Pain relief and osteoarthritis: What do you all... - PMRGCAuk

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Pain relief and osteoarthritis

Mstiles profile image

What do you all use for osteoarthritis pain while on pred?

Tylenol doesn’t do much. I’ve used ibuprofen a few times which seemed to help but wary because of taking pred. I’m stuck at 13 mg. And have been having a lot of pain. GP ordered X-rays showed osteoarthritis in sacral joints, hips, and lower back but not sure what’s going on. Also having neck pain, right side,

into occipital area.

Heating pad provides some relief

47 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

No longer on Pred - but I’ve found this cream helps massively with OA pain - assume you can get in US - probably on Am...... that’s where I get it.

You might want to check with doc first - but personally I

prefer it to another drug - cannabidstore.com/product/s...

Mstiles profile image
Mstiles in reply to DorsetLady

Thank you!

My doctor prescribed voltaren topical, which I used once, had a gut bleed, so obviously contraindicated in my case, but I have acquaintances who use it and say it helps. Active ingredient is fairly heavy-duty I think: diclofenac. On the other hand all nsaids interfere with cartilage renewal so in the end I think using them is counterproductive. Physiotherapy, exercises to strengthen supporting muscles, and living with pain....

Mstiles profile image
Mstiles in reply to HeronNS

Yes I know I need to strengthen my muscles. Have not gone to therapy because of COVID. I stared a YouTube chair exercise program but have really been backsliding the last few months. Hope to do better going forward.

HeronNS profile image
HeronNS in reply to Mstiles

I've been doing my level best with my poor knee and am in the process of finding a brace to stabilize it so I can start walking again. I can't believe less than a year ago I was able to walk forty minutes to the physiotherapist's clinic, and back home again, and now I have to drive. :(

I am not enjoying this latest stage in the downhill slide called old age.

piglette profile image
piglette in reply to HeronNS

I had PRP injections (Platelet-rich plasma) last year, they take your blood out, centrifuge it and reintroduce the plasma into your knee. I thought it had not worked and then a year later having had a new hip I noticed that my leg was stiff but no knee pain, in fact I had forgotten about it.

HeronNS profile image
HeronNS in reply to piglette

What is PRP and what is it supposed to do? Is it something which might help Mstiles? Does it actually make new cartilage? Apparently I have deteriorated cartilage, which should be cushioning the various knee joints, and this is causing inflammation which in turn makes the tissues around the knee swell and then I have pain and stiffness because the extra fluid is limiting range of motion. It is MUCH better now, from physio and rest and exercises but very little walking. I need to walk to maintain mental health and bone density, so it's been a real problem. Ongoing, off and on, mostly on, since the end of April. A brace is supposed to stabilize the knee so that weightbearing, as in walking, doesn't cause more damage but they are having an awful time finding one to fit me as I really don't want to have to spring for an overpriced custom one.

piglette profile image
piglette in reply to HeronNS

My knee X-ray says I have severe tricompartmental degenerative change. ie I have osteoarthritis. This is what they say about PRP:

Platelet-rich plasma (PRP) therapy uses injections of a concentration of a patient's own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. In this way, PRP injections use each individual patient's own healing system to improve musculoskeletal problems.

My doctor said that it should soon be available on the NHS, so perhaps it actually is thought to work. I currently pay for it myself. It is pretty pricey though.

Mstiles profile image
Mstiles in reply to HeronNS

That sounds like my knee. I have swelling which my GP says is part of the knee trying to regrow the cushion that’s deteriorating ??, and recent a lot of pain and more swelling behind the knee too. I was walking 15-20 minutes each day. I need to go see an ortho and get X-rays but haven’t because of COVID and just being fed up with doctors and problems!

I will ask about the platelet therapy when I do manage to go.

Thanks for the info piglette

HeronNS profile image
HeronNS in reply to Mstiles

My GP hasn't even looked at my knee, even at an in-person visit when I mentioned it again. She just kept pushing for me to use voltaren until I pointed out my stomach bleed history and the fact that there is a family history of brain haemorrhage. I've been relying on my physiotherapist to help and still considering whether I should get myself on a list to see an orthopod with a view to knee replacement - the two waiting lists (seeing the doc and getting the op) are both so long obviously I have to do as much as I can in the meantime.

Mstiles profile image
Mstiles in reply to HeronNS

Me either!

HeronNS profile image
HeronNS in reply to Mstiles

In case you misssed it, if we live long enough there is hope for an actual cure: healthunlocked.com/pmrgcauk...

Mstiles profile image
Mstiles in reply to HeronNS

Sounds encouraging, yes if we are still around!

