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Crohn's Disease Forum » Extra Intestinal Manifestations » Arthritis » Joint pain, what will make it stop?


 
03-20-2012, 11:35 AM   #61
JohnnyRottenAppleseed
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I wonder is cipro is causing my joint and tendon pain?
03-20-2012, 04:17 PM   #62
ifeelsick
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I wonder is cipro is causing my joint and tendon pain?
If you are taking Cipro, and experience sudden joint pain or tenderness, stop taking it immediately and call your doctor! This can be the sign of an allergic reaction. Cipro is a strong antibiotic, and while it will probably disrupt the balance of your gut flora, it should NOT be causing you joint pain.
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03-20-2012, 04:20 PM   #63
JohnnyRottenAppleseed
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If you are taking Cipro, and experience sudden joint pain or tenderness, stop taking it immediately and call your doctor! This can be the sign of an allergic reaction. Cipro is a strong antibiotic, and while it will probably disrupt the balance of your gut flora, it should NOT be causing you joint pain.
It does long term I've been off it for almost a year. I will post a thread about Cipro and tendon and joint pain. I know I'm not the only one.
03-21-2012, 11:29 PM   #64
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I posted late late year that I had been diagnosed with dengue fever (a mosquito borne virus that causes joint pain/fatigue etc). I went back to the doctor a week or so after I posted and was told that it wasn't dengue fever (further blood test results had been received), but looking more like lupus. (Apparently the lupus can give false positive readings for all sorts of things??) The joint and muscle pain progressed quite severely, to the point where I couldn't walk or lift my arms or even open a bottle. Have had a referral to a rheumy (I live in North Queensland and the wait is ridiculously long - up to 2 years for urgent cases), saw my GI for a general appointment. She seems to think that it could be drug-induced lupus from the humira, I am no longer having the humira injections so I am hoping that the lupus goes away. I have also been taking a course of steriods which helped get rid of the pain almost immediately - it was a huge relief even though I got quite a few of the side effects - night sweats, uncontrollable hunger, moon face etc. I am down to 5mg at the moment and the pain is starting to come back which is quite distressing because I know what is coming if the pain gets as bad as it was. I am crossing my fingers that once the humira is out of my system I will be well again.
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Drug-Induced Lupus
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Other alternative treatments : Fish oil, , Mulitvitamin, Vit D.
03-22-2012, 11:00 AM   #65
head_above_water
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Oops! Johnny O! I should change my signature...I'm not currently on Cipro. I'm currently on 6MP and Apriso. I was on Cipro for a year...but my joint pain is not specific to my time on Cipro. It tends to jump around and it's in my left knee now. Of course, if you didn't have joint pain before taking Cipro and now you have it...I would talk to your MD. Isn't it so hard to tell sometimes what is from the IBD and what might be a side effect?
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03-28-2012, 01:23 PM   #66
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Hello Jessyy21,

I literally feel your pain! I had rheumatic fever back in 2002 that went into my nerves and joints that was so painful I was in agony constantly and saw every specialist and took every medication available at the time. Finally, my (now) husband convinced me to go to the Harvard-affiliated, Brigham and Women's Hospital in Boston, MA. It was difficult to convince me to go since I had seen every specialist in my area and was extremely disenchanted with the profession as a whole. I was wrong.... and finding a doctor that "gets it" can change your life.

Sorry about the long diatribe but here are my answers to your questions.

What makes it worse:
1. Your pain is erratic because many things affect it. For me, weather is a big one. Increased pain will result from damp cold and/or a low pressure system moving in. I can tell if it is going to rain far more accurately than any weather person on TV.

2. I have many many environmental and diet allergies that were diagnosed after the rheumatic fever. A HUGE factor for me is my diet. If I drink milk, eat soy, or have anything with wheat in it my joints are a disaster for at least 3 days. I was unaware of this connection because the joint pain due to food does not increase until 1.5-2 days after I eat the allergen.

3. When I am getting sick, before I exhibit symptoms, my joints know it. It feels just like it is about to rain but instead of it raining, I am actually getting sick. This actually results from your immune system fighting off the infectious agent. In the normal immune reaction, immune complexes will build up in your joints. For us it is painful because our joints are already irritated.

