Author Topic: SS and tendons  (Read 3465 times)

daisymay

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SS and tendons
« on: December 10, 2014, 07:19:48 PM »
Ive read some posts on here that mention tendon problems associated with sjogrens. How does it affect tendons? I'm asking because I've had quite a bit of tendon trouble, but didn't know it may be directly related.

anita

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Re: SS and tendons
« Reply #1 on: December 10, 2014, 08:00:36 PM »
I know there is some problems with SjS and tendons, but there are several commonly used antibiotics that cause tendon damage and rupture.  The Cipro class is widely known for this and FDA has put out black box warnings.  Here's one of MANY links (you have to copy/paste link due to site rules) about tendon rupture with antibiotics.

webmd.com/osteoarthritis/news/20080708/fda-warning-cipro-may-rupture-tendons

So, if you've taken any antibiotics recently, I would look at this being the cause over SjS.
52 yr old SjS, APS w/strokes, Autonomic Neuropathy, PN, Nephrogenic DI, (CVID) IgG def., Cushing's, Asthma, Gastroparesis.  Sero-neg w/+ lip biopsy.  Meds: IVIG & pre-meds, Arixtra, Aspirin, Plaquenil, Cardizem, Toprol XL, Domperidone, Nexium, Midodrine, Symbicort, Fentanyl, Percocet, Zofran

Head2Toe

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Re: SS and tendons
« Reply #2 on: December 10, 2014, 11:28:04 PM »
Yikes!  Around 2002 I was on Cipro (plus another antibiotic) six times over a six month period.  I was being treated for an infection that kept recurring, because as it turns out, a piece of gauze had been left in the surgical site the first time I sought medical relief...  They found the gauze on my fifth visit to the ER :(

I had been diagnosed with tendonitis in both arms several years beforehand, but I wonder if Cipro is part of the reason I ended up with chronic tendonitis in my arms...  Does anyone know if Cipro can do long term tendon damage even if no tendons actually rupture?

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quietdynamics

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Re: SS and tendons
« Reply #3 on: December 11, 2014, 03:40:40 AM »
I have had tendon, ligament, etc symptoms pre-Dx and pre-Rx.

Looking back it would be in early 20's.. I was always physically active.. so ???

Sjögren’s syndrome (SS) is a chronic multisystem inflammatory disorder.

Mixed connective tissue disease – Mixed connective-tissue disease (MCTD) is a disorder in which features of various connective-tissue diseases (CTDs) such as systemic lupus erythematosus (SLE); systemic sclerosis (SSc); dermatomyositis (DM); polymyositis (PM); and, occasionally, Sjögren syndrome can coexist and overlap. The course of the disease is chronic and usually milder than other CTDs.

Quinolones and Tendon Ruptures ( Includes Cipro in discussion)
According to reports from France, which has an aggressive drug side-effect monitoring program, fluoroquinolones associated with tendon ruptures include, in descending order of association, pefloxacin, ofloxacin, norfloxacin, and ciprofloxacin. The risk associated with pefloxacin has been estimated to be 1 case per 23,130 treatment days, and for ciprofloxacin, 1 case per 779,600 treatment days.
...It can be difficult to prove cause-and-effect relationships involving medications and certain side effects. This is particularly true in untoward effects such as tendon ruptures, which may occur in the absence of any medication, particularly since the reported cases frequently had coexisting risk factors.[15] However, clinical reports, histopathologic findings, and an experimental model support a causal relationship between fluoroquinolone use and tendon ruptures.
...Whether fluoroquinolones should be used in patients with a history of tendon problems or with risk factors for the development of tendon ruptures depends on the seriousness of the infection and the alternatives available.
http://www.medscape.com/viewarticle/410546_3

FDA info on Cipro. http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm346750.htm
« Last Edit: December 11, 2014, 04:58:43 AM by quietdynamics »
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gurs

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Re: SS and tendons
« Reply #4 on: December 11, 2014, 04:15:42 AM »
Steriods too..since Ive been dealing with tendon issues, my Medrol and my hormones (menopause) def causing this. Its a nightmare!!!

