Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Any costochondritis tricks or tips?

Hi, disk:


Chest expansion is restricted by the intercostal inflammation when it is difficult and not only painful to breathe; the AS causes a perfusion of lymph at these joints and along the bones (periostitis) in proximity to the joint sacks.

NSAIDs can help reduce inflammation, but also make us unaware of the damage they are allowing (and doing to us), long-term; these are one of the worst choices for "treatment."

To maintain chest expansion: 1) Get out of inflammation (see NSD Forum), 2) Do deep-breathing exercises, and 3) Maintain chest muscle tone either through swimming (best exercise for AS) or weight lifting.

HEALTH,
John

only thing that helps me is to remember to try to sleep flat on my back. I get flare ups when I have been a bit crunched up, sleeping on my side and top shoulder "leans in" (for lack of better word) toward my sternum.
I try to stretch a bit, not sure if that helps or not, it sure hurts though sometimes.

yes...medicine still needs to evolve to clinch things faster. my upper back stiffness started may last year...and started hurting ribs. no other symptom to date except that i have had eye swelling a few times over the last six to seven years which the doc said is not uveitis. b 27 + of course.
now i am having trouble taking deep breaths...breathing seems shallow. it gets locked at the half way point and i feel a pull in my back muscles, mostly the right trapezius towards the arm when i try to pull in a breath. when i lie down then i can sometimes pull in a deep full breath. this trouble was not there before and has started off ever since i got worried about AS and started doing exercises like toe touch (straining to touch the toes, which i can), backward stretches, cat pose, hip rotation and a few others. i get the feeling that these exercises have actually made taut muscles or whatever even more taut and now i am unable to breathe easy like i could two months back.
my doc had prescribed medication in july last year which i never took, and after having this breathing issue panicked and started yesterday...
morning: nucoxia MR (etoricoxib 60 mg and thiocolchioside (muscle relaxant) 4 mg)
noon: flexilor - P ( lornoxicam 8 mg and paracetamol 500 mg)
evening: zandik ( tizanidine 2 mg, diclofenac potassium 50 mg and paracetamol 500 mg)
for now it hasnt relieved the breathing...i am only three doses down yet...sometimes i can pull in a deep breath, mostly i am not liking it.
interestingly i went to a person well known here for helping people with stiffness, pain etc by giving them a quick massage of say 2 or 3 minutes with his fingers probing for muscle stiffness. when i went to him yesterday evening, he did the massage and picked out a muscle in my back and said this is causing trouble...he gave it a massage and for the next hour or so, my breathing was easy and deep...and then again it got tight. he said all you have is taut muscles, but as my dad says...maybe the AS is causing taut muscles and manipulation does ease for a while , but the tautness comes back on.
another thing i noticed is since yesterday when i took the muscle relaxers and the meds i have stated above...for the first time i felt my knees paining...do MR's release tendons and maybe cause pain to emerge or something.
i guess we are such complex bio-machines that we require a billion combinations and permutations to make us work...one reordered equation can cause a hundred others to re balance!
i know it sounds crazy and repetitive, but my mind goes on thinking...what is wrong with me? is it just me making myself fall sick by thinking about it over and over again. do i really have AS? is it just a pulled muscle group in my back? my esr, crp is all normal. what the heck is this? docs these days are too busy really to spend time and answer your queries and doubts and get bugged in any case when they get the feel that this guy has read up on the internet and is quizzing them...they want patients to just take their word and get on with it...not to blame them, they work more in a day than i do in three days i guess.
the moment i tell a specialist: pain in upper back and shoulders more than 10 months, chest stiffness and restricted expansion, b27 +...they take two seconds to say : AS.
earlier i used to worry about AS, now i say...just make my breathing deep and easy and full...changing goals!

sounds like how i felt when this all started. i "injured" my rhomboid (muscle and/or tendon) early on and that complicated things for awhile; initially doctors just labeled it as localized myofacial pain syndrome.

i was lucky to find a very good manual physical therapist. maybe you can find a good PT to help you.

