Pain relief advice

[Skyler66]

Hi everyone hope you are all well and enjoying the nice weather. I haven't posted for a while but are experiencing a few pains in different places especially lower back which I'm not sure is coming from my hip, just wanted to ask some advice on which pain killer's anyone would advise? I'm currently taking 15mg methotrexate, thank you in advance I have been reading lots of posts on here and being newly diagnosed your wealth of knowledge is brilliant better than the experts in some ways.

[AgedCrone]

know this answer keeps being repeated…but we really must not give advice on any medication.We can tell you what we take…but that doesn’t mean it will be suitable for you.

It must also be remembered when you are on any prescription drug, you must always run any OTC drugs you are thinking of adding by your doctor…..a lot of so called “natural” substances can play havoc with prescribed drugs.

You say you are on 15mg Mtx….so why not call your rheumy nurse…she will be able to arrange a medication review to add something that will help sort your back pain…don’t suffer in silence…if we don’t tell our doctors we are having problems they will assume we are fine.

Hope you get things sorted out quickly.

[Skyler66 in reply to AgedCrone]

Thanks for the advice.

[Boxerlady]

I agree with AC that it's best to contact your rheumy nurse in the first instance. Mine have given me advice on pain relief in the past and when I've occasionally asked about things which it turned out weren't in their remit, they've told me to ask my GP which I have.

In my case, I've been advised to use paracetamol and ibuprofen which are usually enough for me. I did try cocodamol (sp?) once on the advice of the rheumy nurse and pharmacist but it made me too woozy.

[Skyler66 in reply to Boxerlady]

Thanks for that

[Runrig01]

As agedcrone says we are unable to give medical advice, part of the rules of the group. MTX itself is not a painkiller, it is classed as a dmard and reduces inflammation through a complex process. Part of the benefit of reducing inflammation is that it can reduce pain, but many still need regular analgesics. It’s also difficult to suggest what would help without knowing the cause. If it’s due to inflammation nsaids may help, if it’s nerve related amitriptyline or gabapentin may help. If it’s muscular spasms a muscle relaxant may help. If neither of those then things like codeine or tramadol may help. Your GP however won’t go straight to drugs like tramadol if you haven’t tried weaker analgesics first. They follow the analgesic ladder when prescribing, starting with paracetamol and working upwards. Also be wary of supplements that you can buy over the counter that can interact with your meds, turmeric being one of them, but there are many others. A lot of supplements use the same enzyme to metabolise, which results in inhibiting or enhancing the effects of the other drugs. This can result in toxic levels of the drug in your system, or the opposite where it clears the system too quickly therefore not doing it’s job. Also I have ankylosing spondylitis and many of us also take MTX. However it’s been shown only to help peripheral symptoms, but has no effect on spinal symptoms. I use a biologic for my spinal symptoms. Good luck, hopefully I’ve given you a few ideas on what’s available

[Knip in reply to Runrig01]

Maureen, I had no idea about the Tumeric. It was suggested to me that it might help the Chron's but I didn't find it helpful so stopped it. It just shows how one thing can impact on another. Some of my drugs like Methotrexate and Budesonide work for both, as you probably know, so I'm fortunate there! Kx

[Runrig01 in reply to Knip]

I learned the hard way. I was at a food festival and there was a rep selling pharmaceutical strength turmeric from Australia, where it was only available on prescription. I already knew you couldn’t take warfarin with it. I took the antiplatlet clopidogrel and asked if that was ok and assured it was. Within 3-4 days of taking it, I was literally covered in bruises. I also take steroids so my skin is like tissue paper, so I was not a pretty site. When I then looked further bro turmeric I found it prolonged the action of clopidogrel and that your levels could get too high. It was an expensive mistake, at £70 for 2 tubs. Sad as it was helping my pains considerably. I then looked into supplements in general and found many interfere with the metabolism of drugs using the same enzyme, which is around 50% of all meds. Sadly most people assume because you buy it otc it’s safe, and many drug interaction checker sites don’t include supplements. Always check with a pharmacist or Dr if on meds before taking supplements 🤗

[Knip in reply to Runrig01]

