Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Systemic lupus erythematosus (known as lupus or SLE) is an autoimmune disorder, which means that the body's immune system inappropriately attacks healthy tissue and cells, causing inflammation and tissue damage. Lupus can affect multiple bodily organs, most commonly the skin, joints, and kidneys but also the heart, lungs, blood cells, muscles, eyes, and nervous system.
Lupus is a chronic disease and requires a lifetime of management and treatment. Most people with illness can lead full and productive lives. Though it can affect women and men of all ages and ethnicities, lupus is more common in women and usually appears after puberty. Although genetics and environmental factors have been considered to play an important role in the pathogenesis of lupus, some cases can be precipitated by certain medications. Most have no known causes.
People with lupus can present a broad range of symptoms, often with individual variations. Symptoms tend to flare up periodically, alternating with periods during which symptoms become minor or go away entirely (remission).
Skin rashes, particularly in areas exposed to sunlight, are common. Severe flare-ups can cause serious injury to internal organs. Lupus may also involve the blood, resulting in anemia and a decrease in white blood cells and platelets.
Women with lupus can usually have normal pregnancies once the condition is controlled or in remission, but there is an increased risk of miscarriage and other complications. Therefore, pregnant women with lupus are considered a high-risk group.
Lupus can be subdivided into several categories:
Systemic lupus erythematosus is the most typical form. It usually affects the skin and joints. When it involves the kidney and the lining around the lungs, it is called pleurisy or pleuritis. When the lining around the heart is involved, the condition is call pericarditis. The blood-producing cells that are formed in the bone marrow can be affected, causing anemia and easy bruising when the platelets are involved. Lupus of the nervous system can result in seizures, major depression, paralysis, and other serious complications.
Discoid lupus erythematosus affects only the skin, causing scaly rashes, sores, and scars, usually on the face, scalp, neck, or other areas of skin exposed to sunlight. This disorder may also cause changes in skin color and hair loss.
Drug-induced lupus erythematosus is caused by an immune reaction to certain prescription drugs, most commonly hydrazaline (used for high blood pressure), isoniazid (used for tuberculosis), doxycycline for acne, and biologic agents such as remicade (used for rheumatoid arthritis) or procainamide (used to treat heart arhythmias). Like SLE, drug-induced lupus can affect the skin, joints, and lining around the lungs and heart but rarely involves the kidney or nervous system. Symptoms of drug-induced lupus normally disappear some months after the medication is stopped.
Neonatal lupus is a very rare form that affects infants, usually born of mothers who have lupus. The most common symptom is a skin rash that goes away within a few weeks to several months. Less common symptoms may include low blood cell counts and liver problems, but these conditions also disappear entirely within several months. In rare cases, neonatal lupus may cause congenital heart block, a disorder of the heart's electrical system.
Because lupus may affect different parts of the body, it can cause a wide range of symptoms.
Most symptoms typically wax and wane, sometimes punctuated by severe flare-ups. Remission can occur but is not common. Common symptoms include:
Lupus is a disorder in the regulation of the body's immune system. The exact cause is unknown. There is often a genetic component to this illness. However, an environmental event or trigger may produce the symptoms and signs of lupus. In addition, certain medications can trigger lupus in predisposed individuals.
Diagnosing lupus can be difficult because symptoms vary widely and could be caused by other conditions. The diagnosis is based on symptoms, physical examination, and results of specific laboratory tests. Symptoms can include:
The following tests are used to confirm a diagnosis of lupus:
Treatment depends on a complete assessment of symptoms, signs, and any organ involvement by lupus. A number of different types of medication are available. Lifestyle adaptations are also extremely important. Goals of treatment include:
Lupus may be treated with the following types of medications:
Drugs for seizure control, hypertension, and depression are often used as well.
It is important to keep in mind that some herbal supplements may interact with medications. Therefore, if you are considering taking herbal supplements, check with us before trying an alternative therapy. There is no evidence that these herbal supplements help lupus.
If you have lupus, the following lifestyle habits and adaptations can help improve your symptoms and reduce the frequency of flare-ups:
In addition to your medications, there are techniques you can employ to help soothe pain. These include:
Memory difficulties are common lupus in lupus and other chronic illnesses. A daily task list or calendar can help you stay organized. It may also be wise to avoid multitasking, and to develop a habit of immediately writing down new information. Cognitive therapy can offer techniques to help strengthen your memory.
Many people with lupus experience depression. Psychotherapy, support groups, and antidepressant medication can help.
Good communication among family members is essential. Your spouse and/or children should learn about and understand your condition and its symptoms, so that they know what to expect and can make adjustments as needed.
It can be helpful to draw up schedules of activities and chores, and to arrange home delivery of groceries and/or other supplies. The practical and emotional support of friends and neighbors can be very helpful. They may help with errands and chores and they can also provide a sympathetic and caring presence.
Don't overdo it when you travel. Get plenty of rest, as always. Keep the pace leisurely and easy. If you will need to be sitting for a long journey, try and walk around periodically to keep your blood circulating. If you are on a plane, pump your feet back and forth for a few minutes every hour.
Keep your medication with you at all times, in original containers. If you are getting on an airplane, make sure to keep an adequate amount of your prescription drugs with you, rather than checking them with your baggage. Keep your medications in their original bottles or containers with the prescription labels. This is particularly advisable if you are traveling to a foreign country.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If you need to see a rheumatologist, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. We may do diagnostic testing as well. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the Radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.