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irish

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Re: SS and tendons
« Reply #5 on: December 11, 2014, 02:46:35 PM »
One of the symptoms of sjogrens is tendonitis and it can be a bugger. Sjogrens is a connective tissue disease and this means that it affects any tissue that is connected or held together. Muscles are held together by their own connective "glue" so to speak as are tendons, etc. Sjogrens affects all the tissues in different inflammatory ways.

I have had carpal tunnel issues for years and years prior to diagnosis and ended up having both wrists operated on. Also, the sensory issues from this problem are not always talked about, but it is hard for me to do a lot of tasks due to the inability to feels as well as I should with the tip of my fingers.

Also, the Achilles tendon is another one that is a biggie plus the "tennis elbow" or tendonitis of the tendons in the elbow. Any time you have an ache or pain in your body the first thing to come to mind may well be that it is related to tendons. This is something that often comes and goes and we need to be aware of it. Often it is not related to any physical activity but just the result of the autoimmune attack on the tissues of the tendons.

Also be aware that the Achilles tendons can rupture with movement so if you are having pain and stiffness take it slow and easy. My son jumped out of bed during the night when his smoke detector went off and ruptured his Achilles tendon. He is an autoimmune disease patient also. He had to have surgery and missed 6 months of work. Irish


daisymay

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Re: SS and tendons
« Reply #6 on: December 11, 2014, 03:24:26 PM »
I've had carpal tunnel and tennis elbow on both sides. I also recently had some kind of connective tissue pain near my hip joint. It appeared to me that it was from a tendon or ligament that goes from the hip into the upper thigh, but I still mentioned it to my PCP who said (without examining me) "it's probably musculoskeletal. Try some bengay." Thankfully it eventually healed on its own.

Jasper

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Re: SS and tendons
« Reply #7 on: December 11, 2014, 06:42:21 PM »
I have roving tendon problems. The pain comes with no warning and for no reason, and leaves the same way. Usually it lasts for a few days in one spot (or more) and then leaves or moves to another spot. The main troublesome areas are my right hip, right thigh, right knee, right shoulder, right upper arm. Sometimes the wrists have problems. I used to have problems in my left hip and left arm but I have not had them for several months now. The right hip is the most persistent but it is usually under control now with anti-inflammatory nutritional supplements and some physical therapy. The anti-inflammatory supplements seem to have calmed down all of my tendon problems, at least to a degree.

I am sure this is Sjogren's related. It is certainly not repetitive use related, LOL. The pain just appears, for no reason (other than auto-inflammation attacking my tendons).
ANA 1:160; SS-A+; MSG +; Plaquenil, Rituxan infusions, Restasis, HRT, Curcumin, Calcium, CoQ10, NAC, Resveratrol, Whole Omega, Omega 3, R Lipoic Acid, Acetyl L Carnitine, Krill Oil, Mag. Threonate, Bio-Collagen UC II, NAD+, & Vit A, B, C, D, E, K 1 & 2.

Jenny

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Re: SS and tendons
« Reply #8 on: December 12, 2014, 04:29:27 AM »
I also have a lot of tendon issues. Feet, hips, shoulders, elbows and I've had both wrists operated on for Carpal Tunnel. I find that a good stretching regimen really helps. Unfortunately I'm not very consistent about it unless I'm hurting.
65 year old female with back, shoulder, neck and knee pain, dry mouth, losing teeth, dry sinuses,Blood test positive for Sjogrens. Fibromyalgia, Osteoarthritis .
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Nugget

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Re: SS and tendons
« Reply #9 on: December 12, 2014, 09:09:17 AM »
I have tendon issues as well.  Right elbow (which is weird because I'm left-handed), achilles tendon on right heel, and my left hip.  The hip I'm not sure if it's muscle or what.  Anyhoo, I went to see the physiotherapist on Wednesday (first appt.) and we are going to work on this.
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daisymay

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Re: SS and tendons
« Reply #10 on: December 12, 2014, 09:15:54 AM »
What's the difference between physiotherapist and physical therapist? And how is seeing one affected by insurance--is it paid out as physical therapy sessions (my insurance only allows a certain number of physical therapy sessions)? And is referral usually needed?

