I am now 50 and have just been diagnosed with ankylosing spondylitis and several herniated and bulging discs following an MRI of my spine.

I have pain down my legs into my feet and am unable to bend my legs sometimes. I received a spinal injection but it didn’t work. I experienced extreme pain in the joints of my fingers, wrists, hips, neck, and legs. My two pinky fingers have bent inward and I can no longer straighten them.

I have seen a neurologist who disclaimed nerve damage. I have even experienced severe needle-like sticks in my skin and am totally exhausted.

Is all of this really the result of arthritis?

DEAR READER:
I believe most of your symptoms are directly due to the ankylosing spondylitis. There is one, however, that I am unsure of — the needle-like skin pain. Before I go into that I would like to take the opportunity to explain first about this form of inflammatory arthritis.

Ankylosing spondylitis is truly arthritis, but it is more related to with rheumatoid arthritis than osteo- or age-related arthritis. It primarily affects the spine, but can also occur in the ribs, hips, shoulders, feet, and eyes. It affects other joints less commonly.

As the inflammation persists and the condition worsens, new bone begins to form as the body attempts to heal itself. This can cause restricted movement, stiffness, inflexibility, bone outgrowths, and more. If the ribs are affected it can reduce lung capacity, leading to difficulty breathing.

Symptoms vary with the severity of the ankylosing spondylitis. Early signs often include pain and stiffness of the lower back and hips, usually following periods of inactivity, such as in the morning after sleeping all night. Over time, this feeling may progress up the spine and into the shoulders or down into the knees and feet.

Advanced symptoms include fatigue, loss of appetite, weight loss, iritis (eye inflammation), stooping, restricted expansion of the ribs and chest, bowel inflammation, and more.

There is no cure for ankylosing spondylitis but there are some treatments which are geared toward alleviating symptoms.

There are several types of medications to reduce inflammation, pain and joint damage. Some, such as Aleve, are available over-the-counter. Others, such as prednisone, are available only by prescription.

Physical therapy may provide pain relief and improve flexibility. By keeping the joints active, it can reduce or prevent inappropriate new bone growth, allowing for fuller range of motion.

Surgery is not commonly performed, but for those with severe joint damage or deformities, repair or replacement might be necessary.

Now, you will notice that nowhere in the above information, did I mention skin tingling. I am, therefore, unsure whether this is related or not. It may be completely unrelated, or it could be directly related. If the nerves that supply sensation to the skin are pinched or otherwise compromised by the ankylosing spondylitis, you could experience this sensation.

I urge you to make an appointment with a rheumatologist who will be your best resource for more information and treatment.

DEAR READER:
You’ve had a positive reaction to an herbal remedy. As long as it works, keep it up. Arthritis can be very difficult to treat. Be grateful you can find relief in an over-the-counter medication.

I went to my orthopedic doctor because of pain in my hip. It starts in the joint and travels down the thigh and is especially painful at the tendon along the shinbone. I also have right leg weakness when pressure is applied or when walking upstairs. He said the pain was caused by bursitis, not arthritis. He showed me an exercise to try and told me to continue my regular walks.

I take over-the-counter pain relievers, use castor oil and Castiva. Should I continue using these joint medicines or should I use muscle creams to relieve the nighttime pain? I am 88 and do not consider this worthy of surgery but it would be nice to sleep though the night. I’m tired of having to wake up to take another pill.

DEAR READER:
Arthritis and bursitis can be difficult to differentiate. Arthritis is joint inflammation with associated degeneration of connective tissue and bone. Bursitis is inflammation the bursa that is a sac-like cavity surrounding joints that is filled with fluid that reduces friction caused by movement. There are more than 150 bursa in the body. Most people have heard the term “water on the knee”. This is often caused by bursitis. Swelling and redness are often visible but if the hip is affected, the bursa simply appears to cause pain of the hip and thigh because it is located under bulky muscles.

Arthritis is more common in weight bearing joints such as the hips and knees. Bursitis is more common in the shoulders, elbows, big toe and hips.

Direct trauma, infection, joint or muscle stress, and arthritis are common causes of bursitis. Arthritis is generally caused by age-related wearing of cartilage and connective tissues leading to bone degeneration. It can also be caused by auto-immune disorders such as rheumatoid arthritis. Gout is a common cause of arthritis.

