Medication for pain daily

[Sebastian247]

Hi all.

I recently had my first flare up since being diagnosed. It wasn't nearly as bad as many suffer and nothing compared to the pain before I was diagnosed and treated.

But it was bad enough and I had to wear a wrist brace for a couple of weeks to help.

I contacted my GP who told me to take naproxen and expressed surprised I wasn't taking naproxen daily permanently.

I've stopped taking naproxen now the flare up has eased, but wondered if taking pain meds daily is usual for people with RA?

Thanks.

Seb

[AgedCrone]

I can only speak for myself,but I have had RA for 20+ years & have never taken daily painkillers unless I needed them.

So No I don’t think it’s necessary to take analgesics “ just in case”

Most GPs don’t keep up to date with RA treatments …if I were you I’d definitely ask your Rheumatologist’s opinion ..especially about daily Naproxen.

[Runrig01]

I have AS rather than RA,, and it is routine to take a nsaid along with biologics & dmards, to help keep inflammation under control. I did for several year, until I had a severe stroke and had to stop the nsaid. My rheumatologist emphasised it was important to take them regularly and not just as required

[Boxerlady]

I've only taken pain relief in the early days or during flares when I've taken paracetamol and ibuprofen as instructed by the rhuemy nurses. Last year, a consultant suggested trying ibuprofen gel on my wrist but it had no effect.

[Sebastian247]

Thanks for the replies. I've been told naproxen can cause stomach problems (so I take omeprazole) plus I had dysentery decades ago and my stomach has been easily upset ever since. So I'm not too keen on taking naproxen daily, permanently. Think I'll stick to taking pain relief just when needed.

Many thanks. Seb.

[AgedCrone in reply to Sebastian247]

Snap! I too had amoebic dysentery many years ago, and any NSAID is a big NoNo for me…I also failed on SSZ, but if I were you I’d keep trying Mtx for a bit longer. I had great success on it for 7 years..even thought I was cured! I wasn’t of course, but those 7 years were well worth having.

I think you are right to only take painkillers when needed, especially as Naproxen seems to be developing more adverse reactions than was first thought.

[Drmjl18 in reply to Sebastian247]

Perhaps ask your rheumatologist about Etoricoxib instead of Naproxen. I take it daily (90mg) and have found it more effective than other nsaids tried previously. It doesn’t create the same challenge for the stomach and, as others have mentioned, keeping inflammation down as low as possible in early stages is very important.

[Blackberrywine]

I think, if you can, it's best to take only when needed.

[Fruitandnutcase]

I take hydroxychloroquine daily and was told by me rheumatologist just to top up with paracetamol if I need anything more. So far that’s suited me fine.

I was prescribed naproxen when I fractured my sacrum in 2021. I started off on a low dose then another doctor prescribed a stronger dose along with omeprazole and boy did that upset my gut big time also my heart rate shot up to an uncomfortable and scary level. I felt so ill that my doctor said to cut the naproxen and double up on the omeprazole - that didn’t help and things only got better when I stopped the omeprazole too. Now I just have a couple of paracetamol if I feel I need them but I don’t take them routinely.

On the other hand years ago I was treated by a physio who asked when I took paracetamol and I said ‘when I hurt’ and she said I had to take them all the time even when I didn’t hurt. I think that was probably because she was treating something specific that was causing the pain - I had damaged my back - rather than general RA pain - if that makes sense. I also use Volterol gel, Biofreeze gel or Deep Freeze gel or Deep Heat patches and I’ve also got a wrist splint I can use if my wrists are a problem.

[bpeal1]

I take Naproxen daily and have for several years. I have very active disease which is reasonably controlled with rituximab, leflunomide and sulphasalazine. However, my rheumatologist says the Naproxen will also help dampen down inflammation.

If I were you I would speak to your rheumatology team and ask their opinion as to whether you need Naproxen too. They will have a much better picture of how well your treatments are working and whether Naproxen would add anything or not.

[BoneyC]

I was dx. in 1971 as a child and have taken some form of NSAID daily ever since, currently Naproxen. I also take 15mg of Codeine at night to ease pain and knock me out so I get a better night's sleep.

If I followed to the book what various doctors & nurses have said, I would be taking NSAID at intervals throughout the day, with Paracetamol (works better apparently), but, you have to work it out for yourself what works best for you.

Personally (not a doctor) I don't take Paracetamol, I don't think it helps and can cause stomach/digestive issues. I also don't take the full dose prescribed to me of Naproxen or Codeine. If I was to take more than 15mg of Codeine I would vomit like a dog!

I've been on this current drug regime for a number of years and I've found it's about the best I can achieve with pain relief. Hope you find a drug regime that works better for you too.

[Sebastian247]

Thanks. It sounds as though I'm very fortunate that my RA is much less active than some, although I'm not always sure if the low level aches and pains are just normal as I get older or the RA.

[Boxerlady in reply to Sebastian247]

I feel the same. I'm planning to ask the consultant about this when I next see someone - my annual review was due in February but I've been told that they're several months behind so hoping for July/August.

[Summerrain14]

I think it really does vary so much from person to person regarding pain meds for RA. Just let our RA I suppose. When I was going through the diagnosis process my rheumatologist put me on naproxen daily alongside my RA meds to help with pain. I was also prescribed a codine pain med to take with the daily naproxen. Codine generally makes me vomit even with anti sickness meds. I have had a lot of bad reactions to several pain meds and am now currently on a pain patch which gives me 24 constant relief as I was having breakthrough pain on the tablets. My pain relief is for the damage that my RA caused in some of joints rather than for my RA itself now. I would speak with your rheumatology team and seek advice from them. I am so pleased that a course of naproxen has settled down your current flare and long may it continue.

[Lex54]

Hi Seb, I take pain meds daily. Stick to Paracetamol and Ibuprofen though as feel that I take enough tablets. It mostly works well! I take Lansoprasole daily.