Steroids and Ibuprofen

[Washingup]

I am currently on 7mg pred for PMR. I am also suffering from a trapped nerve in my back which I have had for six weeks now which has been VERY painful. My doctor has said under no circumstances to take any medication containing ibuprofen because of my steroids. Paracetomol does nothing to relieve the pain, co-codamol makes me ill. I read on the forum other people take ibuprofen which I think would help me. Any ones thoughts? Should I try them even though my doctor says NO? Thank you for any thoughts from other sufferers.

[Seacat30]

I don't think we should offer advice that goes against the strongly held view of your doctor. Maybe contact them again and ask what you can do safely to reduce your ongoing pain?

[Sophiestree]

I think most doctors would advise against ibuprofen due to the stomach issues that already can exist with pred, so his advice is correct.

I do take ibuprofen when I am at my wits end with the pain. I make sure I eat really well beforehand in the same way I do taking my pred, but if not then something like Omeprazole beforehand to protect the stomach.

It is important to protect your stomach as Ibuprofen can cause issues with people in general and we are even more sensitive due to the pred.

can he offer you anything else. I can't take co-co-codamol either and so have little left in the repertoire.

feel for you.

[PMRpro Ambassador]

My rheumatologist uses NSAIDs alongside pred for me but only occasional use, taken with a meal, or if I take stomach protection such as omeprazole or famotidine for more regular use.

When you say "my doctor" - do you mean the GP or a rheumy? If it is the GP - can you see a different one?

[Washingup in reply to PMRpro]

Thank you for your comment. I am currently on 20mg Omeprazole for indigestion. I have only seen my GP, but he is giving me instructions via email from a rheumy. This problem with my back makes walking and bending painful, it feels so stiff and was wondering since reducing my pred from 8mg to 7mg if it's not contributing to my problem. Oh dear we all have different problems on this forum don't we?

[jenerino in reply to Washingup]

Hi, I'm am in exactly the same position as you. On 7mgs Pred and have chronic sciatica which is sooo painful. I am now on Zapain obtained from doc, which is Codein and Paracetamol combined. They do make me a bit light headed and floaty but they do help a bit with the pain. I don 't take Omeprazole but he has given them to me, should I need them. Might be worth you asking. Good luck

[Uglow in reply to PMRpro]

same for me

[DorsetLady PMRGCAuk volunteer]

I did use ibuprofen gel sparingly for my osteoarthritis whilst still on Pred -but my GP was aware.

You need to discuss with them again-and see if anything stronger than paracetamol can be prescribed -Co-codamol for example

[Washingup in reply to DorsetLady]

Thank you for your reply, my problem is co-codamol makes me ill, so can't take them but I am now thinking I will ask doctor for a different painkiller to try.

[DorsetLady PMRGCAuk volunteer in reply to Washingup]

okay -well hopefully you can find something to help…

[SheffieldJane]

Having experienced the damage that drugs can do to the GI system and the pain and upset, I just wouldn’t take ibuprofen. What about paracetamol and codeine?

[Washingup in reply to SheffieldJane]

My problem is paracetomol does nothing for the pain and cocodamol makes me ill so can't take them. I shall have to see if GP can prescribe something different. Thank you for your comment.

[PMRpro Ambassador in reply to Washingup]

And it is very likely that you need an antiinflammatory effect - not there in paracetamol or cocodamol.

[Washingup in reply to PMRpro]

I've actually managed to get a doctor's appointment just now and will see if he can prescribe an alternative to co- codamol.

[PMRpro Ambassador in reply to Washingup]

The only real alternatives are NSAIDs - but he will probably be difficult about it if he doesn't like using ibuprofen.

[Whitner in reply to Washingup]

paracetamol does nothing for me either. I’m on 1 mg of prednisone daily and I occasionally take ibuprofen for sciatica which works like a charm. I make sure I take it with food in my stomach and I’ve never had a problem.

[Rache]

I also find that paracetamol does little for pain and cocodamol made me feel nauseous. When I fractured my shoulder while undergoing radiotherapy I needed strong pain relief to be able to raise my arm! So my doctor prescribed an anti sickness tablet to take half an hour before taking each cocodamol dose. It was an antihistamine which is sometimes used for travel sickness. I think it was called cyclizine.