What does and does not work

1. Laying in bed hoping the pain will just go away DOES NOT WORK. This will actually make things worse. A vicious cycle will begin in which your joints hurt then your muscles will spasm and tighten around your nerves which cause your muscles to spasm and your joints to hurt.... etc etc. The most difficult thing to do is to get up and move. The best thing for your pain is to get up (put on warm clothes if it is chilly at all) and do any movement that does not cause impact on your joints. Swimming is excellent (if the water is warm and you will not get cold when you get out), or a hot tub with stretching, take a bath and stretch in the hot bath (this is what I do). Yoga is probably the best thing as far as I am concerned. It is very low impact on your joints and works every muscle, ligament and joint in your body. You would be surprised how a tight hamstring can wreak havoc on your neck. Yoga has helped quiet the shooting pain down my legs. Now the shooting pain is nearly gone.

2. A decent TENS unit will be your best friend. A TENS (Transcutaneous electrical nerve stimulation) device coupled with a nice warm heating pad can do wonders for your joints. Using electric shocks to help your arthritis sounds awful but it is really wonderful and feels like a massage chair and not like electric shocks at all (unless you put an electrode directly on a bony process like your knuckle- dont do that- ouch!). I highly recommend a TENS.

3. Unless you see an excellent pain specialist you will be prescribed opiates for your pain. OPIATES DO NOT WORK! I have taken every opiate that exists (I am not kidding). Non-pain specialists were prescribing these drugs to me like they were candy. I was on everything.... Tramadol, Vicoden, Vicoprofen, Percocet, Oxycontin, Ultram, Ultracet, Hydromorphone, Fentanyl/Duragesic, etc. None of these drugs even touched my pain except the Fentanyl but this drug made me so nauseaus I had to take an anti-nausea drug that made me so out of it I barely knew my name. The funny thing about chronic pain is that even if an opiate initally helps with your pain the pain will quickly break-through that dose and require you to up your dose again and again until it does not work at all. My pain doctor knew that. This is what he prescribed: 25mg Nortriptyline (I also take Flexril as needed). Initially I was seriously irritated. I have been taking Fentanyl plus about 14 other medications to combat my pain and he wants to take me off all of that and give me this Nortriptyline??? at a dose far lower than therapeutic doses for depression?? He was right. He was SO right. Nortriptyline is off-label for use on chronic pain and the dose is much lower than what they start you at when given as an antidepressant. I know that chronic pain and depression go hand-in-hand but they are treating your pain with this dose they are not treating you for depression. But when your pain is managable you automatically become less depressed (novel concept). My pain is not completely gone but I can deal with it now. It is secondary to my life. Often, I do not think about it at all.... unless of course it is about to rain.........

Hope it helps
03-28-2012, 01:55 PM   #67
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Hi. I've just read your story. It's given me much food for thought. I'm on Butrans patches, 30mcg per hr. Used once a week. My GP has tried all sorts of other pain killers. Several other opiate patches, but these are really helping with my pain. They don't take it all away but they're the best I've had up to now. I can't take oral pain relief as I don't have enough bowel to absorb it and it also irritates my stomach in a big way. Also, as I have a stoma, I can't take anything containing codiene as it slows my system too much and I may have a blockage, as has happened lots previously. You're absolutely right! I have depression a lot and I feel sick and take anti sickness tablets. It drives me nuts!!! Anyway, I have an appointment with rheumatology on 20th April so I'll tell them about you and ask whether taking the Nortryptiline would be any good for me. The only thing is, it would worry me as I read last week that people who take TEMAZEPAM to try to sleep are at much greater risk of dying. Did you hear anything about that? Are they similar to your tablets? It was in my local newspaper.

Very interesting reading anyway - thanks a lot for that
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03-28-2012, 02:40 PM   #68
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Hi. I've just read your story. It's given me much food for thought. I'm on Butrans patches, 30mcg per hr. Used once a week. My GP has tried all sorts of other pain killers. Several other opiate patches, but these are really helping with my pain. They don't take it all away but they're the best I've had up to now. I can't take oral pain relief as I don't have enough bowel to absorb it and it also irritates my stomach in a big way. Also, as I have a stoma, I can't take anything containing codiene as it slows my system too much and I may have a blockage, as has happened lots previously. You're absolutely right! I have depression a lot and I feel sick and take anti sickness tablets. It drives me nuts!!! Anyway, I have an appointment with rheumatology on 20th April so I'll tell them about you and ask whether taking the Nortryptiline would be any good for me. The only thing is, it would worry me as I read last week that people who take TEMAZEPAM to try to sleep are at much greater risk of dying. Did you hear anything about that? Are they similar to your tablets? It was in my local newspaper.

