Neck and back pain

by Daniel
(Durban)

Hi there

I was wanting to enquire, I am a 30 year male. I have Crohn's disease which was diagnosed in 2009.

My crohns was very aggressive and I was on the brink of a colostomy on 2 occasions. I managed to avoid this by being treated with a trial biologic drug which has kept me in remission for a number of months.

In addition to this I have and very rare AVM in my thoracic area which was causing me to cough up blood from time to time. I went for an embolisation of this in February of this year.

About 5 months ago I started having backache which seemed to be worse in the morning when waking up, it seemed to be relieved when moving around. Over the last few months I started having neck and upper back pain as well. It does not seem to be mechanical pain as it improves with movement.

The lower back pain is present first thing in the morning and sometimes wakes me up in the early hours of the morning. I have to get up and move around for the pain to subside which takes about 10min. I also have lower back pain when standing or walking for long periods as well as driving for long periods

The neck pain is with me for most of the day especially when sitting up straight. I have been to see a physio on two occasions that indicated that my neck and back muscles are extremely stiff. After loosening the muscles, the pain seems to originate from my spinal area, and there is often a burning sensation which may indicate that the pain is inflammatory in nature?

The condition linked with crohn's disease is called axial arthritis which has similar symptoms to ankylosing spondylitis. I have been to see two rheumatologists and both cannot give me an accurate diagnosis although they are leaning towards axial arthritis.

Basically wanted to ask you if there are any other conditions that would result in similar symptoms without me having expeiernced any significant injury, or would you also lean towards an axial arthritis diagnosis. I was under extreme stress over the last few months due to the potential colectomy and AVM problems could this be a factor?

And lastly, the research seems to suggest that chiropractic treatment for patients with ankylosing spondylitis is not recommended as it may cause damage to the joints which are inflamed. I have also had x-rays of my spine, which indicate no fusion to date.

Any help would be much appreciated, I am in the Durban area

Daniel

Hello Daniel,
You are obviously well-read and up to date with your disease.
There are few things of significance:
Whilst Crohn's disease may cause joint complications, those without Crohns also get joint pain. It's possible that your spinal pain has nothing whatever to do with your Crohn's.

I don't agree that patients with inflammatory disease should not be treated with manipulations. I've successfully treated numerous ankylosing spondylitis patients for lower back pain. But obviously with care, more gently... exercise is a vital part of the management. Done daily before getting out of bed. See our lower back exercise programme at C-H.

Simply because you have neck and back pain, with no confirmatory tests that it's axial arthritis, it's non-sensical to say you should not be treated by a chiropractor. Having said that, with care, with interaction, someone you "click" with.

Some people get relief, even complete relief, by avoiding all gluten. That means no bread at all, suggest you talk to a dietician.
As with all arthritis a change to more vegetable protein is vital. Start with making hummus (type hummus into the Search this site function at C-H). It's very easy to make at home. Then more tofu, fish... lentils, beans. However, changes in fibre in your diet should be done cautiously and in small amounts, finding what you can tolerate.

Start taking extra omega-3 oil and eating foods rich in omega-3, particularly fish and flaxseed. Use the latter in your hummus. These seeds must be ground, or liquidised with olive oil.

Reduce your omega-6 which means a move from seed oils like sunflower to olive oil.

Start looking for a chiro in Durban who is experienced, has an interest in nutrition and exercise.

Good luck, I hope this has contributed.

One last thought: fasting. It has a place in the management of Crohn's and AS.

Dr B

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Nov 18, 2013
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Hi Daniel
by: Anonymous

Hi Daniel, I know how you feel. I have Crohns and AVM and also Back pain. We should talk, I guess nobody understands how it feels!

[By all means. I you two have a fruitful interaction.

Dr B]

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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