[Washingup in reply to Rache]

Thank you that's interesting to know.

[Dochaz]

Not sure... is Co-comadol the same thing as Tramadol? I thought I had a cracked rib recently after a fall, but after X-rays it turns out that the excruciating pain is not a cracked rib, but nerve damage sustained when I hit the edge of my coffee table. Paracetamol was no use whatsoever, but Tramadol/Paracetamol (1x37.5 mg pill every 6 hours and no more than 3 a day) works and allows me to function. This is what I was prescribed in France. Maybe it goes by a different name in the UK. Everybody's pain threshold is different, I know.

[Washingup in reply to Dochaz]

Thank you for your comment. I have managed with difficulty to make an appointment with my doctor to see if there is an alternative to co-codamol.

[Hunter134 in reply to Washingup]

I've taken Tylenol when my ostio acts up.Doesnt seem to hurt me.

[PMRpro Ambassador]

Co-codamol is a mixture of two different pain killers, paracetamol and codeine.

nhs.uk/medicines/co-codamol...

Tramadol is an opioid drug used for more severe pain

nhs.uk/medicines/tramadol/a...

[piglette]

There are painkillers such as Tramadol that are not NSAIDs. I was given dihydrocodeine, for my back which I preferred to co-codamol. It is stronger though I believe.

[Washingup in reply to piglette]

Thank you your comment it is very useful, will see what the doctor says. Tramadol could be one for me to try.

[piglette in reply to Washingup]

Good luck.

[autumnlass]

Hello Washingup

When I had an urethral stent in November ‘21 the urologist gave me Voltarol suppositories which were magic! I was a bit concerned as I cannot tolerate ibuprofen but the urologist said they wouldn’t affect my tummy and they didn’t! Hope you find something soon to stop the pain. 😣

[dusty444]

Ibuprofen damages the kidneys as does Nexium which is a PPI for digestive problems. Recently I had an acute kidney injury which the doctor can only point a vague finger at the Ibuprofen but told me not to use anymore. Personally I think the combination of Pred, Nexium and the Ibuprofen were set off when I had covid after Christmas. But covid I think was just the flame to the wick of it all. Listen to your Dr about what to avoid, I wish my original Dr had the knowledge not to tell me to take Ibuprofen.

[craighead72]

I have had a sciatic nerve problem for several weeks now which is very painful in the mornings. I cannot walk properly nor for any distance without making it worse. Paracetamol made not a jot of difference. My GP said to try Cocodamol but only for 3 days at a time and it was also pretty ineffective. The GP then prescribed Amytriptiline and again no real difference apart from making me drowsy and even more slow-witted than usual. She then prescribed Pregabalin and it has worked wonders after persevering for a week or two. So try speaking to your GP again and seeing if he/she will try you on Pregabalin. Best of luck.

[Washingup in reply to craighead72]

Thank you for your reply will mention this to my doctor.

[Missus835]

Same problem. PMR and possible GCA, but did something to my lower hip about a week ago. Pain goes from groin to hip, down outside of right leg, around the knee and now has extended to outside the calf. Can barely walk, without holding on to something to support myself (i.e.the walls). Pain is keeping me awake. Can only sit for short periods. Probably disc or sciatic nerve impingement. I take Ibuprofen. 200 mg twice per day just to be able to function. I take it with an extra strength Acetominophen (together). I try to take it with a hot beverage and food to get it out of my stomach asap. I also take Rabeprazole for stomach 2 times a day. By a sheer miracle, I have a Rheumie appointment later this morning (it's only 4:02AM here in NS and I've been awake since 1 and finally I gave in and arose). Actually the appointment is to get the results of the TA artery biopsy I had a week ago, to "rule out GCA". The miracle is, it's only the second time I've seen her since last May 2022, due to her lack of availability. I'm quite aware that IB is taboo with Prednisone (of which I am at 60 mg since Jan. 21st). Have had to cut work hours in half due to the sitting problem mostly. Working mornings, trying to rest in the afternoons. I feel your pain my friend. All the best to you.

[Washingup in reply to Missus835]

Thank you. Good luck to you.