Great advice Maureen, as always from you. I'm on Clopidogrel too so it wouldn't have been good for me anyway. I obviously had a lucky escape in that it didn't help! Have you found a suncream that helps you? I'm asking because I get a rash on my lower face from the many that I have tried. Boots advertise that some of their creams are for sensitive skin or for babies, but they don't seem to work for me. My skin is really thin too, and I have recently found that Childs Farm lotions are really helping me a lot when applied twice a day to my shins, where I was fearing ulcers. They sent me a free sample of their suncream, but I have found that even that is irritating my lower face, top of my neck and under my chin. I wear a sunhat with a wide brim if out and don't sit in the sun. Take care, Kx

[Tkat10 in reply to Knip]

Sence do a vegan natural sunscreen, zinc based coral safe that does not set my skin off. I buy it from peace with the wild.

[Knip in reply to Tkat10]

Thanks Tkat, I'll look into that. K

[Runrig01 in reply to Knip]

I don’t have issues with products on my skin. I usually use soltan from boots, with the factor 50 face one, and factor 30 for my body. I try and always sit in the shade. I have one of the large egg swing chairs in the garden and put a brolly up beside it so I’m shaded 🤪. Hope you find something that helps. I’ve just ordered some products from a company called gruum (pronounced groom) as rail card had a free offer, they are environmentally friendly and don’t use additives, so will see what it’s like. 🤞🤗

[Knip in reply to Runrig01]

I bought Soltan 50 this year Maureen! I have never been a sun lover but do enjoy sitting under the shad of a tree in the garden! Kx

[Skyler66]

Thank you for your advice much appreciated

[helixhelix]

I have had lower back problems for years, and have tried all sorts of different pain relief. Apart from a short term crisis (eg a disc herniates) I’ve found chemical pain relief to be ineffective. Exercise and physio are what work for me.

I am lucky enough to have had imaging done so I know where the damage is, and then physio can give me very specific exercises.

[Skyler66 in reply to helixhelix]

Yes I too have had lower back problems but this was before diagnosis of RA . Physio also did help me , I’ve just experienced the problem again after a long time and just thought maybe someone had some different advice on pain relief while on methotrexate.

[Knip in reply to Skyler66]

That's understandable Skyler. Painkillers that help one don't always help another. Personally I find the RA team tend to give better advice on which painkillers might help, perhaps because they are dealing with RA pain all the time, whereas GPs are dealing with pain from multiple sources. Many 'GPs have shared care so that they can prescribe meds, rather than us having to traipse down to the hospital paharmacy to collect them, but the Consultant overules them if necessary! Hope they find something that suits you soon. Knip x

[Skyler66 in reply to Knip]

Thank knip, I much agree with your comments just hoping I wouldn't have to contact GP, hopefully I can manage the pain myself over next week or so otherwise I will contact rhuemy or GP, thank you much appreciated

[DelicateInput in reply to Skyler66]

I don't take any drugs for RA. In the past I found Devil's Claw about 70% effective at relieving pain. It was recommended on the Arthritis UK website and you can buy it at the health shop. Generally, the cause of pain in RA is inflammation unless the RA is advanced and has caused joint damage.

The aim therefore is to reduce inflammation. Exercise does reduce inflammation and the easiest exercise is swimming if you have joint problems. Also, watch your diet. Alcohol will increase inflammation though red wine contains an anti inflammatory. Fried food and red meat will increase inflammation.

GPs usually prescribe Naproxen but I found it useless - not only not strong enough but it aggravates stomach problems such as gastritis and ulcers. In fact, a session at the gym followed by a 20/30 minute swim was several times more effective and also improved mobility drastically and reduced swelling even in my hands.

I have used phenylalanine in the past which takes the edge off severe pain but does not cure it and is a mild anti depressant. I was given a bagful of morphine-type painkillers after a foot operation which I did not need but I think they are the strongest painkillers. People vary in sensitivity. In any case, I wanted some wine after all that and a bottle of wine was quite an effective painkiller - just make sure it is red. You could ask the GP for a morphine-based painkiller for episodes of severe pain, which are the strongest they can prescribe.

Somebody mentioned turmeric - I am taking curcumin which is heavily concentrated turmeric. I cannot say at the moment whether it is helping. It was recommended by a friend. It is supposed to relieve inflammation. All I can say is that certain pain, above the knee, has cleared up after three+ weeks but I will have to wait to see if it recurs. Also, I noticed a couple of times when I forgot to take it, the pain/inflammation was a lot worse. I will have to gather more evidence before I can say. You can get it from Holland & Barratt.