Treatment is similar for both arthritis and bursitis with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium, ice, rest and steroid injections making up the primary course of therapy. If the cause is determined to be infection, treatment with antibiotics is necessary. For severe cases that last longer than a few weeks or if you have major swelling, the bursa may need to be drained. In rare instances removal may be necessary.

I recommend that you return to your orthopedist and ask for an X-ray if you have not had one already. Bursitis will not show on the film but other causes such as arthritis can be ruled out. Given your age, the most likely cause of your bursitis is age-related osteoarthritis. If you like, get a second opinion from another orthopedic specialist. You can then compare the results and go from there.

To give you related information, I am sending you a copy of my Health Report “Understanding Osteoarthritis”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Please tell me who to see to get to the bottom of this agony.
DEAR READER:
Because gout affects joints, it is considered to be a form of arthritis. It frequently affects the big toe, but can also appear in wrists, ankles, knees, elbows, and other joints.

Gout results when too much uric acid is present in the body. Excessive alcohol consumption, radiation, crash diets, and certain medications can trigger an attack.

Because gout can mimic several other conditions, a primary care physician might have difficulty making an initial diagnosis. When doubt remains, the physician might have a sample of the joint fluid tested to determine if any uric acid crystals are present.

Dietary changes are vital. Foods high in purines (shellfish, alcohol, organ meats, and more) should be avoided. Alcohol should be substantially reduced or eliminated altogether. Cherries, dried, fresh, or in juice form consumed daily are purported to prevent attacks and should be included in the diet. If an attack occurs, cherries help reduce the pain and its duration. Positive lifestyle changes include weight reduction, control of cholesterol levels and treatment of hypertension. This may help keep this extremely painful condition at bay.

When these recommendations don’t work, medication might be necessary and there are several types from which to choose. Some are taken shortly after an attack has begun, while others are taken regularly as a preventive measure.

To give you related information, I am sending you a copy of my Health Report “About Gout”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I have sleep apnea. During my sleep test, they discovered my restless legs syndrome. I now take Mirapex and Clonazepam and that is controlled.

Would massage therapy be helpful in reducing my pain and stiffness? Also, I’d like to know if there’s a support group I could attend in my area with people who have these same symptoms.

DEAR READER:
Polymyalgia rheumatica (PMR) is an autoimmune disorder that causes stiffness and pain in the muscles of the hips, neck and shoulders. The disorder occurs most often in women and in the elderly.

If you are willing to try prednisone again, I suggest you first discuss the dosage you were on with your primary care physician or rheumatologist. Cut the dose and perhaps you will benefit from the modification.

Massage therapy will certainly make you feel better and is worth a try. I suggest you find a therapist who has worked with other PMR or fibromylagia sufferers. You may wish to experiment with acupuncture. Be sure to find a certified individual who practices in a clean office and uses sterilized needles. If you don’t wish to be stuck with pins, you may prefer acupressure. This is similar to acupuncture but doesn’t involve needles, rather the therapist uses his or her hands to apply pressure to certain areas of the body believed to relieve pain, increase circulation and more.

Relief may be found with acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) that reduce swelling and pain. Unfortunately, most individuals do not respond well to this therapy and require prescription pain relievers such as Lyrica and steroids such as prednisone.

Modify your diet to include garlic, nuts, grapes, curry, cherries, omega 3’s, and green tea. All these items have been purported to relieve some forms of arthritis pain.

Formulate a plan of exercise. You might even ask your physician for an out-patient referral to a local physical therapy group at your nearest hospital or sports medicine center. By obtaining professional assistance, you will not overdo, but will be able to incorporate what will work best for the degree of PMR you have. Should you have access to a swimming pool, fitness center or YMCA in your area, water therapy is an excellent indulgence for individuals with arthritis pain. Water aerobics provide gentle range of motion exercise and provide relief for several days following therapy. You might consider a whirlpool mat in the bottom of your own bath tub where you can do limited exercise right at home.

Barring unknown medical problems, the above suggestions should work toward relieving the pain and suffering you are experiencing.

