DEAR DR. GOTT:
In my mid-40’s I began experiencing knee pain and buckling. My doctor told me it was probably arthritis. The pain then started to move to other areas of my body.
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.
About Dr. Gott