Hope this helps.

[Skyler66 in reply to DelicateInput]

Thanks for your wealth of knowledge and advice that k you

[Mmrr]

I've got back problems too and don't find analgesics help relieve the pain at all. NSAIDs help, but should be prescribed by your GP.

Physio has been my nemesis and made things worse, so do take care before embarking on a course of exercise.

I hope you find something that helps.

[Skyler66]

Thank you so much for your reply and hope you find relief yourself too.

[Green230461]

Make a list of all your aches and pains and discuss them with your doctor first. They will be able to help you depending on your medical needs. Everyone on this site is different so depending on your medication you may need different help.

Don’t be afraid to include the smallest things either it helps the doc with the jigsaw that is RA keep well🏖

[Skyler66 in reply to Green230461]

Thanks so much for that

[Sheila_G]

Great advice from AgedCrone. Good luck

[Celticdancer]

Have you thought about an anti inflammatory diet? When I changed my diet I kept a food diary and marked what foods flared my joints and what didn't. I found tomatoes, oranges, processed food including white sugar, white flour, white rice, white bread, also cows milk, potatoes etc flared my joints but foods like carrots, celery, beetroot, goats milk and cheese, oily fish like salmon, trout, bananas etc calm my joints down. I exercise every day but nothing too strenuous. I found walking, cycling and swimming the best for me. I take daily vitamins and minerals including krill, cod liver oil, vitamins B, C, D and K2. My herbalist told me not to take turmeric if on blood thinners, I sometimes take naproxen and paracetamol for pain relief so I don't take turmeric on days I've taken naproxen. You have to found what's best for you. Also the NHS hasn't got much life left in it as it currently stands before it completely collapses so god knows what will happen after that happens whether we'll be paying for healthcare insurance like the Americans. Anyone who thinks this ain't going to happen is living in cuckoo land so I'm not completely relying on the NHS for all my healthcare needs as it certainly won't be there in the future. You can only rely on yourself.

[Akaka in reply to Celticdancer]

I’ve found the same, the NHS is severely depleted, I have only managed to see a consultant once and she was sure I had not got RA, she did a scan on my wrists and said surprisingly I had. That was nearly 2 years ago. I am now been much stricter with my diet and also finding which foods trigger pain and trying to reduce stress which is another trigger I’ve found out sets of pain. I’m sure diet is the key hard as it maybe.I was told to treat my pain from the nurses after a recent flare (only in my shoulders ) with naproxen and morphine! A month of naproxen did nothing, the morphine I only took at night and it made me uncomfortable and severely constipated and did nothing for the pain. I asked to see a physio 2 months ago and get my appointment tomorrow. I asked for a scan or X-ray on my shoulders and was told it would show nothing?

I also believe the Americans have been trying to get hold of our NHS they’ve already infiltrated the GP service and a lot of it is already privatised I know of someone who works for the NHS that is paid by Virgin Care.

[Celticdancer in reply to Akaka]

I have a relative who has had Osteoarthritis for over 25 years and many years ago a Consultant Doctor who was old school told her that diet, alleviating stress and exercise were the best treatments for arthritis as he didn't believe in taking loads of medications and painkillers as he said you end up taking more medication to counteract the side effects of the medication you've just taken. He is right. Most modern doctors are so hell bent on prescribing medications for this and that, that it seems to me the pharmaceutical industry have a real powerful hold over doctors and nurses. Some medications do help people but its the amount that is being prescribed that is really worrying. It's well known the pharmaceutical industry make huge profits in the billions by keeping people on medicines and treatments as they don't want them cured otherwise they wouldn't make as much profit. It's sickening. I use another health forum which is accessed by people from all over the world including the US and they were talking about the cost of biologic medicines in the US and some said that it was costing $13,000 per month to be on these medicines. For many their health insurance pays some of it, others might get a discount but they're still paying huge amounts for their healthcare. Better to stick to more natural methods as it's cheaper. Anyone who is on a biologic in the UK will find they're going to have to pay for it or certainly for health insurance in the near future. I know of several people waiting for hip and knee operations on the NHS and they're overweight and eat junk food and drink alot of alcohol. Their Consultants have already told them they're too young, too overweight etc to get the hip or knee replacement. They could try another Surgeon but they'll have to wait a long time on the waiting list just to get an appointment with them. It hasn't sunk in that they have as much chance of pigs flying over then they do of getting an expensive operation free on the NHS. It's a postcode lottery for NHS treatment at the moment so some people have reported that they're still getting good treatment. That won't last forever and especially from this winter with quickly rising food and fuel costs, it's going to get alot harder. Best start growing your own fruit and vegetables and if you have your own land or even a garden get some chickens, or even a goat or cow as we'll need to be more self sufficient.

