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I’ve had constant pain in SI joint area since February 2025. Before that it would come and go in spurts for several weeks to a few months over the past 10-14 years.Tried 2 chiropractors, Physical therapy for hip, pelvic floor, and lumbar spine from March 2025 thru January 2026. I’ve had an epidural spinal injection that provided zero relief. The pain doctor wanted to do nerve ablasion but the diagnostic screening provided no relief so that’s now not an option. I’ve been on Methotrexate for 4… read more
Methotrexate, watch your liver numbers. Its a good start when diagnosed, but not for long term. Research your new meds, and weigh the "pros and cons" with your Dr. Acceptance, diet, exercise moderately, and faith, they are basics but will help to get you through the rough patches. Good luck and best wishes on your journey.
That journey sounds absolutely exhausting, and the frustration of constant pain with limited relief so far is completely understandable. Here's a roundup of what has helped others manage spondylitis pain:
Medications
Since Methotrexate is still early, it's worth having an open conversation with your rheumatologist about Show Full Answer
Stacey: I feel your pain. I have been dealing with constant pain for over 25 years. My pain journey and solutions have been all over the place. i use biofeedback, TENS unit, certain exercises to
minimize pain, using hot/cold packs, alternating ibuprofen/acetaminophen for over the counter pain control, duloxetine( not for depression but for pain control), the oral tablet version of Diflocenac( and the gel form topically), Lidocaine pain patches, and I have had an implanted pain pump but in that continuously delivers pain medicine. 25 years ago they started me out with morphine and fentanyl. Realizing that people were dying from fentanyl, they put me on hydromorphone. Having it at the dose its at has helped enormously manage pain level. Pain pump was placed so that the medicine is delivered to the vertebrae whose nerve runs through it to
my right knee having more direct impact on my right knee. But if I have pain elsewhere in the body it doesn’t affect it as much as I would like.Getting a pain pump is a drastic step. There are hoops you have to go thru to do it. Its not for everybody. I would try all the other things first! Good luck on your journey!!- Drew
Yes my Rheumatologist wants to get me to the TNF Inhibitors but insurance requires you try Methotrexate first. Yes, my physical therapy has always worked on strengthening my core all the way around and low back and hips.
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