Neck and back pain

by Daniel

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


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

Find a good chiropractor may be your next step.

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Nov 18, 2013
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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