Very interesting reading anyway - thanks a lot for that
Hi Cavatina,
I am so sorry you are having to deal with so many health issues. I am surprised you are on Butrans and you are on a high dose too. Any narcotic will constipate you (i.e. codeine or Butrans) so I am worried you might get a blockage with your stoma on the Butrans patch. I really feel for you. Chronic pain is awful, especially if you cannot get away from it. When I would sleep (rare) I would even dream that I was in pain. I know taking those anti-nausea drugs if they work can make you feel loopy exacerbate depression symptoms (primarily because that is their mode of action).

Good luck with your rheumatologist. Just so you know the nortriptyline use for pain is off-label and I had previously seen many many doctors for the pain and none had suggested this drug. Also, you will need to take it every day so it builds up in your system and it will take about 2 weeks to see an effect (that is what they tell you but I saw an effect in about a week or so). Every doctor previously had just given me another opiate. They may work for acute pain but not chronic pain. Nortriptyline may also have a constipation or diarrhea side effect. I will look up the rates for you but just so you know I didnt have any issue with it. And the doses you are taking are like 25mg and for the on-label use for depression they start the doses at around 100mg. I really like the idea of less drug in my body! NO nausea at all, in fact it did not feel like I was taking anything at all. And, I slept so much better. Not just due to the pain decrease but because of the drug.

Regarding your temazepam question.... totally different drug. I have taken it though (I have taken everything seriously). Temazepam is used for sleep. Brand name is Ristoril. I do not like that medication because the half life is too long and I would wake up in the morning with the "hangover effect". I also do not like Ristoril because I had a reaction to it. I did not fall asleep and was mentally not competent. I had to be taken to the ER. It very likely interacted with one of my other meds. This is when I was on about 15 of them at once. The ER doctor looked at my list of meds (which I kept on me because I could never remember everything) and said he did not believe that I was on all of these drugs. I was though. I am pretty sure its a bad sign when a doctor doesnt believe your meds list.

Are you looking for a sleep aid? Some people like temazepam. I am just not one of them. Also, temazepam you would take only on nights you have trouble sleeping, but nortriptyline is an every day type of thing. I took it at night because it is supposed to make you a little sleepy. If it does though, it is very mild. I could take it in the morning too with no problems.
Good luck with everything. I hope you have an excellent visit with your rheumatologist.

Last edited by Judith; 03-28-2012 at 03:21 PM.
03-28-2012, 03:37 PM   #69
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Cavatina,
I said I would look up the constipation side effects of nortriptyline. Here are the results. There was a study done back in 1970 about this (it is a pretty old drug). Patients were put on 50mg dose of nortriptyline for psychiatric symptoms. In the placebo group 43% of patients reported constipation during the study. In the nortriptyline group, patients reported constipation less frequently when they had been on the drug for a period of time. The study looked at patients on the drug for 1 week - 4 weeks. Here are the percentage that reported constipation:
Week 1: 61%
Week 2: 51%
Week 3: 44%
Week 4: 29%

At week 3-4 patients actually report constipation equal to or less frequently than placebo controls. The study also reported less frequent headaches in nortriptyline treated patients.

One side effect that did increase is "dry mouth". I have heard this is true more often with increasing doses. This side effect also appears to decrease over time.
Hope it helps!
Here is the study in case you want to check it out:
http://www.ncbi.nlm.nih.gov/pmc/arti...02156-0032.pdf
03-28-2012, 03:59 PM   #70
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Judith,

