What pain relief med can I take with Pred?

[Motida]

Last week I got flung down on my back when the bus did not wait for us to be seated. My shoulder blades seem to have taken the full force and now I have pain there and between the breasts. I cannot rise from a sitting position without pressing on my chest to avoid the pain. I cannot cough either. I am doing the deep breathing advised on the NHS web page.

I got checked out in a walk-in clinic and heart was okay and no bruising to be seen. The nurse told me that the pains were muscular and I should take paracetamol and try and get an X-ray via the GP.

I remember that Ibuprofen should not be taken with Pred (I'm on 7mg now) but wondered if there were any other pain relief drugs which would be stronger. The nurse did not know anything about PMR.

Any tips would be appreciated. Thank you.

[piglette]

You poor thing. You could take Ibuprofen for a very limited time with pred. Then there are aspirin and paracetamol and stronger painkillers which you would have to get on prescription. You could ask your doctor for something or some advice.

[DorsetLady PMRGCAuk volunteer]

You can take ibuprofen for a short time - might have helped initially as a flooding dose for say 48 hours, but past that point now.

You could try co-codamol [comes in different strengths] I did take it on lower doses of Pred for my osteoarthritis. As it’s on prescription you will need to speak to GP.

[Bcol in reply to DorsetLady]

If I remember correctly the 8/500 tablets are/can be over the counter the 15/500 & 30/500 tablets are prescription only.

[PMRpro Ambassador]

You could use NSAIDs such as ibuprofen for a short time providing you take some form of stomach protection with it. And there is cocodamol though you might need to get a prescription for the stronger doses that actually work.

I think you should have been checked out in the ED - it sounds as if it could well be more than muscular and an x-ray really called for. It isn't too late.

[Motida in reply to PMRpro]

Thank you very much everyone. I have ibuprofen and hope its in date! I will get an x-ray tomorrow hopefully. I am fine walking about and if I keep my shoulder blades as close as possible the pain on the front is less. Where I got checked over they did not do x-rays or other imagining. I was so grateful to be seen in ten minutes as you can imagine.

Fingers crossed all will be well.

[TedBruno17]

Hi Motida,

I have reduced from 10mg to 6mg very quickly. Within two months. Quite a lot of pain made me panic and go back to 10mg for a couple of days. Rheumatologist told me to take painkillers and I have been pain free for a week or more ranging from 8 paracetamol to 5 paracetamol daily.

[Motida in reply to TedBruno17]

Thanks TedBruno 17. I saw a doctor this morning and she suggested that I increased Pred as well and take Ibuprofen but only if an x ray does not show any fractures. Ibuprofen is not good for fractures for some reason. Now I am waiting to hear if the ambulatory dept will accept me today to review an X-ray otherwise the results wont come through for 4 days, but at least my lungs are clear even though it is too painful to cough. So grateful for everyone's support here.

[PMRpro Ambassador in reply to Motida]

The antiinflammatory effect slows the healing process! Inflammation isn't always bad. Did she also tell you to take stomach protection if you are taking ibuprofen and pred?

[Motida in reply to PMRpro]

Thanks PMRPro. Yes she saw my prescriptions and saw Famotidine 20 mg at night. She is a trainee GP and just come from several months in an A&E dept so understood why I did not relish a day there if at all possible. If no x-ray is on offer I will get one done at Vista perhaps. Just staying as positive and hopeful as possible. No pain working at the computer which is a blessing.

[Motida in reply to Motida]

Just to say that the dr. phoned to say that the ambulatory dept did not feel my injury or condition was bad enough for them. I then asked for a chest x ray but she refused, to see if there are any cracked ribs. She would have to read the results after 4 days and decide what to do again. The decision of the ambulatory dept convinced her.

Her advice was pain relief as required and if things get worse to go to an A&E in town not our local hospital. I have to accept that whatever I have done it is not as bad as it feels. So I am licking my wounds and hoping for the best. She did suggest that I could increase the Pred but not keen to do that. At least she phoned me back!

[PMRpro Ambassador in reply to Motida]

I'm just flabberghasted - how do they know how severe it is without imaging?

[Motida in reply to PMRpro]

I think that by prodding around just above the breasts she assumed things were not that bad. Even if there are any fractures they are not treated apparently as they mend themselves.

If ambulatory would not x-ray and treat me then it was not possible for her to send me herself, and that's why she suggested going to another hospital to their A&E. They would not know the back story if I did not tell them. At least I can walk and do most things. Just getting up from a chair I have to push hard into where the pain comes.

Thanks for your concern.

[PMRpro Ambassador in reply to Motida]

It is fair enough to say that broken ribs aren't "treated" - but you do need to know they aren't causing other problems and what you describe the nurse having done seemed a bit perfunctory. And you need proper pain relief .

[Motida in reply to PMRpro]

Just wanted to say that I went to our A/E Department on Tuesday and had a good experience. I have never been to an A/E for myself. Was x-rayed in three different positions. No fractures were seen but the dr. said that fine cracks dont show up especially on the breast bone. He did all the other checks and advised me to sleep sitting up which I can do in a recliner chair for a few days.

His mother had had PMR and he said there was no need to increase the Pred particularly as I have got down to 7 mg for 31 days.

He prescribed co-dydromol 1000mg for four days and four times a day and warned me that it will be 4 to 6 weeks before I can move easily without pain. He even asked if I could manage at home. Unfortunately the codeine in that drug made me dizzy and very nauseous, so I stopped it, as I thought good food was more important. My GP will see me next Tuesday to assess things, so all in all I just have to be patient.

Thanks everyone for your support and comments. I told the dr about our community and he said I was lucky to have found you.

[PMRpro Ambassador in reply to Motida]

Good - obviously someone thought it was worth it!! And took it seriously. I hate codeine - horrible stuff,

[Bcol in reply to Motida]

I really don't see any point or logic in refusing a x-ray.