[Akaka in reply to Celticdancer]

I agree totally with you everyone is happier eating junk. unfortunately I don’t do well with medication and never have. My brother had to stop his chemo as it was killing him quicker than the cancer and his digestive system is recked. Pharmaceutical companies have far too much power. I find juicing much better for my digestive system, unfortunately he is still feeling nauseous after having stopped the treatment and struggling to eat.I have my veg patch and have grown veg for years now, even after my husband died a couple of years ago I still continued you can’t beat it. I’ve given up growing brassicas though as everything gets eaten before I get to it 🤣. I’m afraid the NHS as it was is disappearing fast, medicine via an app is in!

[Skyler66 in reply to Celticdancer]

Celticdancer, thank you there is certainly a lot to think about there I will definitely take on board your comments much appreciated advice and agree with you about the NHS such worrying times we are in.

[Happy5]

Sorry you're in pain we all can sympathise.I concur with AgedCrone and suggest you discuss pain management with your RD team.

It may help to ask GP if your back pain cause can be identified, knowing what's happening

can help find the best solution.

Meantime icing or warming the area may offer some relief?

I also like reflexology not sure if it helps with pain but I always feel better for it

[Tkat10]

I know in this heat suggesting heat packs to the effected area seems mad but it works for as well as a good hot bath(when weather not silly hot). I have also used pernaton gel which helps too and had acupuncture as I too like others get little relief from chemical analgesics (just that away with the fairies feeling which is not concussive to a career).

[Skyler66]

Yes. Thank you trying the heat and freezing and they do give a little relief just need to persuver thanks everyone

[Briefencounter]

When I had really bad groin pain , ( caused by undiagnosed pelvic fractures at the time ) my rheumatologist took me off meloxicam , the NSAID that I was on then , for RA . He prescribed Naproxen which gave me amazing pain relief for that pain and other pain/stiffness caused by RA . Unfortunately , rheumatologists now have a different take on the length of time that they will allow you to take NSAIDs , "lowest strength for the shortest time" , so I'm having to taper off . But it was the one pill , out of many , that has given me the greatest pain relief 😌.

As they say in the adverts , " other NSAIDs are available ".

[Skyler66 in reply to Briefencounter]

Nice to know thank you so much

[Skyler66]

Thank you for the advice.

[Living-in-the-moment]

Hi, sorry to hear you are in pain. Obviously I agree with the wise words written by previous contributors. However the best solution that I have found to pain relief is:- suitable pain killers and Mindfulness, or Cognitive Behavioural Therapy. It is not a quick fix but it does really help and is not at all 'hippy' . My personal experience (40years) leads me to believe that pain killers on their own do not work completely. Hope you feel better soon.

[Briefencounter]

Fentanyl is my "drug of choice" - since it was used during the ops I had on my knee and elbow replacements . I wasn't aware that you could have it for pain relief . Are you talking patches here ?

[Skyler66]

Thanks for your advice I will look in that

[Tourk]

There are far to many options to list so it's a case of finding what works best for you.Some excellent natural remedies and a host of Pharmaceuticals.

As others have mentioned if in dought check with your doctor before taking none proscribed medication.

For myself my lower spine was damaged in a rta back in 1984 so nothing can be done to fix it . So I've tried many different ways of controlling the pain.

For my condition a mixture of Tramada Oramoph helped buy citrophan with co-codamol keept in reserve. I aways keep some cannabis for when nothing else works but to be honest I'm not keen on it . Only use it if I've got into a state of to much pain and over tiered and need to sleep.

I find halfway the battle is keeping the right attitude towards pain. If I'm having a bad day I have to forget any plans I've made. Catch up on some TV or xbox instead.

Keeping your mind active or distracted