Night time inflammatory back pain and tradional DMARDS

Hello - thanks for the great question! I see another member has responded. I hope you've had the chance to consider what has presented and view the link to the information he provided from the Cleveland Clinic. My first thought was - do not disregard biologics - It is the way to slow the progression of this disease. My experience with DMARDs is that I have not had any positive results with these drugs. They did little to ease my pain. I am using an NSAID, muscle relaxants, and tramadol. Also, I am currently on a JAK inhibitor which is helping immensely, as anti-TNFs failed me. This drug, Xeljanz, is actually considered a DMARD by the way it is made but acts like a biological drug. I've had very little side effects while taking it and am feeling better. As Lawrence states, "For each person who has a negative time, at least one will say they saved their life." Not everyone reacts the same to medication and each case is unique. I hope you get the chance to stop the pain, stop the progression and continue interacting with your community for suggestions. Do speak with your rheumatologist about your options. I hope you remain open-minded to his suggestions. Here is a link that may help you also with just general information on DMARDs. https://axialspondyloarthritis.net/treatment/dmards Sending thoughts of healing ~ Rebecca (community moderator)

Ok, first, please reconsider your stance on biologic's. Remember, DMARDs are first-line treatment. You cannot judge your reaction based on anyone else. For each person who has a negative time, at least one will say they saved their life. I am that one for you. I am not saying you need them. That is up to your doctor, but I ask you not to toss them out based on your mom's experience.

I have used DMARDs separately and in conjunction with Biologics for over 20 years. You need to know that a DMARD is not a pain reliever. They suppress your immune system to slow the progression of your disease. Slowing progression is expected over time to reduce pain. So taking any DMARD will only indirectly impact pain.

What will impact pain are pain relievers, exercise, and for some people, nutrition, and sleep. I hate pain relievers, so for the most part, I refuse to use them except Tylenol. I use exercise, Methotrexate, and the biologic to stop or halt disease progression.

Now the main question. I have used all of the regular DMARDS, Including Sulfaszen, Methotrexate pills, Hydroxychloroquine, Leflunomide, and Methotrexate by injection. I have not used Azathioprine. I like Methotrexate by injection best. So no, I have not found that any of those stopped my disease progression. Hence my use of Biologics for the last 23 years.

One more thing I hope you will take a look at is a good website by the Cleveland Clinic that discusses DMARDs. Here is the link:

https://my.clevelandclinic.org/health/drugs/22683-dmards

Also, if you have other questions, please ask. What you describe is a challenging situation. I understand that you might feel like you are grasping for straws. But please talk to your rheumatologist, be clear with the rheumatologist about your challenges, and most importantly, keep searching. First, stop the pain; second, stop progression; finally, find and hold on to your community. Look at it this way: you have your community now to get 1 and 2 in hand, and you will have a winning combination.

Many blessings,

rick