Confused about Naproxen masking inflammation before R... - NRAS

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Confused about Naproxen masking inflammation before Rheumy consultation.

Bertie67 profile image
17 Replies

Hello All. I'm a bit confused and would really appreciate your experience with the following......

I've been taking naproxen since seeing the GP on 1st April and I'm now waiting on appointment to see Rheumy. My symptoms before taking naproxen were consistent with RA and bloods then showed RF at 257. However in last couple of weeks the Naproxen has reduced the inflammation dramatically and the pain is under controlish, although I still occasionally take paracetamol. Still have fatigue and brain fog but these are both intangible!

My main concern is that when I see the Rheumy there will be no inflammation or swelling evident and I'll be dismissed as a hypochondriac!! It's too late now to take pics of swelling as the naproxen has improved this. Am I missing something here? Any information on how Rheumy diagnoses inflammation if it's not there?

Thanks for taking time to read, any info greatly appreciated.

Lee x

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Bertie67
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17 Replies
helixhelix profile image
helixhelix

A good rheumy should diagnose based on what you say, what the blood tests say, and what your physical symptoms say. So shouldn't just depend on your crawling into surgery with swollen joints and major inflammation. So having a positive RF is a help as that will mean that they'll look carefully right away - the majority of people with positive RF do have RA (not all, but around 70% I think). Before your appointment try to write down the symptoms you have had in the past, especially things like morning stiffness and which joints were inflamed. But fatigue and general unwellness are also symptoms of RA, so add them to the list. And even tho' the inflammation may have gone, my rheumy always talks about me having boggy joints even when not obviously inflammed - which according to Mr Google means they feel different to a trained person when they prod and squeeze. So it may well be that the rheumy will still detect that your joints aren't 100%.

Bertie67 profile image
Bertie67

Thank you so much, that is really helpful and has reassured me that they won't run me out the door shouting fraud and charlatan after me!!

I have a very short memory and because the naproxen is working quite well at the moment, I've forgotten how bad I was before, deluding myself that maybe there's nothing wrong! (Denial?)

I have been determined to keep going and am due back at work after 2 weeks scheduled time off however I've torn a ligament/muscle in my right calve due to wonky walking getting upstairs and am now on the couch RICEing!!

Thanks again for info, much appreciated.

Lee x

Hi Lee,

I'm not quite sure how soon your rheumy appointment is but would you perhaps consider having the 48 hours prior to the big day without taking naproxen?

Having had my symptoms supressed by a steroid injection that lasted 2 months I wasn't diagnosed for another four months so I stopped taking Ibuprofen a few days before my second appointment and had plenty of swollen joints to show the rheumy - which made it easier much easier for him to diagnose me there and then. Mind you I'm sero negative so this was even more important than it will be for you. And as Helix says some rheumies are better at detecting subtle inflammation than others.

faceit profile image
faceit in reply to

Wow twitchytoes I wish I would have read this post before I took my pain meds. I have a doctors appointment tomorrow and I want all my pain to be apparent. Drats

nomoreheels profile image
nomoreheels

Just a thought, & I certainly don't advocate anyone not taking prescribed meds but, as naproxen is non-specific anti-inflammatory & a pro tem to start of your RA treatment you could maybe lay off them until swelling occurs, take pics as evidence & then restart as before. You'll obviously get some discomfort but if you're so concerned about being thought of being a hypochondriac it will at least ease your mind to have this to show at your first appointment. Just to end on a more positive note my preferred Consultant overlooks my lack of swollen joints & treats it as just the way it presents, or more to the point doesn't, in me. But, as I can attest to, not all Rheumys read from the same hymn sheet.

Bertie67 profile image
Bertie67

Thanks so much for the advice. I never thought about not taking them, doh!!

From what I read here, it's so important to get early diagnosis and begin treatment to avoid damage and mobility problems. I certainly don't want to have RA but if I have then I do want a diagnosis ASAP. Plus I'm not a very patient patient :-)

Lee x

nomoreheels profile image
nomoreheels in reply to Bertie67

Hiya Lee, As you quite rightly say it is important to be diagnosed early but it does appear you have had classic symptoms for some time. Family history, carpal tunnel release surgery, aches & pains etc. are all pointers but RA can be notoriously difficult in certain circumstances to pin down. Could be that your cold, which could have been a virus, & your following symptoms has kick started RA fully to get a score they're acting upon. Hope, if it is RA, with all the help that's out there that you're soon on the road to feeling more like your old self after so long of being in limbo.