Because I am not familiar with the community in which you live, I recommend you contact the Arthritis Foundation toll free at 1-800-283-7800 or go online to www.arthritis.org to determine the nearest support group in your area.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I’m a 65-year-old woman. Last August my right knee began hurting and I could not bend it. I don’t remember injuring it. After an X-ray that was negative, my doctor gave my knee a cortisone shot and I followed up with physical therapy for eight sessions. That helped until I wrenched my right foot while going down a step. My knee also twisted with the action. It was first believed there was a hairline fracture of the 5th metatarsal and my foot was in an air cast for eight weeks but it turned out the injury was to the tendons and soft tissue, not bone, confirmed by an MRI. After nine visits to the physical therapist for my foot I was “almost” better and I started resuming my daily activities. That’s when my knee started the same problems all over again. To make matters worse, the back of my neck and shoulder tops are tight and hurt and I’ve had some numbness in my left little finger and lips.

My doctor just wrote out prescriptions which I had to discontinue due to the side effects, since I’m very sensitive to medications. So, I am using a hot pack on my neck, doing some stretching exercises from physical therapy for my foot and knee, followed by ice packs. I’m still a mess. There has been no improvement and I’m tired of hurting and having this weird numbness. What else can I do? Please no more doctors or pills.

DEAR READER:
My initial reaction was to consider that the knee pain originated from a form of arthritis, a breakdown of cartilage that causes pain and stiffness of a knee, elbow, shoulder and other joints. Any movement can trigger pain and you certainly didn’t do yourself any good when you wrenched your foot on the steps.

Consider your body to resemble a well oiled machine. All parts work well when nothing is wrong. When malfunction causes that machine to falter, the entire system reacts, muscles such as the ones in your shoulders and neck tense and tighten. You put additional strain on parts of your body that aren’t accustomed to malfunctioning and those parts react with pain, tingling and numbness. This might also reflect a pinched nerve.

I suggest initially that you visit your doctor (or find a new one who will not push pills at you) to discuss a plan of action. Work together to formulate your own plan since no one knows your body better. You’ve had physical therapy and know the drill.

You might consider a topical ointment such as Castiva for relief of symptoms from arthritis and muscle strain. Another option is to substitute your hot pack for an old towel that you wet, wring out and dot with lavender oil. Place the towel in your microwave for a minute. Remove it and wrap it around your neck. Those tight muscles will loosen and relax you as you inhale the aroma (this is essentially an inexpensive version of aromatherapy). Your shoulders will feel better, the tightness should improve and the tingling might disappear.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Thank you for sharing your experience. There are numerous endorsements for arthritis, including grape juice and pectin, anti-inflammatories, over-the-counter Castiva, and prescription drugs. Plain castor oil is simple and effective. If it works, stick with it.

DEAR READER:
I believe that your pain is caused by age-related osteoarthritis. Given the fact that it comes and goes, I do not blame any possible mercury in your fillings as the culprit.

The issue of mercury-induced illness from old fillings has, to my knowledge, been largely ruled out. Some consumers remain skeptical, however. Mercury can be very dangerous, primarily in those people exposed to moderate amounts regularly. Because a tooth filling is relatively small and contains very minimal amounts, I don’t believe you should be worried. If you are still concerned, visit an oral surgeon who can explain about older fillings. He or she should also be able to remove them and replace them with safer, modern material.

To give you related information, I am sending you a copy of my Health Report “Understanding Osteoarthritis”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Thank you for sharing your positive experience. I have received hundreds of letters endorsing the purple grape juice and liquid pectin treatment. It is safe, easy, and inexpensive. For this reason I have included it in my newest Health Report along with many other home remedies.

To give you related information, I am sending you copies of my Health Reports “Dr. Gott’s Compelling Home Remedies”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
All reports I’ve received refer to purple grape juice for arthritis pain. If the lower sugar content of white grape juice works for you and your husband, stick with it.

Unfortunately, pectin purchased in a grocery store is only available in small packaging, because the volume is tied in to the amount required to make a batch of jam or jelly. Perhaps fewer people are making home-made goods and packaging larger volumes is not a money-maker. How sad. It’s one thing that could certainly be sold in bulk, since many individuals with arthritis profit from the grape juice/pectin combo for relief of their joint pain.