[Reedmaker]

my Rheumatologist recently prescribed Naproxen anti inflammatory as have horrible sciatic and shoulder pain plus inflamed feet and knees. She said there were worries about stomach ulcers and to stop if stomach problems occurred. I’ve not started the course yet so don’t know if they help…

[Pongo13 in reply to Reedmaker]

I’ve had costochondritis following over a month of coughing! I was prescribed naproxen with a built in stomach protector. I’m only on two pred per day. I found the relief from pain a blessing. And no tum probs.

[Hidden in reply to Pongo13]

I found naproxin wonderful for pain relief and generally feeling more perky, unfortunately both my GP and Rhuemy said naproxen can affect the heart and kidneys and not to take it though another GP prescribed it in the first place. I now only take naproxin when I'm really desperate

[Dambusters]

I am on 11mg Pred and have other problems, so am pn lots of meds. I currently have trapped nerve. I take Lanzaprolole to protect stomach and use Voltarol cream.

[Blearyeyed]

If this is pain from a trapped nerve the Ibuprofen may not be beneficial.Have you tried requesting a short term prescription for a medication specifically for nerve pain / nerve relaxant.

Something like Garbapentin or Pregbalin on a low dose for a month may be worth asking about and trialling rather than taking Ibuprofen which is not generally recommended.

Your GP can prescribe both of these for diagnosed nerve pain without needing a specialists consent.

[Pixix]

I tried, but it gave me stomach issues (despite a PPI), so I can’t really take it. I tried Pregabalin, & gabapentin, but both Gabapentin gave me the worst side effects! I taje amitryptylline, which helps a bit, but doesn’t take the pain away. I have sciatica, trochanteric bursitis, hypermobility (currently causing joint dislocations), a benign spinal tumour , OA, fibromyalgia & PMR & suspected rheumatoid arthritis, so I’ve tried most painkillers. The best was pethidine, used mainly by anaesthetists, I think, & time release tramadol does take the edge off it. I’ve had 3 urgent referrals to rheumy, but the queue is a year long. One thing that does help me is depo medrone injection, but it didn’t touch the sciatica or bursitis, but was helpful with joint pain.

[RachelJDH]

I nervously took one ibuprofen when I had toothache as paracetamol was not doing it. The ibuprofen really helped and I did not notice any side effects but I would not do it often.

[Pippah45]

Have you tried the Ibuprofen gel on the spot? I am actually allergic to Ibuprofen but I can tolerate the gel. My personal choice for pain like that is a good Osteopath or Massage Therapist.

[Donaloge]

In letters to my general practice my rheumatologist routinely includes “ibuprofen as required” in the list of my medications, although I take if only occasionally. So I assume that she does not think it should not be used.

[Miacaro45]

My rheumatologist told me not to take ibuprofen because I am on so much Prednisone. I have been using either CBD cream (without THC) or CBD suppositories. It works well for the pain.

[lkcreedon]

I occasionally take 1 difene. It works for me but it is very occasionally. Doctor is ok with this.

[lkcreedon]

I also do take a nexium(Omeprazole) about 2hrs beforehand to protect my stomach

[HelenDaisy]

I had spinal stenosis so badly I needed urgent surgery: decompression. I was lots better in that I could walk and work again, but only got so far with the pain, until I saw a chiropractor regularly. It cost a lot but has been worth it.

[kalgoorlie]

I have a similar issue with piriformis pain currently, and am on 3mg prednisolone. But I thought I would try a TENS machine and can honestly say I find it very good for pain relief.

[PUMC]

Have you tried lidocaine patches? They are 4% strength over the counter in the US; or 5% by prescription. I used them after I hurt my back in a fall, and they helped immensely.

[BabyRuby1]

I’m on 2 mg prednisone after two years of pmr

My rheumatologist said it’s ok to take Advil or aleve if I have pain coming off prednisone if my stomach can handle it. He said Advil or aleve is better to take than prednisone if tummy can take it. Luckily mine can

[phebamom]

Ibuprofen is a NSAID, non-steroidal anti-inflammatory drug. NSAIDS are horrible on the stomach. My husband's cousin came to visit for hubby's 70th birthday on Sunday. He is on Prilosec for an ulcer at the bottom of his stomach from taking Aleve. The doctor told him to never take a NSAID. NSAIDS are on the list of the 10 worst drugs to take for your kidneys. If you are 74, then your kidneys have reduced function. Just part of the aging process. The worst thing you can do for your kidneys, stomach and liver, is to take an NSAID. Nerve pain is the worst pain there is. I had a slipped nerve in my elbow, the funny bone nerve. I ended up having surgery, but until the surgery I was in horrible constant pain. You are right. There is nothing that touches the pain. Sounds like you are in one of those horrible spots we face as we age; stuck between a rock and a hard place. You have my total sympathy. They will get to the bottom of it. I have a friend who is doing physical therapy now for a trapped nerve in her hip. Have you been offered physical therapy, or chiropractic care?

