately (maybe one 10-day course in the last 12-18 months).  At one point I had been on them for close to a year, but that was before any joint involvement.