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NRAS
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Pain relief

Hey have RA for 8 years now, I take methotrexate, naproxen, folic and co codamol. My pain relief is just not working and I'm in bloody agony all the while. Does anybody have suggestion as to an alternative pain relief tablet.

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Hi Antbar Sorry to hear you in such pain but I would advise you to see your rheumatologist asap as this happened to me and I got a steriod shot and will be soon starting methotrexate injections. You need to call them now and get help as it seems your meds have not got your RA under control. Hope this helps.

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Hey thanks for that. Had the steroid injection, didn't feel any benefit from that and also I was also on metho injections, came off them as they made me feel lousy.

Thanks anyway

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You need to discuss with your docs as to why you are in pain. It could be because of damaged joints in which case you need better pain relief and an assessment of how badly they are damaged. Or it could be pain caused by inflammation which suggests your disease is not properly controlled and you need to change your basic disease modifying drugs (the DMARDs).

Or it could be for some other reason!

But step one is knowing exactly what's causing the pain.

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I take Salazopyrin, naproxen and cocodamol. Like you I have been in pain for weeks and this week I requested and got prednisalone which I started yesterday. I already feel an improvement. At the moment I am waiting to see if a biologic has been approved. Speak to your rheumatologist as this could be the next step for you.

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I always recommend looking into LDN. I have been taking it since diagnosis 2015 and it has made a great difference with pain. I have not been taking pain meds for over a year. Have not been taking any RA meds.LDN no magic bullet but has shown to help with pain and atuning RA. Many that have taken LDN have been able to reduce their RA meds.

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Hi, was this LDN medication prescribed by your Rhumatology team or your GP? I’ve read your link on it and it seems to make a lot of sense. 🤗x

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LDN Research Trust have a list of prescribing doctors. Rheumies do not usually have the training to use LDN. I got my prescrption from one of them also the contact to a compounding pharmacy that makes the small doses needed.

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Great! Thanks for that Simba 🤗x

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Hi, can you confirm what LDN is? Thx L

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Are you sure your mtx is working?

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It's working for sure as a while ago I tried to leave it off (clinics idea) by the thurs I was in agony.

Anyway thanks for that

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got a treadmill thus walk daily and swim once a week

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Not with my pins. No ramp in my local pool so can't get up ladder.

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email head person at that pool or town council saying it is a great physical rehab - non restrictive

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Hi Antbar I got diagnosed with RA IN 2008 i was having hard troubles with managing your pain went to pain clinics has steroid injects had sulfalazine hydroxicloizine and methotrexate pills & injections nothing worked until I went to my Doctor in agnony crying my eyes out she put me on morphine patches but I was allergic to the glue then she put me on zomorph slow release it was a miracle with the steroids injection and my morphine pills I was almost pain free first time in years ........I hope you get the right drugs to help you !!! Sending hugs !!!😉

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Hey thanks for that, the most positive reply yet. Do you still take mtxt.

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But if your pain is from inflammation then just going for stronger and stronger pain relief is perhaps not the best direction to go in. Especially morphine based drugs. Please push to get to the bottom of the pain, and if because still uncontrolled disease then push to get considered for biologics. They can work wonders.

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Hi antbar I’m not taking and DMARDS .......I’m hoping to go on biologics see how it goes 👍🏻

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Hiya Antbar, welcome. My first thought was are your RD meds up to date dose-wise relative to disease activity which means discussing the reasons or need for pain relief with your Rheumy or GP. Whilst it is pretty common to be coprescribed pain relief, NSAIDs, corticosteroids & such it's worth ensuring the big guns such as DMARDs &/or biologics are working on the main issue, on the rogue cells causing the inflammation which is most often the cause of pain.

That said I'm also on MTX & prescribed various selective meds & pain relief to target specific areas of pain & inflammation as MTX remains the only DMARD I'm either able to tolerate or that works well enough (3 others have been & gone!). I do also have OA so some overlap but those I'm prescribed are co-codamol for general pain relief, amitriptyline as a muscle relaxant to relieve cervicogenic headaches, cervical & lumbar pain, pregabalin for nerve related pain, buprenorphine patches for generalised pain (prescribed in the main for OA), etoricoxib for both RD & OA inflammation/pain & prednisolone used in conjunction with MTX to keep the RD bubbling under.

It may seem like a lot of meds but they've been carefully formulated over time to target specific areas where pain relief is required.

I don't know if any of this helps as you're asking for one (an) alternative pain relief. The reason I've replied is because my experience proves, in my case anyway, there's no one magic tablet that cures or relieves all pain. 😕

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Thanks for that, complex or what.

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Hi, I’m on Cimzea injections but still have lots of pain from long term joint damage, and I find that 2 tramadol alongside 2 paracetamol works wonders for me. Hang in there! I’m sure your GP will help with your pain relief, good luck!! 🤗x

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