I am sorry that your daughter is dealing with this. I can definitely relate to what you are dealing with as I have AS and two of my teenagers have Juvenile Spondyloarthropathy.
It is good news that the MRI does not show damage, but concerning that it shows inflammation. Beyond physio, what does the Rheumatologist suggest to treat the inflammation and pain your daughter is experiencing? Will she stay on the Naproxen and Tramadol?
It is actually very unusual to see sacroiliac damage in a teenager. It takes repeated episodes of inflammation to create the damage. An MRI will pick it up sooner then an x-ray, but it is still more common to spot the inflammation first. Our Pediatric Rheumatologist advocates treating the inflammation agressively to prevent the damage in the future. My daughter has inflammation on MRI, but not yet damage. My son has both inflammation and damage to both his sacroiliac and left hip.
Before diagnosis, both of my kids battled pain, stiffness, fatigue, and just generally feeling ill. My daughter stopped participating in sports that she loved because she was simply in too much pain. My son battled through it, but watching him dissolve into tears upon getting into the car after practice was breaking my heart. Both were put on anti-TNF therapy shortly after diagnosis. My daughter receives Remicade infusions every 6 weeks. My son takes a weekly Humira injection (every other week helped, but did not completely eliminate his inflammation). Both kids are back to school, back to sports, and back to being normal teenagers.
I am not sure what is available in England to help with school issues. In the US, parents/students can request educational accommodations through the school district by filing a "504 Plan". My kids 504 plans excuse excessive absences, allow them more time to make up missed work, allow them more time to get from class to class, and allow them to type or have a scribe for long assignments, tests or papers. They are also provided with a second set of textbooks and a key to the school's elevator. Because they are typical teenagers, they don't want to stand out or be different, so they only use these privileges when they absolutely have to.
Again, I am so sorry that your daughter is dealing with this, Best wishes in finding the best course of treatment for her.
