There has been lots of discussion regarding pain meds

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Regular Member

Date Joined Aug 2005
Total Posts : 289
   Posted 8/4/2007 2:58 PM (GMT -6)   
I would like to see what everyone thinks about this then.  I have never in my life taken anything stronger than ultram.  Ultram no longer works so I have never bothered refilling it.  I have taken NSAIDS but not without the side effects of fluid retention, stomach pains, and diarrhea.  Ibuprofen is something I can take without the severe side effects but it does not touch the pain well enough.  I took an antidepressant a while back when docs said there wasn't anything wrong with me and it didn't work either though I know there are probably several others out there I could try.  I do NOT want to go back on prednisone if I can avoid it.  I am starting to flare again and they say it may take up to 2 months before the Rituxan kicks in IF it is going to work.  I know it has knocked my immune system down because I have an ear infection, cold, and have a skin infection from the most minor cat scratch (it would have never been called a scratch it was so minor) so the b cells are down.  But I hurt.  I hurt not to the point of not being able to go on with most aspects of my life but enough to make me short tempered, grumpy, irritable, uncomfortable and do nothing but work and rest.  I can't go to the park, walk, play, and hesitate to grocery shop.  I am sure I am not where many of you are and the only visible signs of RA is the swelling on top of my feet which has worsened tremendously though my hands, wrists, shoulders, jaws and knees hurt as well.  I want to enjoy life without the side effects of prednisone and was considering a pain management specialist.  My rheumatologist doesn't rx pain meds, my GP doesn't rx pain meds so I cannot ask them and I don't even think they would agree with it.  In my opinion if I actually could find a pain medication that would work I feel I might even be happier, less moody and less mean.  If I didn't hurt maybe I wouldn't be so miserable and grumpy?  Maybe I would actually sleep through the night?  I did ask about the neurontin or lyrica but the rheumy said it won't help.  So there went my sleep opportunity because I do remember getting sleep on that.  What would you all do?  Would you see a specialist and go on some sort of pain relief?  Would you go the route of trying an antidepressant first?  Would you have someone approach the lack of sleep first?  Or should I have all of them addressed at the same time?
Just curious because for some reason my optimism is decreasing as my CRP and pain are increasing.
dx: Rheumatoid Arthritis.  Duration: 10yrs. Dx'ed 2006.  Asthma, hypertension, hypothyroid
Meds: Methotrexate 25mg wkly, Arava 20mg, Rituxan infusion, Folic Acid, Fish Oils, Advil, Advair 250/50, Diovan HCT 160mg/25mg QD, Women's One a Day, tylenol PRN.

Regular Member

Date Joined Aug 2005
Total Posts : 289
   Posted 8/5/2007 8:26 PM (GMT -6)   
nevermind it isn't important
dx: Rheumatoid Arthritis.  Duration: 10yrs. Dx'ed 2006.  Asthma, hypertension, hypothyroid
Meds: Methotrexate 25mg wkly, Arava 20mg, Rituxan infusion, Folic Acid, Fish Oils, Advil, Advair 250/50, Diovan HCT 160mg/25mg QD, Women's One a Day, tylenol PRN.

Veteran Member

Date Joined Mar 2006
Total Posts : 1354
   Posted 8/5/2007 8:52 PM (GMT -6)   
Babyboo - Im sorry to hear you are in so much pain. Im not going to be much help to you as I am unable to take pain meds due to my Crohns disease (I have ankylosing spondilitis too). I also take 25mg Methotrexate and am on the dreaded pred, I do understand how you would never want to take that again, if I can ever get off it I will try my darndest to stay off it too.
I justed wanted to tell you that the relief of your pain is important and that I hope someone will come along to offer pain med advice.
Please hang in there.
Take care

Veteran Member

Date Joined Nov 2003
Total Posts : 7314
   Posted 8/5/2007 8:57 PM (GMT -6)   
Theresa, I was in a similar situation. I'd been Dx with Crohn's and AS and my PCP was scripting pain meds, but the short acting Vicodin. I knew I needed Something longer term and I also wanted more info about nerve blocks and joint injecitons, which the Rheumy wouldn't do. I called the Pain Center affiliated withmy hospital and found that because they were out of network, I didn't even need a referral. They accepted what my insurance paid for out of network and life was great.

My Pain Doc worked with me to find the med which best treated my pain and I've had several procedures toget me relief. Additionally, he put me on Neurontin & Cymbalta to relieve the nerve pain and depression and Ambien so I can sleep. I don't expect that I'll ever be pain free, but my pain levels are now at least tolerable most of the time. That's a really big change and I hope that you can find a Pain Doc to help you get to this point too.
Keah a.k.a. Wormy
 God helps those who help themselves.
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Regular Member

Date Joined Apr 2006
Total Posts : 103
   Posted 8/6/2007 11:38 AM (GMT -6)   
Dear Theresa,

My rheumy manages my disease but my PCP manages my associated pain and sleep issues.

Like you the pain is not excruciating most of the time but it is enough to keep me from doing anything more than work and rest for work.

I am currently taking MTX and low dose prednisone as well as mobic. I am working on discontinuing the mobic and then the prednisone if possible. I also take folic acid and diazide for the side effects of the MTX and the prednisone respectively.

For pain I currently take Ultram (when I start to take it out on other people or I'm working.) I also take Rozerem for sleep but will be switching to Ambien.

If your PCP won't manage your pain you must see a pain management specialist. I don't understand your PCP, pain management should be a primary goal in managing your illness.

Be assertive and demand to get what you need. In the mean time renew the Ultram if you still can and try using it around the clock rather than as needed. Taking it around the clock may be what you need right now. I have done that at times and it has made a huge difference. If the Ultram does not turn out to be enough ask for a narcotic analgesic.

Good luck and I hope you feel better soon.

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