Random flares - what painkillers really work?

[camellia47]

I’ve had RA since 1998 and suffered quite a lot of joint damage in the early years, but since biologics came along, my life was transformed.I belong to a walking group, love gardening and cycle whenever we can find safe routes.

Very occasionally I have flares which usually get better after a day or 2.

I take Methotrexate weekly and have been able to reduce the dose to 15mg.

About 3 years ago I had a bad flare in my knuckles and phoned the hospital helpline for advice. My consultant rang back and arranged a steroid injection which worked like a dream.

How things have changed! I’ve been having random flares since the weather changed and finally phoned the helpline for advice. 4 days later someone phoned back and suggested paracetamol for the pain and to phone again if it got worse. I’m over 70 so shouldn’t take anti -inflammatories but can anyone tell me what I can safely take now. Paracetamol is safe but has no effect. I’d love to know what other ‘elderly’ patients find useful.

[Jaxine]

I take paracetamol and codeine it's the only pain killer that reduces my pain when having a flare up. Before anyone mentions it, I know not to be taken long term, but with RA we already toxic drugs long term. If in pain takes a painkiller that works.

[camellia47 in reply to Jaxine]

Thanks Jaxine, I have some Co-codemal and will give these a try short-term.

[AgedCrone in reply to camellia47]

But go carefully... cocodemol is very constipating as you get older..... have a word with your pharmacist! He will know what you should take..

[Lolabridge]

I also take cocodamol when pain gets too much as I find paracetamol alone has little effect for me. I have the over the counter type (8mg codeine) and also the prescription only Zapain type which are much stronger. Thankfully I’ve only had to take the latter very rarely. The downside with both of these are that they are addictive and can cause constipation so take care on both counts!!

If your flares are fairly frequent or last more than a couple of days at a time do let your Rheumy nurse know. It may be that your meds need tweaking as perhaps they are not working as well now as they have been.

[camellia47 in reply to Lolabridge]

I will get in touch with the help line again and try and set up a review appointment as soon as things get back to normal. Thanks

[AgedCrone in reply to camellia47]

Also if you have had that Co-Codamol in the drawer for a long time it may be out of date ......so check that before you start taking it......if you are going to take it.

[camellia47 in reply to Lolabridge]

Thanks for your help.

[Boxerlady]

I take paracetamol and ibuprofen (2 of each 3 times a day) as per rheumy nurse instructions. A GP told me to take the same dose but 4 times a day when I had a very painful tendon injury a couple of years ago (pre-RA) saying that it had been shown that they are more effective when taken together. He did say that I should consider taking a stomach protector and that he would have insisted if I'd been over 60 but I wasn't on it for long and had no stomach issues so didn't. Maybe it's worth checking in case a stomach protector would give you more medication options?

[Eve673 in reply to Boxerlady]

Same here. I take both together. Have no stomach issues with them.

Am on Simponi, injected once a month.

P.S. Celebrex (celecoxib is the generic name) does absolutely nothing for my pain control.

[Magician-be]

25 years of RA and 25 with MTX. If I have a flare I take a low dose of Methylprednisolone (Medrol) 4mg and that stops the pain within a few hours. I can feel the flare coming on so its impact can be reduced by taking a dose.

I took a variety of NSAIDs in the early days and only found one that worked, but it stopped working for me about 18 months ago hence the use of corticosteroids.

[KittyJ]

I’m sorry camellia but we can not advise you on what is safe for you to take. Please speak to your GP/rheumy again explaining why you can’t take what they advised. Please don’t just take what people on here tell you to take, we don’t know your history or other illnesses and it’s not safe 😊

[Jaxine in reply to KittyJ]

I don t think anyone has told Camellia what to take we are informing her of what we take, there is a difference!

[Jaxine in reply to Jaxine]

We go on this forum discussing our journey with RA and we do ask for advice and often on many issues , we are not asking or expecting a medical opinion but just some guidance from others. I stated ' take a pain killer that works for you ' I did not state 'take the same as me'

[KittyJ in reply to Jaxine]

Again, she was asking what she can take in her post and we can’t advise on that. That was her question and I was responding to that and not you so I don’t know why you have got so incensed by my reply.

[KittyJ in reply to Jaxine]

Jaxine she is asking what she can take and shouldn’t take what other people are taking. I haven’t said other people are telling her what to take at all 🤷🏻‍♀️

[Jaxine in reply to KittyJ]

The problem with messaging is you loose sight of body language and tonation. I was not at all incensed by your reply. But you're right Ijust read the post again!

[sunnyweek]

I use co-codamol prescribed by GP when paracetamol isn't enough. I also have anti inflamatory naproxen. I'm wondering why over 70s shouldn't take anti inflamatories. Do you take a stomach protector, ie omeprazole.

[wishbone]

Afraid it's a daily dose of paracetamol and tramadol for me and has been for years. It is effective, but tramadol does come with baggage in the form of addiction and bunged up tubes. Not sure about the former, but I do suffer with the latter. Dislike taking the stuff but what can you do when your RA is not well controlled and you can't take NSAIDs due to heart and stomach issues.

[OldWiliby in reply to wishbone]

Hello wishbone, Reading through I see you can’t tolerate anti inflammatories, neither can I even with a stomach protector, I came across one called ‘flarin’ available in boots chemist (maybe others) and it’s amazing! It is an anti inflammatory and I don’t know how but it stays it gentle on stomach and it works for me, the only downside is that it’s expensive but I get relief even on a tramadol day, not sure of any use.. 🤷‍♀️

[attatel]

I take cocodamol 30/500 and occasionally tramadol if it gets too bad. I'm in my early 60s so unsure if the advice changes in the over 65s - I know some drugs aren't suitable. I've been on steroids since lockdown so atm I only take one dose (2 capsules) of cocodamol at night. Hope you can get something that helps.

[medway-lady]

I've used Zapain but rarely and only for emergencies. Not sure whats in it but its on a prescription.