I'm on Orencia, re R/A, started in Feb.; so much joint aches and pains, I still have them! Rheum says my lab tests show my R/A is under control, and that my osteoarthritis is the problem?? I seen her because of joint pain,and so much swelling in feet and legs, before that I got dry eyes. When I started Orencia, I had to quit my inflammatory (Arthrotec), which always helped in flareups, only allowed to take tylenol daily, and if I have severe flare I can take a Naproxan. Actually I feel worse since on Orencia...maybe it's coinsidental?? I see rheumy a couple weeks ago. She did say Orencia was working, but if I couldn't tolerate taking them...it's up to me if I chose not to. I was on Rinvoq a couple months previously, had sie effects, so had to stop it. Then it was suggested I try Orencia. I'm still not sure about Orencia, even tho I'm on it. Not having a good daily life!
Oranchia: I'm on Orencia, re R/A, started in Feb.; so... - NRAS
Oranchia
if you have OA as well as RA then you are still likely to have pain even though your orencia is working for your RA. You could also have joint damage from your RA that’s causing your pain as well. Ate you consistently taking your pain killers? I don’t have OA so can’t help with suggestions but if you put that into the search box you may find some useful past posts and maybe search for another group for tips for OA. I hope you get some relief soon.
Unfortunately the drugs that control our RA don’t control OA in the same way.
I too have developed OA over the years & despite being on Rituximab the pain from the OA continues, Maybe if you don’t settle any better on Orencia your rheumy might change it…but if she feels OA is causing your pain ..you might feel worse on something else.
You say you are only “allowed” to take restricted amounts of Tylenol & Naproxen….. so right now try keep your joints moving gently, & ask your doctors if they can prescribe some more effective regular pain medication,
I hope you geet some relief soon.
Tylenol is paracetamol. It would not be strong enough for my osteoarthritis pain which at my age I'm almost bound to have after 45 years of Rheumatoid Disease. By now I can usually tell the difference between the two types of pain. If your inflammatory markers are normal, you don't have swollen joints, then it may well be osteoarthritis pain.
Treatment for that is adequate pain relief so that you can do regular small amounts of exercise. The difficult bit is balancing doing too much (which makes it hurt) and doing too little which also makes it hurt. Have a look at the exercises on the NRAS website or the Royal Osteoporosis website and do them several times a day, little and often is best. Walk somewhere every day, if possible in nice places like public gardens. I find people to talk to in public gardens too!
But talk to your medical team about decent pain relief so that you are able to do preventive exercise - if you put to them in that way, I've found it's usually possible to overcome their fear of you becoming addicted to opiates which might be more effective. Codeine is changed by the body into low dose morphine and works reasonable well for this type of pain. Non-steroidal anti-inflmmatory drugs (arthrotec and naproxen) are best avoided as you get older if you can.
why is naproxen best avoided as you get older?
Studies of older adults show that chronic NSAID use increases the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction. Continued NSAID use can exacerbate a number of chronic diseases including heart failure and hypertension, and can interact with a number of drugs (eg, anti-coagulants, corticosteroids). Preferred analgesics in older adults that may have a lower risk of these adverse drug reactions include paracetamol, a short half-life NSAID (eg, ibuprofen), or low-dose opioid/opioid-like agents in combination with paracetamol (in appropriate patients).
I can give the references if you want to read the original studies (and there are quite a few of them).
I have had RA for 35 yrs, was doing quite well, I guess it wasn't my RA effecting me, it's the Osteo that's giving me the problems. It's mostly my lower limbs. My RA markers are good! I do have swollen joints too.? I hear what you are saying, I will be more active. I haven't been...even the least active in the last six months. As an oldtimer also, thanks a lot for the advice, greatly appreciated . Hope you have a good day!😊