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HomeAnswersRheumatologyankylosing spondylitisI have had ankylosing spondylitis for 14 years. Please help.

What is the treatment for aggravated ankylosing spondylitis symptoms after Covid?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At December 21, 2021
Reviewed AtOctober 12, 2023

Patient's Query

Hello doctor,

I have ankylosing spondylitis (HLA B27 positive) for the past 14 years. After I had COVID six months back while recovering, I had a dull pain in the sternum and cartilage of the chest. I took antibiotics, and the pain subsided. But now, for the past few weeks, while sleeping, it is paining in cartilage, ribs, and shoulder blades, and even a few hours after awakening, the pain is persisting. There are no issues in breathing. I am taking one tablet Saaz DS 1 g daily, and when pain triggers, 120 mg Etoshine.

Kindly help.

Answered by Dr. Nupoor Acharya

Hello,

Welcome to icliniq.com.

The symptoms suggest active disease at present. You are currently on a low dose of tablet Sulfasalazine (anti-inflammatory) which can be increased if needed. To control the inflammation, I suggest taking tablet Etoricoxib (non-steroidal anti-inflammatory drug) 120 mg every night for two weeks and to get the following tests done - CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), AST (aspartate aminotransferase), ALT (alanine aminotransferase) and creatinine. A further change in medication can be suggested after the test reports.

I hope this helps.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I have attached all the blood reports. For the last few days, BP has been high. So the doctor whom I am consulting suggested a few more blood tests. I have also attached those reports.

Thank you.

Answered by Dr. Nupoor Acharya

Hello,

Welcome back to icliniq.com.

I have gone through your reports (attachments removed to protect the patient's identity). Your CRP (C-reactive protein) is a little high, suggesting some active inflammation going on. Also, your cholesterol is high, and your liver enzymes are mildly elevated. There is a possibility of you having fatty liver. I suggest you consult a specialist for the same. For the pain, I suggest, take tablet Etoricoxib 60 mg twice a day for the next two weeks regularly. Repeat CRP test after two weeks. If your symptoms persist, you might need an increase in the dose of Sulfasalazine or additional medicines. For cholesterol, I suggest, take tablet Atorvastatin (statin) 20 mg at night with dietary modification.

I hope you find the reply useful.

Best regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Nupoor Acharya
Dr. Nupoor Acharya

Rheumatology

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