Thoracic Back Pain

My son,age12,has recently been diagnosed with a complicated case of Crohn's. His blood work and labs are all negative, yet terminal illeum severely affected and stomach also peppered with ulcers.
He has had 3 remicade treatments-all of which helped Crohn's symtoms (symptoms) drastically, but left him with severe migratory joint pain-shoulders, thumbs, fingertips,elbows,knees, and the most severe in his back-between the shoulderblades.  After the last treatment 3 wks ago, the severe, stabbing pain in his back will not go away and is still with him. He is on pain meds and muscle relaxers now for this-just to help with some relief. Last wk had MRI, found a hemangioma on T7-right where his most severe pain is.  My question-could remicade cause or aggravate this-since it seems to get worse with each treatment-and now does not migrate. What can I do to help alleviate pain? Where do I go? Can this be treated nonevasively? What do we do for Crohn's pain now-since this treatment obviously does not work for him. This has all but completely incapacitated him and he is unable to do much of anything-school is out of the question.

[Kevin Pho, MD]

I am not aware of Remicade being associated with hemangiomas.  

Other medications to try can be Azathioprine and 5-MP, or methotrexate.  Steroids may also be needed on a longer-term basis.

If not improved, you can also try probiotics or shorter-term antibiotic therapy.  

Surgery would need to be considered if the medications are not helping with the symptoms.

A referral to a GI physician should be done, preferably at a major academic medical center.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[susankayk]

A related discussion, symptoms liver was started.