Joint pain, long term Prednisone side effect

Was finally able to get off Prednisone on July 20th. Had been on it since Feb 20th, 2011, save for 9 weeks. So thankful that Remicade appears to be working well.
However, I'm experiencing some nasty joint pain in my feet, ankles and knees.

I enjoy running, trying to build my mileage to become a better running and to help reverse osteopenia. Didn't have a problem with ankle pain while on Prednisone, so I'm thinking it's a long term side effect of the Prednisone. I've read this could last up to a year based upon how long I was on it.

Even when I don't run my feet are stiff and painful when I walk after being off them for about 30 minutes or more. First thing in the morning is the worst, but it subsides after a few minutes. The ankle pain is much more persistent.

Looking for some suggestions on how to reduce the joint pain. Really don't want to start popping pain medication on a regular basis.

Your pain sounds like tendonitis, and could be a side effect of your long-term steroid use, or the remi, or your UC. Pick one. Either way, it doesn't help solve the problem (unless it's the remi - you should probably tell your DR about the joint pain).

I will not advise the use of NSAIDs, even though that would be the most effective treatment. People with IBD should not use NSAIDs. Since you already know that the stiffness will resolve after an hour or so of activity, plan your runs for late in the day, and try to put ice on your sore spots after your run.

You might talk to your DR about adding sulfazine to your meds. It's an old arthritis med that works really well at treating joint pain due to IBD.

Thanks everyone for your advice.
I have an appointment next Tuesday and will ask about getting a prescription for sulfazine. NSAIDs are on my "Thou shalt not touch" list.

Here's what complicates things a bit. I broke my right ankle back in 2008, had to have a plate and 14 screws inserted. Recovery was a long slow processes.
The hardware has been giving me some added discomfort lately. Going to ask my GI if she thinks I'm in a good position to have the hardware removed.

My orthopedic surgeon warned me that people sometimes develop really bad arthritis at the break site about a year after surgery.
It's been almost 4 years since surgery, and haven't had any serious joint pain until now, post Prednisone.

In reality my ankle pain could be from: arthritis due to fracture, Prednisone, Remicade or from just having UC.

Please keep the suggestions coming.

I have similar joint and ankle pain after 2 months of stopping prednisone. I thought I was just feeling old. I was taking a lot of stairs at my dad's house carrying my daughter and after two days my tendons swelled up and I could barely walk. My doc said for relief I should avoid flat shoes and wear something with a small heel. This worked and the swelling went down. I still have that stiffness and crunchyness in the morning. Make me feel like I am 100 years old!

Stereo, I really object to your blanket statement that "meds don't really do anything for this." Based on what, your personal experience? My personal experience and plenty of others' has been that sulfazine treats joint inflammation very effectively. In any case, the OP doesn't even know WHY he's having joint pain.

Omega 3s are a great idea, though, and it's good that you brought it up. I've been taking omega 3s twice a day since my diagnosis and I always forget to mention it.

See here for basic info on sulfazine.  Here is a longer article about joint pain associated with IBD. 

If you scroll down you will find this information: Sulfasalazine is an azo-bonded combination of 5-aminosalicylic acid and sulfapyridine ....Sulfasalazine is poorly absorbed in the small intestine. In the colon, sulfasalazine is split by bacteria into its constituent moieties. The 5-amino compound lowers colonic prostaglandin E and alters gut flora. The sulfapyridine appears to be antiarthritic ....

 

Hi Jay,

I was on pred for 4 years on varying doses from 5mg to 60mg until June 2011. I started remicade in April 2011. After getting down to 5mg and once I was off pred, I had the worst joint pain, my feet, my hips, my knees, my arms, my shoulders everything. I could barely walk down stairs and would take them one at a time. I have a 45 min commute to work and after sitting for that small amount of time, I would slowly walk to my office from the parking lot in sheer pain.

In Sept 2011 I began seeing a personal trainer. I used to work out prior to taking pred (it made me swollen and feel awful while on pred, so I did not work out). Within a month of going to a trainer 2x a week for 30min sessions, doing lunges, lifting weights, working on my core I began feeling better, within 3 months, I felt even better and could not believe it. I now go to step classes on a bosu ball (very difficult!!) and keep up with the training. I feel so good and the pain is 99% gone. Every now and then I have a bit of it, running down the stairs in the morning or maybe that's just what happens when you are almost 37??

Take care!
Beth

Joint pain is definitely no joke. When I had it this summer, I was imobile and performing daily activities became really difficult. I was crying in my bed at least a few times. Woot, I sincerely hope everyone can find something that works for them...

Thanks again everyone for all the suggestions.
I ordered some Zyflamend and it should be in tomorrow.
Will ask my GI about sulfazine when I see her on Tuesday along with asking what she thinks about me seeing a rheumatologist.
I drink a good amount of water already, at least 6 glasses a day, but I'll bump that up to 8.

Got serious about running and lifting about 3 years ago, right after I got married. Had a bad side effect from marriage, had trouble fitting in my pants and went from using the fourth notch on my belt to the first. Had always been thin, and wasn't about to start slipping now. So exercise and eating better became part of my daily life.

When I started running my old friend Mr. Shinsplints was there waiting for me. Finally got rid of him by switching my running to barefoot running, Vibram Five Finger shoes. They took a while to get used to. Incurred a few more injures because I increased my mileage too quickly. Had been training to run the Rochester marathon the last two years but had to stop due to these injuries. Currently training to run it in 2013.

Ran 4 miles this morning after taking a few extra minutes to stretch out my calves. Things are feeling pretty good right now.

I think kazbern is right about the pain being associated with scar tissue. That's where a good deal of my ankle pain sources from. It feels sore like after physical therapy would stretch my ankle after my surgery.

Found exercise to be wonderful in helping with UC and keeping down Prednisone side effects.

Thanks again for all the info and suggestions.
Please keep them coming.