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Pain meds...what has worked for you

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Rheumatoid Arthritis
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Posted 5/11/2006 7:33 PM (GMT 0)
Hello...this is my first post here.  I have rheumatoid arthritis and am really having a tough time lately.  I am on prednisone, methotrexate, naproxen, folic acid, prevacid, and plaquenil.  I take Ultram as needed for pain.  That seems to dull the everyday pain somewhat, but I am having severe pain this week.  I just started on Enbrel on Monday so I hope it's not in reaction to that.  But I called the Dr. today and she gave me Darvocet for the pain instead of the Ultram.  I remember taking this back in December when this all first started and it didn't seem to help all that much.  Have you all had any success with either of these meds, or has something else worked better for you?  It hurts just typing this sad
Posted 5/12/2006 12:10 AM (GMT 0)
Hey RAGirl, welcome to healing well... I am on Enbrel for psoriatic arthritis and it was worked wonders for me... Give it some time, you should be feeling some relief within the first month or so. What dosage are you on? I hope you find relief soon... Duck
Posted 5/12/2006 12:59 AM (GMT 0)
RAGirl,hi and welocme to HW,I would like to start off by saying you are not alone and you have come to this site with wounderful people here.I'm so sorry that you are having such a hard time with the RA, it suck's I know and it hurt's as well.

Ducky is right you need to give it some time,I was on Humira for a good long while but had to come off of it because I had raised liver level's and I'am now on Plaquenil 200mg just started this one to soon to say if it is going to do me any good.

Please let us know how you are doing.
Posted 5/12/2006 1:03 AM (GMT 0)
Thank you :) I am currently on 50mg Enbrel, once a week. I took it Monday morning and by Monday evening started feeling worse. It's just progressively gotten worse through the week. I'm going to see how things go over the next few weeks. I see the rheumatologist again in about 3 weeks. I'm trying to stay as strong as possible as I have a 5-year-old I want to be strong for. I really have to hold back the tears sometimes...I just want to feel better. Sorry to come on and complain as my first few posts here. I like to be more supportive than that. Guess it's just a real bad week this week.
Posted 5/12/2006 3:55 AM (GMT 0)
hi RAgirl,

 

we all have to hold back the tears sometimes...and also just let them stream out too!

RA is really tough, especially if it has gone untreated for a very long time.

how is your case?  new?  severe?

the list of meds i'm on now, as you'll see down on the bottom has been my best combo for pain control related to RA.

it took about 4 years to find the right pain med regimen that actually works.

the Humira plus adding the Imuran for RA i think has helped control the bad throbbing of the joints and has kept me from going to the ER for about a year now for pain treatment.

the Imuran and prednisone and TNF shots are really the only things that help the throbbing.

opioids help on general, but i really wish they stopped the swelling & pain.

i was on Ultram years ago...but it made me too nauseous.

Darvocet worked very well for my joint pain and related pains for several years; this year though, i was taking 2 darvocets like every 4 hours....so more efficient meds were needed.

are you able to take any COX2's?

with all TNF's...a wait is required.  everyone is different in their response to therapy.  some folks begin to feel results in 6 weeks or sooner, other's take many months.

i was on Enbrel for 1.5 years.  it took about 4 months to have benefits from it.  after the time i was on it...i hit a plateau and i started to get worse (mind you though, the RA i have is way out of control & was far advanced).  so a more aggressive therapy was needed.

since  last august i've been on Humira 40mg every 4 days, and only this past month have i started to notice positive results!  so that's almost 9 MONTHS of waiting for the med to work!  so you have to give them a realistic time frame to start to work...hopefully it will be sooner than later!

you could be in an RA flare...an acute period where symptoms are worse & more painful than usual.

do you take prednisone?

best wishes.

erin  

Posted 5/12/2006 2:15 PM (GMT 0)

RAgirl,  I'm so sorry to hear about the pain you're currently in.  I'm currently in that stage of trying the tnf-inhibitors and waiting for them to actually kick in.  Some days are definitely better than others; on the really bad days, I know just what you mean about having to hold the tears in.  I currently take ultracet, which is basically ultram combined with acetaminephan.  My rheumatologist told me that the combination often works better than ultram alone.  Is it perfect?  Absolutely not.  But, as you've already stated, it takes the edge off while I wait for the enbrel to fully kick in.  I've also started taking plaquenil, but have not noticed any benefit yet.