Rosie_rabbit profile image
Rosie_rabbit

Hi Lee, there's definitely a theme here ..I used to take naproxen prior to diagnosis and it did offer me great relief for a time. When I asked my rheumy about taking naproxen prior to a consultation or ultrasound or something and he actually suggested to stop taking it for a couple of days prior to attending my appointment. Might be worth having a chat with your gp perhaps as we aren't medically qualified on here and can just share our experiences.

What I would say about naproxen though is that it can be tough on your tummy. I took it without a problem for a couple of months but once the tummy problems start it makes it hard to continue with it which isn't good if it works well for you. So, if you're not already, I would definitely be recommending talking to your gp about taking something like omeprasole to protect your tum.

As for forgetting what it felt like, I can so agree with that. Diaries are great for this although I've rarely had the patience for them haha!! Anyway, good luck and I hope you have a good appt with your consultant.

Rx

nomoreheels profile image
nomoreheels in reply to Rosie_rabbit

Hiya Rosie. My consultant (abroad) used to ask me a every other time I saw him to not take my etroricoxib for a week before my blood test & x-rays as he wanted to make comparisons on inflammation as I don't present much swelling.

Bazzypants profile image
Bazzypants

Hi Lee I wouldn't worry the naproxen is doing just what it should that's the idea of the medication, it does not mean that you are cured or that the RA has gone away all its doing is helping you live a more comfortable life and embrace it this is working for you. Your RA team I am sure will be pleased with your progress. Just because today its working well it does not mean you will not have flare ups in the future enjoy while it lasts. As for being a hypercondreact just because your not swollen does not mean your not experiencing pain of some sort, I went to a RA doctor last month with no swellings but lots of knee pain had an x ray only to discover I now have OA and RA in both knees. xxxxxxxxxxxxx stay well

Hapi72 profile image
Hapi72

Hi Lee, I'm new on here and only recently diagnosed. I was suffering from classic symptoms when I went to the doctors and they put me on naproxen and omeprazol, this was 2 weeks before my consultation, like you the naproxen helped and when I went I was experiencing pain but no swelling, however unlike you my rf was only borderline and as such was told that my pain was probably due to vitamin D deficiency. More bloods and X-rays later I have been diagnosed as sero-negative and am now waiting to start sulfasalazine. Personally I am scared to stop taking the naproxen as I still have a lot of pain whilst on it and I was diagnosed anyway.

Hope that helps.

Sarah.

Bertie67 profile image
Bertie67

Thanks all for the wonderful replies and sharing your experiences with me. It's so comforting to know there are people here that really understand.

Rosie, thank you for the info. Glad to say GP prescribed me omeprazol along with the naproxen.

Lee x

dickfend profile image
dickfend

Hi Lee I am in my 43 yr of RA and have had several bouts of surgery as well as many many different drugs over the years. I am currently on AntiTNF (infliximab) infusions every 6 weeks together with Methotrexate and Naproxen and as far as I am aware it is regular blood tests and X-rays that will determine if it is RA. As I understand the drugs will not mask the RA being present in the body, they will only mask the pain resulting from the damage caused by the RA. I do hope you get a true diagnosis soon as I know how frustrating it can be not knowing precisely. I also hope that you get the care that I have received from the NHS . Regards Brian

chook profile image
chook

I think your blood tests should still reveal you have ra, the gp is just trying to alleviate some discomfort before the rheumy prescribes treatment. My gp did the same and the rheumy kept me on naprosyn along with mtx and prednisone...so dont worry

earthwitch profile image
earthwitch

A very strong positive reaction to NSAIDs may actually help confirm inflammation. Definitely be prepared to describe very briefly the difference you have felt between before and after NSAIDs when you see the rheumatologist. A really good resonse to NSAIDS may also lead the rheumatologist to consider one of the forms of spondyloarthritis rather than RA, as spondy typically does respond well to NSAIDs.

faceit profile image
faceit

That sucks bazzypants

binlid profile image
binlid

hi ive been diagnosed sero positive for 2years and as others have said i was put on naproxe initially and it helped i have since been told by my consultant to come of naproxen for no reason known to me xxxx

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