Several months later, my right SI joint is still not a happy camper. I have to be honest: it is really starting to get to me.
Since pain is certainly not foreign to my everyday life, I don't run to the doctor as soon as something starts hurting (or I'd be there constantly). I usually settle for stretching, taking it slow, taking some anti-inflammatory meds, and hoping it will go away. It's only after something bothers me for a good long while that I will give in and finally call the doctor.
So, when my lower back started bothering me on the right side back in October, I didn't think too much of it. I did some gentle stretching, took some Tylenol (which is safe for my pregnancy), and tried to ignore it. Then I got distracted by the lump I found in my armpit (when it rains it pours?). In fact, the pain in my back didn't really start to worry me until my pilates instructor told me in November that she thought it was being caused by some inflammation in my SI joint. The thought of the pain being associated with a joint started to make me nervous.
But I still put off calling the doctor until my OB told me that I ought to check in with my rheumatologist. So I did. And then my rheumatology team prescribed some physical therapy in an attempt to deal with the problem without having to take any extra meds. Thus, for the pasts couple of weeks I have been seeing a physical therapist twice a week to learn stretches, posture, and exercises to lubricate the joint, as well as getting focused massage in that area to try to get the muscles around the angry joint to relax.
Unfortunately, it really hasn't been helping that much. I'm not getting quite as much sharp pain as I was before, which is good, but I'm still dealing with a fairly large amount of dull, constant pain in my lower back on the right side. It hurts to stand. It hurts to sit. It hurts to lay. It hurts to carry. It hurts to lift. So most of the time I'm not exactly sure what to do with myself. My belly is finally starting to show, so I'm also starting to get a lot more nervous about the future. If I can't take the pain now, how will I deal with it when I've got extra weight to support? But I've been diligent with my stretches, posture, and exercises and I was still optimistic that my physical therapist/massage team would have something up their sleeves to get me through.
Yesterday, my physical therapist essentially gave up on me. We talked about how I was diligently doing everything they had taught me but that it still wasn't really helping. And, it seemed to me, she just got overwhelmed. I got the distinct impression that my combination of problems - SI joint pain, RA, and pregnancy - was just too much for her to figure out. It felt like she just wasn't up to the challenge. Instead of offering me PT solutions, she told me that she thought it was time for me to speak to my rheumatologist about anti-inflammatory meds or getting an injection in the joint. She even offered to cancel my upcoming appointments until I had a chance to speak with my doctor.
Maybe she's right. Maybe it is time fore me to move on and consider other options. But I left physical therapy feeling pretty discouraged about how she had basically washed her hands of my problem. I mean, I realize I have a complicated set of issues. I know that sometimes stuff is going to hurt no matter what I do because of the RA. I understand that being pregnant makes me difficult to treat because I can't do everything you want me to. But I just felt so discouraged that she didn't have any more ideas.
I did call my rheumatologist and the nurse got back to me this morning. He's going to have me try taking 650mg of Tylenol every six hours for the next week to see if that helps. Unfortunately, this doesn't seem to be significantly more Tylenol than I have already been taking on my own to deal with the pain - so I am not super optimistic that it is going to solve the problem. The next step is to consider an injection to the joint, but my rheumatologist says he would prefer not to do so, so that makes me nervous too.
I don't want to feel worried. I don't want to be stressed. It doesn't make me happy and I know it isn't good for the baby. But I can't help feeling a little overwhelmed by my inability to do anything at all about the pain in my back. And I'm starting to feel pretty scared that I have been working so hard for weeks to fix this problem but I haven't managed to make any headway. What on earth will I do as my belly grows?