Subject: Advice if possible

Hello! I'm quite new to this and was looking for some advice on symptoms. 7 years ago I started having periods of severe inflammation in my knee which would last for about 5 days at a time and at points I would only have 2 days between each flare up. I tried many tablets such as hydroxycloroquine, sulphasalazine, and many more. None of these appeared to work. My rheumatologist doesn't want to put me on methotrexate as all blood tests in the past 7 years have been relatively normal and not shown signs of arthritis. The one thing that does benefit me is cortisoid injections. This stops all inflammation for about 4 months, which makes such a difference to my life. However, it doesn't stop the pain.
Over the past few months I started feeling an intense swelling type feeling in groin if I'm sitting/lying down for periods of time, which is then extremely stiff when I get up to move around. I also get aching pain on the outside of my hip. Both can stop me from sleeping most nights so I stand a lot to try and ease it off.
I haven't reported these symptoms to my doctor yet, but I was wondering if these are the symptoms of arthritis now in my hip? The pain can occur both at the same time as my knee and separately.

Thank you!

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Subject: Re: Advice if possible

Hi Kirsty

Have you had the groin pain investigated - there is a huge connection between gut and joint pains.

I have AS and hip pain was a common issue for me - but would often flare more when I had inflammed intestines. I am 48 now - but when my arthritis started in my teens I thought it was my appendix.

I would ask for 2 more tests - 1 for AS (which is a test for HLA-B27 gene). Then also I believe there is a test for intestinal permeability.

The fairly settled theory is that arthritis (and other conditions) can be caused or exacerbated by passing of gut bacteria and undigested protein from the gut to the bloodstream.

To prove if you are being effected by your own gut bacteria or food - you can try a short fast or elimination diet to see if the groin pain subsides and if this has an impact on the hip (and hopefully knee) pain.

If you go on medication such as methotrexate - these induce intestinal permeabilty on purpose in order to get the drug to the bloodstream and dampen the immune response.

If you have done these tests before you ever start medication - then you will have might have another tool in you armory to fight this if the medication becomes problematic.

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