I'd check back with your Rheumy! Maybe they had a specific idea/instructions for how they wanted you to take those meds. Maybe ask them about pain killers that can be alternated and do not interact with one another, I think they exist.

Good luck and hope you feel better soon! Maybe the big one won't come!

I take Celebrex and Tramadol every day, and I take them at the same time. Actually, I take two 200 mg of Celebrex in the morning, and 200 mg in the evening. I also take 100 mg of Tramadol in the morning and 100 mg in the afternoon, and sometimes I take 50 or 100 mg of Tramadol in the evening, also. Both my rheumy and my orthopedic doctor told me this was fine. Perhaps you should ask your pharmacist, and your rehumy.

V

I would definitely follow up with you rheumy, and if they won't, find a new one.

Over the counter NSAIDs like naproxen are used both for pain and for antiinflamatory effects. Tramadol is a pain med, and really does nothing for swelling. Steroids do not help directly with pain, but are antiinflamtories (google rawarrior. Kelly has a very informative blog that will give you a lot of RA information).

Some doctors are reluctant to talk about pain management, so if that is the case, find a doctor, maybe your PCP can refer you, to someone who does pain management. When you have RA, pain is part of it, and it is a lot easier to deal with if you can keep the pain under control.

I find that if I take the pain meds on a regular schedule, I can keep the pain at a manageable level. I can't get it to go away completely but I can keep it in the back ground. I take tramadol also (OTC NSAIDs like the naproxen did nothing for me). I take 2 x 50 mg tabs when I get up, and then 2 x 50 mg every 4 hours. I take my last dose 4 - 6 hours before bed (it will keep you awake if you take it at bedtime). The maximum dose you can take in one day is 300 mg, so keep track of what you take.

If I get side - tracked (I have four kids and also work full - time) and forget to take the tramadol on a regular schedule, the pain take over and I can't really function well. If I stay on schedule, I can get through my day.

Start with the lowest dose possible, and work up if you have to, to find what works for you. With pain management, you don't wait until you are in agony to take your meds. You take it on a schedule to keep your pain at a manageable level. This is what makes me mad about your rheumy , my rheumy, and every other doctor that does not give good advice about pain management.

Also, you really need a rheumy that is going to treat your RA aggressively. Research shows that RA does the most damage during the first two years. If you want to avoid the bad joint damage and deformities, you need to start on medications now. You need a DMARD (disease modifying drug) to put the RA into remission. Prednisone is a temporary fix, and it is not a drug you can be on for a long term. It has some really bad side effects -- take it to get yourself through flares, but be cautious about taking it long term, and if your pcp or rheumy tells you it is ok, find a new doctor.

I'm sorry for your diagnosis. Its really not fair. Keep your chin up.

Thank-you for the advice. I made an appointment for next week. Either he will do something different or I will have to go and see someone who will.
The pain pills don't help the fatigue at all, they just seem to add to it. I know I am early on with this, but since March, I have only had one 3 week stretch when the pain pills weren't necessary.
I'll keep you posted and Again THANK-YOU!

I find it strange that your Rheumy would dx RA , not give you any medication plan and tell you to come back when you have a flare.
I so agree with Madi that the thinking now is to treat RA aggressively to slow down the disease and prevent bone erosion and deformities. If you're not happy after your appt this week get a second and if needs be, third opinion.
Good luck. Please let us know how you get on.
Hugs