keyplayer's post reminded me to mention that a low starch diet is helping me, but I am HLA-B27 positive and there is an odd correlation between that and a gut bacteria that feed on starch (link). But I figured I would mention it on the off chance it is relevant to you. I have undifferentiated spondylitis, spinal stenosis, degenerative disc disease and probably reactive arthritis (has not been formally diagnosed while active, but textbook symptoms).

My opioid troubles started with knee surgery and then shoulder surgery and then real or imagined flare ups and a "nagging cough that isn't going away with OTC medicine, can you prescribe me some tussionex?"

About steroids - I have a prescription at the ready in case I get a flare that is the likely reactive arthritis and I have had a few shots over the years (including the one where they do 4 shots around a vertebra twice). I would never take it regularly.

I take NSAIDs like candy, which is not great for the stomach but helps. To a large extent I am habituated to the daily pain and just need something for flares.