should i change doctors?

hi guys hope to get some advice ,pains was so bad i had to go to the doctors she signed me off work for 10 days and gave me steriods for 6 days they worked really well and started to feel normal ,went to see my rhemy and told him all about my pains and stuff and how much things have got bad hes didnt examine me very well i felt and given me methatrexate no pain relief and sent me on my way i havnt taken them yet wil do tonight .my problem is im in really bad pain feet are throbbing,what pain relief can i take with methetrexate also have to go back to work which worrys me because of the pain and they arnt very understanding quites stressed about it any adice i would be greatful thankyou :)

11 Replies

  • Hi, it might be worth going back to your GP to get your pain relief sorted out as they tend to look after that side of things. I can understand how stressful it would be worrying about going back to work, I'd speak to your GP about this too. Do you have an occupational health department as they are usually very supportive. Tracyx

  • yeah i will make aappoinment with the doctors today and see what they say thankyou x

  • I've found GPs are more useful for pain relief. Rheumatologists tend to just concentrate on the disease management and not the pain. If you have just started MTX its going to take a couple of months to start working. You might want to ask your GP about having a steroid injection to help you through the next month or so. If they don't seem keen, ask GP to get in touch with your rheumatologist and check whether they would approve it or if there is anything else they would suggest. You can always take over the counter antiinflammatories (ibuprofen, naproxen, etc) and paracetamol (unless you have been told not to for any reason) - may not sound much, but the ibuprofen can really help, and if things are bad taking paracetamol between ibuprofen doses can help too.

  • Did your rheumy give you a diagnosis of RA and did he use blood tests to diagnose you as well as examination? As others have said its your GP who will usually prescribe pain relief not the consultant. The Methotrexate won't work for a few months probably as it isn't an anti-inflammatory or a pain killer - but rather it is a disease modifying anti rheumatic drug (DMARD) that is meant to slow down the disease by suppressing your over active immune system. You should be able to continue taking pain killers just the same way but with the anti-inflammatories you should always check with your GP if you are taking a DMARD - especially Methotrexate. Also the consultant presumably mentioned that you need regular blood monitoring on MTX? It should be every few weeks at first and if you have been give a rheumatology nurse to contact you could probably speak to then about pain relief or steroids but I think you should just see your GP as soon as you can. You may not need to change doctors but speak to your GP about the way the consultant made you feel. Hope this helps. Tilda

  • hi tilda ,yeah im going to see if i can make a appoinment started takeing mtx last night i feel awful this morning my head feels abit strange and i feel abit sick do u know if that it can have side affects straight away.? Yeah i have had R A for five years after my son was born they kept sending me away at first saying it was cos i just had ababy had a blood test and scanned which confirmed it ,im going to see if i can get a appointment today thanks for thr advice

  • Oh I see. I do hope this rheumy explained that you can't conceive when in MTX as it can make you miscarry or do damage to the unborn baby? It sounds as if he or she has very poor communication skills and I am pleased you will be discussing this with your GP as soon as possible - I really hope they are helpful to you. Tilda x

  • sw the gp she signed me off work for another week,yeah i like to have abbay oneday but i am on contreception just want to get on top of things beofre i thin of another one,my mum has put me in a panik i tokk mtx last night and didnt take folic acid before i didnt think u had to before i thought i was told 2 days after so i amabit worried x

  • Don't worry about the folic acid. I was told at first to take it 3 days before, then changed to 3 times a week. Usually it is not taken on the same day as mtx, but some take it everyday. Just check with yr rheumy team when they want you to take it. Do you have a number for a rheumy nurse you could contact? hope you get sorted.


  • i changed my doctor but the other is just as bad and who know if they write anything on your notes if you change.

    but give it some thought before you do it

  • As far as work is concerned, you do have some protection under the law because of having an ongoing health condition. You are entitled to "reasonable adjustments" under the terms of the Equality Act, ie alterations to your work which will help you to be able to continue in the workplace. The Equality Act replaced the old Disability Discrimination Act, but lots of people/documents still refer to that. NRAS have some helpful information, but also google for it.

    Definitely see your doctor about pain relief - there are lots of things they can give you which may help. As others have said, rheumatologists normally leave this to GPs, and it's better really because GPs are usually more accessible.

    Good luck - remember to rest up properly and give the mtx a chance to work.

    Dotty x

  • Agree with what's been said above - mtx can make you feel nauseous but I wouldn't think you've been on it long enough yet. Pain relief is the GP's domain - my recent rheumy visit ignored anything I said about pain - as has been said above, she was just interested in inflammation and testing range of movement to assess joint damage - there are over the counter meds. you can get for pain but I would def. go back to GP and ask what you can take. Mtx can take 6-8 weeks (I was told) to kick in, but in meantime GP should be helping you with pain.

    Work should accommodate you - my company was very good, RA is on the disability list so companies have to look at providing you with appropriate work station or even, as was my case, seeing if you can go from 5 to 4 day week (they don't HAVE to do that if it compromises the business, but they do have to look at it) I was lucky as they gave me 4 day week which helped a lot. Retired now, and that helps loads!!!!

    Rest up as much as you can; use the cold and hot compresses and get the GP to put you on pain relief.

    Keep us posted.

    Lynn x

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