for me, it is inflammation at the entheses (i've had my share of tendonitises and a few torn tendons as well). for me, the muscles spasm in response to the inflammation in the tendons and ligaments at the entheses. so ultimately for me, getting the inflammation under control is key. however, working on the muscles as well helps. one kinda helps the other in my experience. i've been on zanaflex since 2001 and it not only helps my muscles, but once i started taking it, my tendons felt better too. i still notice it, like this past week, when i took the zanaflex, not only were my calves not so tight, but my plantar fasciitis was better as well. for me, the muscle relaxant is only helpful.

when my muscle spasms are bad, activity does make them worse. the PT had to get my muscles out of crisis mode before they could tolerate (strengthening) exercises.

i also found a physiatrist (dr of physical / rehabilitative medicine) to be even more useful in determining the root of the problem. my physiatrists were the doctors to send me to rheumatology. the ones that recognized it was inflammatory arthritis. and the ones that could tell it was not a number of other things that they saw and worked with every day.

if yours is also inflammatory in nature, then a good rheumatologist too. it took me several tries. it can be a tricky thing when everything is so involved that its hard to see what is causing what. for me, things had to be settled down a bit first before we could determine cause and effect. the PT and physiatrist helped me get to that point. a good rheumatologist probably could as well, i think there are multiple paths to the same end point.

hey dragonslayer!

is there a test for anti klebsiella antibody or is it just a usual IgA test? my esr, crp is all normal..no radiographic changes, upper back pain and chest stiffness, once in a while left eye inflammation (said to be non uveitis). age of onset of symptoms 36.

best

For the last few years, weekly physical therapy has been a big part of my solution to deep breathing and especially sneezing pains. Sometimes I start to hold back a sneeze, throwback from all those years when it would set off pain and spasming... but now it's not a problem!

Then when I started strict NSD, my physical therapist started noticing that my ribs don't tend to crack as much, like they're not even trying to fuse anymore. So that was the 2nd part of my solution, thanks in large part to Dragonslayer for raising awareness of Ebringer's diet studies.

does the tummy breathing cause any problem in lung position? i ask because i met a serious AS sufferer the other day and his lungs had moved into his belly area as they just couldn't expand in the thoracic area. he was telling me that one should try and blow air into a football bladder with a tight strap around your belly to prevent lungs from trying to make space there...what does that sound like? and hey ...how long have you been having the aches and pains?

Hey, disk:

Regret the IgA-Kp test has not been commercialized and it looks more and more as if it will never become a standard test.

It is not unusual for ESR and CRP to be within normal ranges, despite increased symptoms. Your age of onset is not uncommon for women, but just a little late for men; AS is quite different between genders.

HEALTH,
John

Thanks John...

Trying to slowly work my way into the NSD diet...in our part of the world...the older generation has always said...dont eat soft flour products...eat hard grain flour and always chew it to almost liquid in the mouth (made me now think of what we were taught in school...that saliva breaks up starches into simpler sugars in the mouth itself and digestion begins there)...now i think maybe chewing chapattis (wheat pancakes eaten in india) much more in the mouth would break starch into simpler sugars and not leave much to pass on as food for klebsiella...it might not alleviate AS but maybe for many in th eolder generation it kept things at bay for just that little bit longer. the food that we eat today was unimaginable five decades back...it was actually more of an LSD diet then and now it is a hyper starch diet worldwide! phew!

Disc - Hi, welcome. Just a briefie at the moment as I must leave soon for my 7 hr train trip to go for my rheumy appt.

Stretching is the best way possible to deal with the chest constriction. There are very 'specific' exercises that noe can do. Check out the NASS site: National Ankylosing Spondylitis Society (UK) and SAA, Spondylitis Association America. They both carry stretching exercises that you can follow. Other than that. Ask your rheumy to advise you of a phyaio T, who is conversant 'with' AS. It is also possible that you may find a hospital near to you that holds AS/RA exercise classes. But, the chest expansion exercises are crucial to keeping those chest walls as expanded as possible - without them and good breathing one ocld end up with COPD and other lung problems.

You might also find that you can goodle up exercises varous. Don't have time at this moment to check out and by the time I return this thread might have disappeared...

Wish you well - and, don't worry about it and don't try to overstretch. Pain and 'no gain' aint what spondy exercises and stretching is about. *Never go over the pain threshold and *Never try tp push the body. Can end up hurting yourself.

Go well - OK. Gotta run ---->> ---->>