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Ra and pain management

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  • Ra and pain management

    Ok how many of us have the pain controlled? Seems like the dr is distracted just treating the root cause. I cannot handle nsaids and am frustrated about being in pain, i feel like i shouldnt have to" just suck it up"
    Beyond the Ring-para dressage, training, coaching

    Proud Team Four Star Minion! Renegade for Life!

  • #2
    Are you seeing a pain management specialist, or just a rheumie? A pain management specialist should be more familiar with the full range of meds besides NSAIDS and opiates.


    • #3

      Given the myriad types and sheer numbers of medications out there; I'm having problems understanding why you can't find meds that would work. I also don't believe any medical person told you to suck it up.!!! Please don't feel that way!!
      What do you mean you can't "handle nsaids"? There are soooo many! Have you tried all the sub classes of nsaids? Celebrex? Voltaren? How about the IV meds for RA? Those are terrific! There are many nsaids that have no GI side effects too.
      And....treating pain is mainly about treating the cause; not just the symptoms.
      You have a long road to travel here; I suggest you jump on in and work with someone to make your life better! It's gonna take some work though! Best wishes!


      • Original Poster

        I have tried sub classes and sadly it wasnt just gi effects, i bleed under my skin! I am onn sulfasalazine for the root, but need breakthrough pain control.

        Im attempting to reapply for disability but i need my neurologist to help and he wont! I have a migraine almost every week!

        I cant even handle advil but t3 i can fully function on

        i also have kidney disease so that affects med choices greatly.
        Beyond the Ring-para dressage, training, coaching

        Proud Team Four Star Minion! Renegade for Life!


        • #5
          I was initially diagnosed with RA, but now they can't decide what the official diagnosis is. In the meantime I can no longer handle NSAIDs very well due to the GI side effects. In Feb my rheumatologist put me on Nortriptyline for neuropathy and titrated me from 10mg to 30mg and it has been managing my pain MUCH better than NSAIDs ever did. There's still some occasional breakthrough pain, but it's bearable. The tricyclic anti-depressants (Nortriptyline/Pamelor, Amitriptyline, Imipramine, etc) and other anti-depressants (Effexor, Cymbalta) are also used for pain management at low dosages, so they might be an option for you.

          That being said, I learned the hard way to make sure to refill my meds way ahead of time! The doc neglected to tell me that there is withdrawal when you stop the Nortriptyline, and my refill came 1 week late. I ended up missing 3 days of work due to severe nausea and muscle pain even though I was only on a low dose.

          I also take Vit D daily as well and there seems to be a correlation between Vit D deficiency and the autoimmune diseases. I was extremely Vit D deficient when I was first tested (<4) and it does help a bit in managing the pain.

          ETA: I looked up the effects of Nortriptyline on the kidneys:
          "If you have a history of kidney disease or liver disease (including hepatitis or cirrhosis). This drug is cleared from the body by these organs. Reduced liver or kidney function may result in more drug than expected staying in the body. This could lead to unwanted side effects. Your doctor will want to monitor you closely and may need to adjust your dose accordingly"

          So it's not containdicated at least! You just might require a lower dose.
          Last edited by Satchel85; Jun. 4, 2012, 04:41 AM.