Retallack profile image
Retallack in reply to Mstiles

I have the same in my hip which pre lockdown was symptom free as I was exercising regularly so the muscles were supportive. Would encourage you to self refer to local NHS physio which I did online. Was sent exercise sheets, have had one face to face and regular video link appointments. Physio says it will be a long road to build the muscles again but I hope worth it. Good luck.

Mstiles profile image
Mstiles in reply to Retallack

Thank you. I’m in the US but will explore the virtual visit with Physical Therapy. An exercise sheet sounds useful!.

Retallack profile image
Retallack in reply to Mstiles

Sorry, did not realise you were in the USA.

Morning, being on Pred knocks out a few options, ie the NSAIDS. The only other pain medication I use is Co-Codamol 30/500 which works for me but I know it doesn't agree with others. Voltaral didn't agree with me at all and the various creams I found to be totally useless. Keeping up the physio and gentle, sensible exercise is very important. Peter

Mstiles profile image
Mstiles in reply to Bcol

What is co-codamol? I’m in the US, my GP hasn’t mentioned it as an alternative. I’ll ask about it. Thanks!

Bcol profile image
Bcol in reply to Mstiles

Hi there Guess this isn't going to help much as it is what you are already using. in the US one of its versions is marketed as Atasol Codeine and Tylenol 3 and Tylenol 4 which I think has 60mg of Codeine.

Pinched the following fromWikipedia

8 mg of codeine phosphate per tablet (e.g. Tylenol 1 in US/Canada)

10 mg of codeine phosphate per tablet

12.8 mg of codeine phosphate per tablet

15 mg of codeine phosphate per tablet (e.g. brands Tylenol 2 in US/Canada, Norway, Australia (multiple brands), United Kingdom)

20 mg of codeine phosphate per tablet (Prontalgine in France, Empacod, South Africa and Zimbabwe)

30 mg of codeine phosphate per tablet (e.g. Tylenol 3 in US/Canada, ratio-Emtec-30 or "Emtec" in Canada, available elsewhere in capsules such as Tylex or in tablets/caplets e.g. Solpadol, Kapake, Panacod and Zapain).[1]

60 mg of codeine phosphate per tablet (e.g. Tylenol 4 in US/Canada, and generally contain from 300 mg to 1000 mg), 1 gram of paracetamol per table

Mstiles profile image
Mstiles in reply to Bcol

Thanks For looking tha up for me Bcol.

Bcol profile image
Bcol in reply to Mstiles

No problem

I have an arthritic hip which is always painful, I take one cocodamol 30/500 three times daily, it does help. I tried ibuprofen but the bp went up , tried topical but that didn't help. Hope you fi d some relief.

Hi, i also use a heat pad, i find that helps, plus co codamol. The Dr wanted me to have Morphine i refused . Im now on pain patches , i started off on 10mgs and have just this week gone up tp 20mgs i also have chronic Arthritis in my pelvis hips etc ,so i have two things going on. It takes the edge off . Hope this helps .

Mstiles profile image
Mstiles in reply to Viv54

What medication is in the pain patches. Are they prescription?

I am occasionally taking one heavy, 1,000-1,500mg of Tylenol, and then lie down for at least an hour. It seems to help a little. Most of the time I just lie down to rest my body. I put up with the discomfit/pain in order to lessen dose of prednisone. I am not bothered with pain at night, just the usual couple of bathroom visits. I am down to 2.5mg of prednisone, which helps lower the eye pressure.

Mstiles profile image
Mstiles in reply to Noosat

Glad it helps you! There are so many warnings about taking Tylenol I’m cautious although my GP said I could take it everyday, but it doesn’t help much. Such a hard time with this disease figuring out what is causing which pain!

Noosat profile image
Noosat in reply to Mstiles

My GP said not to take Ibuprofen, and could take up to 4000mg of Tylenol a day without harm. I have never taken more than 1500 and very very rarely, because it doesn't seem to give much relief. I find exercise and rest the best medicine. :) Of course a lot depends on each of us as an individuals how much pain/discomfit we are to bear

Mstiles profile image
Mstiles in reply to Noosat

Yes Tylenol didn’t do anything for me either. Yes test, exercise when possible, also heating pad seem to help the most.

PMRpro profile image
PMRproAmbassador in reply to Noosat

GPs can be very cavalier with tylenol/paracetamol. Yes, the max recommended dose may be 4000mg/day - but that is for younger patients. A friend of mine in her 80s was persuaded by her GP that her pain was OA and she should take paracetamol instead of the very low dose of pred she had achieved. Less than a month after starting the paracetamol she had a routine blood test - where the liver values were such that an emergency ultrasound was ordered. All OK - entirely the paracetamol. But it does go to show - it is a nasty drug too.

Noosat profile image
Noosat in reply to PMRpro

I agree completely, that s why I take it only occasionally and then never anywhere near the limit :)

PMRpro profile image
PMRproAmbassador in reply to Noosat

Yes - I noticed your very sensible limit!