Jasper

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Re: SS and tendons
« Reply #11 on: December 12, 2014, 09:49:18 AM »
"What's the difference between physiotherapist and physical therapist?"
----------------------------------------------------------------------------------

They are the same thing.

I think one needs a diagnosis first and then a referral to a physical therapist. The physical therapist works out a treatment program based on the diagnosis.

My insurance (Medicare) also has a limit to the number of visits per year. This can be appealed if one needs more visits.

I think most PT programs get a person started in the PT clinic, do several sessions in the clinic, and then the person continues the exercises at home. Of course, this all depends on the original problem and the program.

I went to the PT clinic twice a week for a while, then once a week for a while. Then the clinic PT was over. However, I did the exercises at home every single day, both while I was going to the PT clinic and then after I was finished at the clinic. In fact, I still do the exercises daily when I first wake up in the morning. I think it helps and i sure do not want to revert back to having the problems I was having before I started the exercises (last January). Mine are mostly stretching and strengthening exercises. They take about 45 minutes to an hour each am. I just turn on some chamber music and do the exercises. I rather enjoy them and they do make me feel better.
« Last Edit: December 12, 2014, 12:55:22 PM by Jasper »
ANA 1:160; SS-A+; MSG +; Plaquenil, Rituxan infusions, Restasis, HRT, Curcumin, Calcium, CoQ10, NAC, Resveratrol, Whole Omega, Omega 3, R Lipoic Acid, Acetyl L Carnitine, Krill Oil, Mag. Threonate, Bio-Collagen UC II, NAD+, & Vit A, B, C, D, E, K 1 & 2.

daisymay

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Re: SS and tendons
« Reply #12 on: December 12, 2014, 10:35:39 AM »
I could really use help with exercises. Because of hypermobility, my joints are loose and even minor exercise/housework can cause pain. I need to learn how to do exercises correctly to help avoid injury as well as the pain. The reason I shy away from pt is, since insurance only pays for so much, I fear using my pt allowance for something like this and then having an injury happen and really need pt but not have the coverage. Always a balancing act!

Jasper

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Re: SS and tendons
« Reply #13 on: December 12, 2014, 01:10:54 PM »
Yes, it is a balancing act due to the limited number of PT sessions one is allowed.

I was having so much trouble with my knees and hips so I went to an orthopedic doctor in January 2013 to find out what was going on with them. I had great difficulty doing stairs, up and down. I had a lot of trouble getting up from a chair and had to use my arms and hands to get up. My knees were unstable as were my thighs. My right hip hurt every step I took, like I was stepping on a nerve. I just needed to know what the problem was.

Well, as it turns out, I have mild OA in my knees and that was causing the knee pain, at least part of it. The problem was that I also had Bursitis in my hips bilaterally, especially the right hip, and Gluteal Tendonopathy in both hips, but especially the right hip. I also had a very tight and tender IT band on the right. In addition, because of the pain I had been having, I was not using the muscles as much and I was gradually getting weaker muscles, and this was complicating and adding to the problems and the pain. It was a vicious circle.

The ortho gave me a choice, an injection into the right hip which she said would help with the pain, but not fix the problem, or PT. I opted for PT. It was a good choice. It took a long time, but I gradually got stronger and steadier, improved my muscle strength, improved my balance, and decreased the pain.

I also added some anti-imflammatory supplements, which I think helped too.

I can now do stairs with no problem and I do not even need to hold onto the railing, let alone pull myself up with the railing. I can rise from a chair, even a low chair, with no problem. My knees and thighs are steady and do not shake and wobble anymore when I do stairs and when I rise from a chair. Most of the time I have no, or very little, pain in the hips and knees. 

So, for me, it was definitely worthwhile. But we are all individuals and have to balance the limited amount of PT we can get.
ANA 1:160; SS-A+; MSG +; Plaquenil, Rituxan infusions, Restasis, HRT, Curcumin, Calcium, CoQ10, NAC, Resveratrol, Whole Omega, Omega 3, R Lipoic Acid, Acetyl L Carnitine, Krill Oil, Mag. Threonate, Bio-Collagen UC II, NAD+, & Vit A, B, C, D, E, K 1 & 2.