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Spinal stenosis, herniated disc with tear, degenerative disc disease?
ajpurp posted:
I am a twenty three year old who has been diagnosed with lupus by two rheumies, one at John Hopkins the other at UPENN so there is no question I have lupus but I recently went for an MRI and was diagnosed with all of these things including facet disease and degeneration of the sacroiliac joints. I don't even know what half these things mean but cannot get in touch with my rheumatologist and was curious if this could be caused my lupus? and if it can be an issue with me having lupus outside of the intense pain? and if there is anything I should tell the pain management doc when I go. OH right and if anyone knows of a good pain management doctor in New Jersey? any help would be greatly appreciated
K2isKsquared responded:
Lupus arthritis rarely occurs in the spine. Lupus arthritis is usually seen in the hands, wrists, knees, ankles and tends to occur symmetrically -- as in both wrists or both knees will be affected. It is also uncommon for Lupus arthritis to cause permanent damage.

I did some web searches on your specific issues, and I hope these websites will be of some help.

Good Luck and keep posting.

ajpurp replied to K2isKsquared's response:
Thank you very much for the links they were informative, I still wish I could get in touch with my rheumy
jessi19661 responded:
I have all of those spinal conditions plus scoliosis and partial fusion of SI joints. And "probably" lupus. Not official yet but being treated for lupus as well.
Already had double fusion in my neck. 2 yrs ago. Having cervical MRI tomorrow due to more and new neck issues again. Then back to the neurosurgeon, I understand the intense and horrible pain, post to me if u need to talk. or if i can help
HG1948 responded:

I have all of the problems you have described. I developed severe degenerative joint disease in 1989. I too have spinal stenosis, facet disease, and arthritis of the thoratic spine, neck and lumbar area. I now have nerve damage. I awakened several weeks ago very frightened because I could not stand. I now have numbness in my lower extremities, and I am under the care of a neurologist.

I don't know which research theory is right or wrong about the "origin" of my joint problems. My rheumamtologist believes that some lupus patients do have inflammation and occasionally have degenerated joints, as a result of their autoimmune disease. Is it lupus or one of the other 100 autoimmune diseases, I don't care anymore.

My rheumatologist also believes that RA and lupus are very close "relatives". However, I also know that correlating with something and causing something are two different things. She thinks one predisposes you to have another.

I just had an orthopedic back specialist tell me that he believes my problems are genetic. (My mother did have symptoms that were almost identical to my lupus symptoms for several decades and suffered from crippling arthritis.)

How about giving "shout out" to Dr. Zelman and asking him?

Oh, be sure to tell all of your doctor's all of your helps in diagnosing and prescribing treatment.

God Bless!
jessi19661 replied to HG1948's response:
Hg, I feel for u reading ur reply to the poster. It is also a very good reply, a lot of info....informative to all of us who suffer with the spine issues and all that stems to the rest of the body from spine problems. I would be very scared if i could not stand! I have awoken in the morning to locked up hip joints (caused by--you guessed it--not the hip, but the darn spine!!!!) I couldnt walk without help, but it got better slowly throughout the morining, and of course I rushed to Dr. and surprise, surprise......gave me prednisone.......story of my life. Love it and hate it.
Anyway, I hope u do better soon and are well tonight. I wanted to let u know how helpful this post was to me and probably everyone else.
squirmy1963 responded:
I also have slipped disc with pinched nerves. I do not know of a medicine that helps nerve pain, but physical pool therapy has helped a lot. Surgery is another option for me. I also have a swollen area in shoulder, base of neck and around the shoulder blade. It is also red, and hot. I've read that Lupus does not affect this area, but it sure seems common with Lupus from what I have seen on this board.
squirmy1963 replied to K2isKsquared's response:
My rheumy told me that the symmetrical inflammation is R.A. and the one sided inflammation is Lupus arthritis. Different because RA will cause permanent damage. I might be wrong but, my mother has Lupus with R.A. and I have Lupus with Lupus arthritis that affects my left side. NOw when my vessels are swollen, and I bleed thru the skin, it is symmetrical. blood dots appear about the same place on both sides of arms and legs. I hope Dr. Z can clear this up for me as well.
HG1948 replied to squirmy1963's response:

I just got through showing the swollen area at the base of my neck and around the shoulder blade to the neurologist, while he was doing my EMG, which was ordered by the rheumatologist.