You mention Nortriptyline. Do you know if amitriptyline would work as well since they're in the same class? I ask because low doses of amitriptyline are prescribed for IBD patients to help control other symptoms (such as abdominal pain) with EXCELLENT results so it would be nice if multiple issues could be controlled with one drug.
03-28-2012, 05:15 PM   #71
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Actually, Nortriptyline is one of the metabolites of Amitriptyline (your liver makes Nortriptyline from Amitryptiline). Nortriptyline has fewer side effects than Amitriptyline (likely because it is given only as the active metabolite). I would think that many people would benefit from Nortriptyline especially since it has a very low incidence of side effects. But, as with any drug, just because it worked wonders for me doesnt mean it will work for everyone. For example, I take Tylenol for a headache because Advil is useless. However, I know many people swear by Advil..... it just doesnt work for me.
04-05-2012, 11:40 AM   #72
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Well, tapered myself off of steroids, but had to get back on them for tapering so soon. Had my Remicade shot also about two weeks ago. Did great until this week...went to Houston, TX for a 3 day conference. It was raining and humid. The swollen fingers, feet, elbows, and aching knees all came back!!!! Hard to explain to colleagues that were with me. No one really understands what we go through...
04-22-2012, 09:18 AM   #73
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Firstly, thanks a lot Judith for info. re Nortryptiline really interesting - I don't get constipation with Butrans thanks. The doctor is going to put me on
Nortryptiline to help me sleep, but from what you say, it should help with other stuff too - fingers crossed! The blockages I have are usually caused by adhesions re having had six major operations. Loads of pain - hell at these times. Luckily I haven 't had an incident for a while. It has, I feel, improved things since I stopped smoking three years ago.
Anyway, the visit to the new doctor in rheumatology was extremely encouraging. She was brilliant! Really listened to my history and thoroughly examined me in a way no-one has in the past few years. Even the Pain Clinic told me to go away and keep taking the tablets, two years ago!! After a consutation with the rheumatologist lasting around half and hour! Unheard of! She said that my problems are caused by Crohn's. She thinks I have inflammatory arthritis, accompanied by Fibromyalgia and Joint Hypermobility. Obviously, the effects of all these, plus the fact that I was in a hospital bed in 2001 for 9 months. Fed by tube for 7 months. On a life support machine for nine days. I'm very lucky to be here! If anyone wants me to elaborate, I will, but it's a long story. Anyway, I digress! The new doctor, Dr Lane, who I will add to the list, has put me on a short, intense course of Prednisolone, for a month. (Bit scary!) She has written to my GP to ask her to give me Nortriptiline. I'm seeing her after a month, when she will do a blood test. Then she is going to give me Methotrexate and/or (I can't remember which) Sulfasalazine. She's also pleased I go swimming as it's obviously good to keep active. The next step in that is that she will refer me to a gentle circuit training six week course. It was such a revelation to think that someone was actually listening properly and knew what was wrong. Thanks to my Crohn's consultant for suggesting it. I had actually started to feel like a fraud because people were saying 'Why haven't your joints swollen? That's usually the case when you have arthritis" I don't feel bad any more because joints don't necessarily swell with my kind of arthritis!!!!! Does anyone know if I will struggle with the above meds. as I can't usually take anti imflammatories such as Ibrufen. Hope not. Thanks a lot for you interest folks. I'm so glad to have found you.
04-22-2012, 10:26 AM   #74
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I'm really glad you found a Rheumatologist that you feel comfortable with! That can make such a huge difference. I like the idea of the circuit training course. Let us know how you get on with everything.
04-22-2012, 10:34 AM   #75
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Thanks David - great to have your input!
05-04-2012, 11:54 AM   #76
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Hi all - help!!! I've been on the Prednisolone since 21st April, starting with six a day for five days, four for 5 days, then three for 7 days, reducing to one a day and finishing on 21st May. OMG!!! I feel so ill - is that normal? It's a bit confusing though because I was in hospital for two days last week with a bowel obstruction - much pain! Don't know if I'm sufffering the aftermath of that or if it's the steroids. I'm also wondering if my drugs are possibly reacting against each other. Went to the GP yesterday and she took me off Domperidone, which I didn't feel were helping with the huge nausea, which is my main, and most difficult to handle, problem. She gave me Gaviscon to take four times a day but it doesn't help much at all. The only time I don't feel sick is when eating or sleeping. The Butrans were making me feel sick but it's much worse now. The pain is slightly improved but it doesn't seem worth it as I feel so bad. At the moment I'm taking 15mg Lanzoprasole and 135mg Mebeverine in the morning. Gaviscon, four teaspoons four times a day. Butrans patches, 30mcg once a week. Risedronate once a week. In the morning I also have Glucosamine, Multivitamin, and Cod Liver oil tablet. I have Paracetomol when necessary. The GP wants me to stop the Lanzoprasole if the Gaviscon works and when that has been stopped for three weeks, she wants to do a test to see if I have some sort of infection. Does anyone have any
ideas about what my problem may be and how to resolve it? The trouble is, my problems are complex and three different doctors are trying to help. Do I hang in there and see what happens? My next Rheumatologist appt. is on 29th May and Gastro Consult. on 11th June. That seems an awful long time away right now!! I feel as if I want to stop all the meds. and start again!!
05-04-2012, 12:59 PM   #77
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In the morning I also have Glucosamine, Multivitamin, and Cod Liver oil tablet.
I'd try stopping those three for a few days and see if it helps at all.
05-04-2012, 01:51 PM   #78
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Thanks David, I'll try that. I'll let you know the outcome
05-04-2012, 05:21 PM   #79
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I've had good sucess with Sea Bands, which are an anti motion sickness product you can buy at the drugstore for like $10. They are these sweatband looking things with an acupuncture ball inside that when worn on the wrists interrupts the nausea signal from your brain.

