Rheumy nurse

Had a call yesterday from nurse to tell me what the consultant has advised regarding the pain and swelling in hands and feet. He said to try one of these:-

1. Butrans Patch

2. Tramadol

3. Co-codamol

I have tried all these over the years for Fibromyalgia and had very bad adverse reactions. Seeing my GP next Thursday to see what see has to say. Any thoughts would be greatly appreciated, of any other meds that may help. I have osteoarthritis in both hands and feet.

Thinking of getting a wax bath for my hands, do you know if these help?



7 Replies

None of those are "treatments" and none will get rid of the swelling or the cause of the pain. They are all just pain relief. Sounds like the rheumatologist is slightly fobbing you off here. Have they totally ruled out inflammatory arthritis? Have you had ultrasound scans of your joints as well as xrays, given that xrays will show damage but ultrasound will show actual inflammation. When you see your GP can you ask them to try and get you seen again by the rheumatologist really soon? You don't need to have raised ESR or CRP for inflammatory arthritis - its not part of the diagnostic criteria and a lot of folk never show increases in these, though of course if you are someone who does, then its really useful for monitoring changes.

Wax baths can be really nice. Is there any possibility you could try one before you commit to buying? perhaps physio or OT might have one they could use if you got referred. Again though it won't deal with the cause though it might help the pain, particularly if you can't take other painkillers.

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Thank you Earthwitch, this is exactly what I thought, my GP did mention inflammatory arthritis when I saw her last. I will try and get an ultra sound scan as I have only had X-rays. As my usual rheumatologist has left and I have been transferred to another one my appointment isn't until sept/oct. the nurse told me that he is now away, not sure when he's back, but will try and get my appointment brought forward.

Will ask about physio/ot when I see her on Thursday.

Thanks again for your excellent advise, as always.



I have a wax bath and it is out again at the moment is is very soothing x


Thank you summer, I will definitely try one asp, either through OT or Physio, as advised by Earthwitch, before I purchase one. I think I need the cause sorted and treated before trying any more pain meds that don't agree with me.



There was an interesting article in the British Medical Journal last week, about pain relief. It pointed out that, for most people, pain relief doesn't work.

The article suggests that the present trend to regard pain relief drugs as grouped together and to only use one from each group isn't helpful, as individually we may respond to one drug in that group and not another.

They suggested only trying something for two weeks. If it didn't work for you, then to try something else. They marked out the guidelines for osteoarthritis as a good example of guidelines for pain relief compared with most of the other guidelines.

I was pleased to see this, as I have found a rather dismissive response to pain from some doctors - as though if you don't get relief from something that's offered, it is as though your pain can't be that bad or you are being deliberately difficult.


Thats really interesting. I'll see if I can find that article


Thank you oldtimer, I can relate to " the pain can't be that bad" but if you can't tolerate these strong meds. What are we supposed to do, suffer in silence?

Will look at this article for some inspiration



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