Mstiles profile image
Mstiles in reply to PMRpro

Yes my GP has prescribed lots of drugs I have never filled. Haven’t asked for the Tylenol with codeine though but am wary of the codeine.

I'm right there with you. I have a lot of osteoarthritis in my neck and lower back as well as some other problems. Early on I got some relief from steroid injections in my back and neck. However, most recently I am getting a significant amount of relief from nerve ablation in my neck. My suggestion is that you see a pain management doctor who can perform these types of procedures. Additionally a TENS unit can be a lifesaver. It works by confusing the brain. the brain can only think of the TENS unit stimulation and can't recognize the pain.

Mstiles profile image
Mstiles in reply to Amkoffee

My GP did recommend TENS. did you have X-rays or other tests to figure out it wasn’t PMR pain but arthritis?

Amkoffee profile image
Amkoffee in reply to Mstiles

Oh I've suffered from back pain for 15 years. But then one day (4 years ago) I had new pain and I went to my GP who tested my inflammation markers and diagnosed me with PMR. The pain of PMR is somehow different than the arthritis in my back and neck. And I don't know how to describe the difference but I'll try. Arthritis is more of a sharp pain and PMR feels more dull much like the cramps I used to get when I had my period. But of course not in the abdomen. The main place I noticed it was in my upper thighs and girdle area.

Mstiles profile image
Mstiles in reply to Amkoffee

Yes the pain does seem somewhat different. I’ve been confused as I’ve had pain popping up all over that I never had before, plus some that seems like the pain I had in the occipital area before I was diagnosed with GCA.

trying to get it sorted!

Amkoffee profile image
Amkoffee in reply to Mstiles

It is difficult when you suffer from a variety of painful diseases.

Rosbud profile image
Rosbud in reply to Amkoffee

So pleased for your explanation , tried to explain to my GP , it's like dragging period pains but being A man I don't think he quite understood x

I used ibuprofen, cautiously while on pred, with food, and haven’t had any stomach problems..I have tapered off pred now 3 1/2 years on it, pred covered up a lot of my OA pains...now it’s all up to OTC meds for OA...

Mstiles profile image
Mstiles in reply to daworm

I’ve done that a few times with ibuprofen too as it does work. Like you, with food. Congrats on your tapering success. I’ve stalled tapering trying to figure out what’s causing all my pain.

I've been off since August, stayed a long time at 2 then 1 & 1/2 , finally 1mg then I stopped, I still get some pains not sure what causes it, still some PMR hanging around or just old age and OA...but I figured if I feel the same without prednisone as I do at a low dose I may as well drop the prednisone...although at times I think maybe I should be back on at perhaps 5mg or less...prednisone really didn't cause me much side effects and at a lower dose I doubt very many at all, but it has to do something too, if its no better at a low dose than ibuprofen or meloxicam, both of which I have tried, then whats the point...sometimes I feel like I should go to a really good medical center like Cleveland Clinic or Mayo's for a really good work up and physical...hard to do now with Covid getting bad again....ive also used muscle relaxers, they seemed to help plus it helps to sleep...just don't overlap med's that shouldn't be taken together...

Mstiles profile image
Mstiles in reply to daworm

I know, it’s so hard to tell what’s causing pain. It must feel great to be totally off the prednisone, mentally at least. I feel I’m going backward as I was down to 8,5 last June and then in July had to increase to 13 and been there ever since...long story....fires and blackouts in California. Etc.

it’s a journey, thank goodness for this forum and all the great people on here.

Noosat profile image
Noosat in reply to Mstiles

I know how you feel. I am going to have aortic valve repair in December and have to make myself feel calm and not worried, because I do not want to go above the 2.5 I am now taking. As I have reduced, my eye pressure has gone down. Decisions, decisions, decisions. Do have a great day.

Mstiles profile image
Mstiles in reply to Noosat

Wow, 2.5! That is inspiring! Best wishes for your surgery Noosat ❤️

Hi, I live in the US too. I can understand what you are going through. I am on 10 mg prednisone for PMR. It does not help for osteo arthritis. My problems are similar. I was diagnosed with spinal stenosis recently with right leg sciatica.

Tylenol and Advil do not work for the pain. I am staying away from Tylenol with Codein. I had a lumbar epidural which helped to some degree, but actually Physical Therapy has been working the best to reduce pain --- being active is very important.

Good luck with your efforts to feel better.

Mstiles profile image
Mstiles in reply to 4840

Thank you. Yes walking and being active really do help. You have to work through the “initial inertia” to actually do it when you’re feeling bad though!

Yes, when we have to, we'll do what it takes to get relief. Luckily there is help when we seek it.

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