[Washingup in reply to phebamom]

Thank you for your reply. I have taken on board what you have said about NSAIDs. I will see what my GP says and was thinking about chiropractic care.

[phebamom]

goodrx.com/healthcare-acces...

[Amkoffee]

Ask your Dr for either gabapentin or pregablin. They're both medication that works well for people with nerve pain.

[Washingup in reply to Amkoffee]

Thank you. Will ask him about above painkillers.

[Duketta]

I take 400 mg of ibuprofen three times a day with every meal.I'm currently at 5 and 1/2 mg of prednisone and I noticed a big difference with the ibuprofen.

But of course you have to make sure you have no other medications that it will contradict.

God bless and I hope this helps. 💖💖🙏

[Washingup in reply to Duketta]

Thank you for your reply.

[Janetknit]

I had the same problem last August and had a guided epidural of steroids into my vertebrae. It was a miracle procedure, I would give anyone with severe impingement if nerves my endorsement of this procedure. Nothing else worked… no pain killers at any level helped

[phebamom in reply to Janetknit]

I had that same procedure on my neck several years ago. It stopped chronic neck pain dead in its tracks.

[Peptink]

I asked my rheumatologist about taking ibuprofen along with my prednisone dose of 7mg per day. She said it was fine to take the two together. Just my experience. I hope you start to feel better soon.

[Countrykitten]

Have you tried any treatment for your trapped nerve? Gentle Osteopathy could do more good than drugs. Drs don't have much to offer in terms of painkillers. I find Tramadol just make me feel woozy whilst not having much effect on pain. Amitriptyline is used for nerve pain but, in my case, case, dreadful constipation. I 'live on' Co codamol for want of any other pain relief that helps, but I know what you mean about them making you ill. I haven't been able to take Celecoxib since being on Pred, but I do have to admit to taking the odd one when my arthritis pain becomes overwhelming. Do try Osteopathy if you can. Good luck.

[phebamom in reply to Countrykitten]

I agree. I was once hooked on Amitriptyline. A hard drug to get off of. I ended up having surgery for the nerve in my elbow. Only those who have trapped nerve pain can understand how ghastly it is. Ditto for the constipation with drug.

[Washingup in reply to Countrykitten]

Thank you. I am thinking of trying chiropractic care first. If my pain continues will ask my GP about alternative painkillers and hope I don't get side effects.

[DancingBonny]

Hi Washingup, I know how you feel. I have been to see a chiropractor this afternoon and he did say the pain in my hip was sciatica and it would take a while to go. I have another appointment next Tue. I have great confidence in him as have been going to him off and on (more off than on!) for years so give it a try. I wish you the best of luck.

[Washingup in reply to DancingBonny]

Thank you.

[Groovykindoflove1992]

I was prescribed Celebrex whilst on pred. Celebrex is an NSAID like Ibuprofen, Diclofenac and Naproxen, but my rheumy said it was slightly milder on the stomach. She doubled my daily dose of Lansoprazole whilst I was taking it, but told me to stop the Celebrex if I had any stomach pain at all. I had no problems with it at all. Before pred I had terrible stomach pain when on Diclofenac and Naproxen, but Celebrex was fine 🤞

[Golden20]

I’m so sorry to hear that you are suffering so much. It’s enough having PMR, let alone a trapped nerve too. The advice given you by your doctor, is standard for ibuprofen and steroids. However, I have taken it rarely, when nothing else works. I take a PPI alongside with the ibuprofen and so far, have had no problem but that’s me. I wouldn’t advise anyone to do the same. When I mentioned this to my doctor, she was not very happy with me. I hope the pain you are suffering will stop soon. Sorry I can’t help you further.

[Washingup in reply to Golden20]

Thank you.