The area is getting larger. When I showed this to my primary care physician, he just shrugged his shoulders and said "...this problem was common with prolonged prednisone use." The rheumy said the same thing except she added "...Stand up straight!"

Today, the neurologist just ordered an mri of my thoractic spine and my neck.

I'll be real honest with you. I've sacrificed a lot because of lupus including some things very dear to me. I've also sacrificed high heel shoes, loss of 50% of my hair, my career, but living out the length of my life left, trying to conceal to big buffalo like hump on my back, has just about pushed me to the edge of "sound reason". I just feel like yelling at my body, "I'm mad as hell, and I won't take it anymore! You better straighten out!" (LOL)

Oh well. I too have thought of surgery, but I've read reports from other people here of unsatisfactory outcomes with regard to getting pain relief.. (Actually, my rheumy has warned me many times to not have surgery on my spine. She told me that none of her lupus, RA, MCTD, or Sjogrens patients have had long lasting pain relief from any form of back surgery.....)

I hope you find something soon, and will come back and tell the rest of us.

squirmy1963 replied to HG1948's response:
I am very interested in what your MRI shows. I hope you share what they find. TENS unit is somewhat helpful. It helps reduce inflammation, when the blood system is not doing it's job. I really don't know, the steroid shots, phys. therapy, steroid shots, pain meds, to be honest I still don't know of anything that helps. It is so very frustrating. I truly think that when one skeletal spot is swollen it can cause problems throughout the body, whether it has synovial fluid or not. From what I understand it's the joints with synovial fluid that Lupus targets, but the spine doesn't have this fluid. So most back pain in Lupus is diagnosed as secondary Fibro. But Fibro doesn't cause red hot swelling like we have, so I am anxious to hear what your report says. My docs just say they don't know why, it's so swollen there, except the base of neck swelling is from the "scapula" which I think is the shoulder blade.
squirmy1963 replied to squirmy1963's response:
p.s. I've been on prednisone for over 5 years straight, but none of my docs have said the swollen back or neck or shoulder is common with prolonged steroid use. I also have swelling of both sides of the pelvis bones, but I think that is directly linked to the slipped disc. I have also taken Methotrexate for a very long time, I have fewer flares and less severe flares since we added it to my big bag of meds.
squirmy1963 replied to squirmy1963's response:
About my post above, R.A. vs. Lupus arthritis. I could easily be wrong.
K2isKsquared replied to squirmy1963's response:

I have SLE and RA. I did some research on the symmetry question and found these websites:

I believe it is common for both RA and Lupus arthritis to be symmetrical -- as in affecting both wrists or both knees. SLE and RA can cause red, swollen, painful joints. In Lupus arthritis when we aren't flaring the joints can feel pretty normal. In RA there is permanent damage to the joint, which can be seen via Xray.

RA also has a curious side effect of stimulating bone growth, so you can feel nodules of extra bone where they shouldn't be, and this also can be seen via Xray. There can be severe disfigurement of joints if RA is left untreated.

While symmetry is common, there are no rules that can't be broken in these diseases. I have one ankle that is locked from the arthritis, and the other ankle bends normally. My wrists follow the usually rules, as both of my wrists are damaged.

Many of the meds used to treat Lupus are also used to treat RA, since the goal of both treatments is to interrupt the body's immune response.

I hope Dr. Zelman will weigh in to educate us on the differences in arthritis with SLE and RA.

squirmy1963 replied to K2isKsquared's response:
thanks K2. great info.
squirmy1963 replied to squirmy1963's response:
Do I need to address Dr. Z directly or see if he responds to this discussion?

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