On the upside, the wait I'm sure is worth it in the long run.  I have been taking enbrel for 9 weeks, but I was on humira previously for 12 weeks with no effect (so I've been taking tnf-inhibitors for a total of 5 months), and I'm just now starting to feel like the enbrel is doing something.  After an injection, I've noticed a definite decrease in pain and stiffness for a day or two.  By the third day, I'm feeling much like I did prior to the injection, but I'll take what I can get at this point. 

You mentioned that you're on prednisone?  Can you ask your doctor to increase the prednisone just until the enbrel kicks in?  or does  prednisone have much of an effect for you?  Prednisone is a double-edged sword in that, at least for me, it works wonders, but can have devastating side effects.  Some people have consulted pain management doctors as well.  I haven't.  Just hopeful that something will work soon.  Please take care of yourself, and I hope the pain gets better for you soon.

Elcamino

Posted 5/12/2006 3:15 PM (GMT 0)
hey ya'll,

i just wanted to add something to this thread that may be pertinent to the topic.

some people might run into this comment by their rheummy:

                                                 "Narcotics do not help RA"

i have recieved that comment severel times @ my rheummy appts. when discussing pain management.  when OTC NSAIDs failed, all COX2's were exhausted and everything under the sun was tried to help the joint pain...i asked about other options, etc....and the rheummy refused to RX opioids!  confused now this bewildered me for a great long time. confused

 

the theory is:  opioids actually do not help RA pain!  so don't get insulted if your rheummy refuses to write something like Darvocet or Dilaudid...

***opioids do not contain any anti-inflammatory properties! *** BINGO! so that's what they mean when they give hassle on pain management beyond NSAIDs and steroids. cool

 

NSAIDs, prednisone, TNFS, DMARDs, and COX2's all contain the anti-inflammatory properties needed to help RA joint pain. :-)

 

now...here's the thing.  mad RA pain gets SEVERE!  mad and opioids are indeed needed as adjunct therapy for very bad pain.  so that's why most of us have to get RX narcotics through our PCPs or pain specialists.

 

narcotics do help joint pain, but they really do nill to stop swelling & throbbing.

 

hope this was helpful.  for years i was like, "how can he say that pain meds don't work for RA pain????"  eyes   but it all comes down to inflammation. viola!

 

i hope you find a good combo of treatment RAGIRL.

sincerely,

erin

Posted 5/12/2006 3:23 PM (GMT 0)
Everyone talks about prednisone working so well...it has helped me the most with the swelling I would say...but didn't do anything for the pain. I've been on 10mg since December of last year. She hasn't increased it all and I know she would prefer I weren't taking it all (she as in my rheumatologist). I think she's trying everything else in the hopes I won't have to stay on it for very long. I was looking at my meds she gave me yesterday...it says Wygesic...is this the same as Darvocet? I've been trying to figure that out. It is taking some of "sting" out of the pain, but most of the pain is still there and I still walk like I"m 80 years old cause of the pain in my ankles.

I am currently taking prednisone, prevacid, naproxen, lexapro, folic acid, methotrexate, plaquenil, and just started enbrel. I'm going to try to make it through the weekend, and see how I feel after the next enbrel dose. If I"m not feeling any better or feel worse, I'll call the doc again.

Edit: Erin, we must have posted at the same time.  I understand what you are saying...those anti-inflammatory properties are needed.  I just need something, like you said, as an adjunct for these really bad days. 

Post Edited (RAGirl) : 5/12/2006 9:26:07 AM (GMT-6)

Posted 5/12/2006 3:43 PM (GMT 0)

Just to clarify.  My rheumatologist was perfectly clear about the ultracet not doing a thing for inflammation.  He only prescribed me the ultracet for my comfort while he tries to find a drug that will attack the actual inflammation.  He will not let me just take ultracet and nothing else.

RAgirl--I'm sorry the prednisone has not done anything for your pain.  When I took it, it was at a fairly high dose (80 mg tapered down to 20mg in a week), and I was feeling the best I had felt in a long time (and the best I've felt since).  I don't believe it's good for anyone to take long-term prednisone at that high of a dose, though.  The risks of doing so would be great.  By the time I had tapered down to 20mg, I wasn't feeling quite so good anymore.

Elcamino

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