These are awesome for medication induced nausea. They're a bit tight but they helped me sooo much. Also Peppermint Altoids are helpful, too, and peppermint herb tea.

The doc could prescribe Zofran which is a very strong anti-nausea drug, too-but it is constipating, and with a bowel obstruction you don't want that!

Hope you get to feeling better soon!
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05-05-2012, 02:09 AM   #80
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Thanks David, I'll try that. I'll let you know the outcome
Hopefully it works. But that you had an obstruction recently is of course concerning and I'm worried it is related to your narrowing. Do you know specifically where the obstruction was and did they evaluate how narrowed your bowel is?
05-05-2012, 07:01 AM   #81
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Thanks a lot for that Mountaingem. I'll try the Sea Bands. You're right, no I don't need anything to constipate me! After your info., I'm hopeful. I'm afraid I hate peppermint tea but find that lemon and ginger tea helps a bit. I've not heard of Altoids. Are they medication or sweets? Anyway, good of you to try to help.
05-05-2012, 07:06 AM   #82
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Hi David. No, they didn't say where the obstruction was and neither did they say by how much it is narrowed. I didn't know they could tell me that, or even the relevance. I only know that they very much steer clear of operating as next time they do, they said I would be fed by tube permanently - hope that doesn't happen but I'm prepared if it does. I'm seeing my Consultant on 11th June so I'll ask to see the Xray and see if she can answer your questions. Thanks again
05-05-2012, 07:21 AM   #83
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Hey, I get joint pain as well.
It calmed down a lot after taking anti-inflammatorys.
I also changed my diet as well, I was only eating veg,fruit,white meat and GF bread.
Now.. I'm on the gluten challenge and I must say.... I feel like s%*t.
But it's only way to find a diagnosis....
3 elements help with joint pain I found-
Vitamin D + calcium suppliments + antiinflamitorys...
05-05-2012, 08:14 AM   #84
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Hi. Sorry to hear you're still having painful joints. It's all over my body so not a lot of hope for me! I'm in the early stages of steroid treatment and the pain seems a bit less so hopefully they'll sort me out. My main problem right now is the nausea so I'm trying all I can to beat that too. I can't take calcium or Ibuprofen as they irritate my stomach. Thanks a lot for the suggestions though.
Hope you continue to improve with your diet.
05-05-2012, 12:40 PM   #85
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Altoids are a candy-usually where you find breath mints or gum.
05-11-2012, 11:29 AM   #86
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Quick update to the above. Thanks to everyone for help and advice. At the moment, I've stopped taking Lanzoprozole as the GP wants to do a test to see if I have an infection and can't do it until I've stopped those for two weeks. Also, on David's advice, and on the advice of the rheumatologist, who didn't think they did much, I've stopped Glucosamine and Cod Liver Oil tablets. I'm using Sea Bands - constantly, even at night, and I'm having four teaspoons of Gaviscon three times a day. I'm down to two steroids a day now. The last two days have been - and I can't believe it - nausea free! Also, the pain has improved a lot, so hopefully, I'm getting there. I think it will be a long process but so far so good. After spending soooo long feeling abbsolutely awful and not wanting, or not being able, to do much at all, today I weeded the front garden!!! I feel so much happier. Thanks thanks and thanks again!!!
05-12-2012, 02:23 PM   #87
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Something else for all of you with arthritis who are on either immune suppressors or biologics to discuss with your doctors if you feel it is pertinent:

Blastomycosis
Histoplasmosis
Coccidioidomycosis

These are fungal infections that can lead to joint and muscle pain and love people who have a reduced immune response or are on TNFa blockers.
05-12-2012, 05:04 PM   #88
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That's very interesting David - maybe that's me. I'll let you know when I've had the test.I'll certainly put those suggestions to my GP. Thanks again.
05-12-2012, 05:13 PM   #89
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No problem. And in response to your post above mine, I'm so happy to hear you're doing a bit better!
06-09-2012, 10:47 AM   #90
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I discovered DMSO a year ago when my joint pain was out of control . It works and is a miracle. It does take 2 days for it to work. I advise you to read all you can about it. Love #2
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