Have you been diagnosed with RA? I feel so bad for you, because dealing with pain has been made so complicated by abusers. If you don't have RA, then you shouldn't be here asking about pain management. And opiod abuse, turning RAMPANT through the streets, only makes it more difficult to ask However, you should be asking qualified doctors.

I'm just going to say this: if you have RA, then you should be able to get decent prescriptions for medications that will relieve RA symptoms, including pain. Opiods are not bad, in and of themselves, unless they're abused, and abuse is more predominant from people who may not need them, in the first place.

Good luck.

hi nixe

are you being treated by a rheumatologist?

what is your RA treatment protocol?

i have been in a rheumatmology practice about a decade. This practice has an adjunct pain management clinic inside - you get referred. The pain management clinic, also, does not prescribe narcotics, any. They offer physical therapy scripts, topical nsaid creams, and steroid injections both in the office and under guided fluroscopy either under novacaine or while asleep in the outpatient department of a hospital (I have done both) - i have utilized all.

Back in my rheumatology office I have discussed all 17 nsaid options with the rheumatologist over the years and we have tried many (many many many).

I have used the hot water pool under a PT script at the hospital (pretty good). when the biologic has been cooking (I don't get an infection for a good long spell) that is helpful also.

I had narcotics for 7 to 10 days after my wrist surgery from the surgeon, and after my cervical fusion, and did not use up the prescription. Thus I have a few pills of wicked old crap in the medicine cabinet and I use a half for extreme emergency. i hope they are not like moldy.

at the therapist office I have used meditation. I find that as the years and years have marched on this is my new reality and I don't fight it as much as I can't even remember the more pain free me. I also like to use distraction - that worked great at work.

depot

I agree that medical advice should go through your rheumatologist, but I think the information you are seeking is just other people's experiences and more for alternative ways to relive your pain. There are people with RA who have severe pain and there are some who use opioids.
I would like to think physicians are being better educated on the use of pain medications to help with this problem of narcotic abuse and addiction, though it is quite complicated.
My pain is pretty mild and I usually just deal with it. Sometimes I use heat, and I use compression gloves. For a really persistent pain, like I currently have in my shoulder, I am going to beg my rheum for a steroid injection (the last time on the other shoulder worked beautifully). I try to avoid OTC pain meds, but that's just because I don't think my pain is persistent or bothersome enough to me. And I will not use narcotics for multiple reasons, not even when offered some recently for a broken bone. I do not even want them in my house with a teenager and another family member who is recovering from addiction.

I have used massage therapy for many years but not for RA pain. My massage therapist is very knowledgeable about RA and knows how to handle my hands. I used acupuncture many, many years ago for another problem (cervical nerve issue) but only briefly, so i do not know if it really helped. I know of many others who have used it for this-and-that with success.
Properly treating your RA is important of course but still many have pain.

oh! I forgot. I tried novacaine patches. Did not work for me. Others might find it helpful. I use prescription NSAID's only and not OTC. In my case it is strictly to give me function, so I can walk.

and I have wraps for:
ankles
knees
hands
wrists/combo hands/wrists

for the hands I have splints that will restrict the thumb or not. soft or hard splinted for bedtime.

My stupid ra favorite is my neck brace, worn backwards. Also alternating ice and heat if I am home will do something - not much but something. here's a tip that I found useful. I buy the cold packs only from the Physical Therapy clinic. That way I am replicating what they use (commercial brand) at home and not on amazon. I have a trap - across neck - for moist heat- hydroculator with a neck terry cloth. purchased same place - the PT clinic.

The PT's have taught me a lot about function and dealing and laughing. i also own a massage table. giving someone else a massage, works, my hands. two for one special.

depot

In Canada, it is still not as hard to get opioids as in the US. But that is rapidly changing. I take Nycunta twice a day, which is a sustained release Tramadol. I have a prescription anti-inflammatory. I also have morphine, but I don't really find it helps much with a bad flare. I do use it if my neck hurts (old whiplash injury) or for my ham string pull etc etc. Basically, I don't go to that unless nothing else helps. And it has to be a LOT of things hurting. I'm trying to stretch a prescription to 8 or more months, and I do keep track of when I use it. Then, it will be seen that I am not abusing it.

For RA pain I prefer meds which stop the flares, like DMARDS and biologics. Like I said, pain killers don't do much for me, with a bad flare. I didn't take pain meds much before my meds failed 2 years ago. My goal this summer will be to try and cut down and get off Nycunta. I have been off prednisone for 6 weeks, after 2 years on it. So I know it is possible, provided Orencia, Arava and mthx keep working. I've been taking decongestants for over 2 weeks for this daycare cold, and my liver is really stressed out. Nope, I won't be doing those blood tests till the cold gets out of my lungs, and I can tell my liver is doing better.

Hi,

I have had RA for about 40 years. I was diagnosed in the 80s before they knew what caused RA or how to treat it. I took NSAIDS, I took gold injections. I was a human guinea pig. Only ONCE in all those years did I use pain medication.

now i am in remission. have been for nearly 10 years on enbrel, then humira, now orencia and the methotrexate. in between when the medications stopped working i went on prednisone.

if you have RA you need to get on proper medication. pain meds will help the pain but it will not stop the progression of the disease...and that can be serious.

The only thing that will halt the pain is proper treatment/management. Use ice or heat whatever feels good. Myself it's heat. Use splints, compression garments. I have found NSAIDS work best. I have had some relief in hands with Aspercream with 4% lidocaine but it is short lived. I have not found opioids to be very beneficial.

When I first got RA, I was sent to a special, government physiotherapist, who specialized in RA. One of the things she did, was put one arm in an ice bath, and the other she did hot wax.

I was really flared in those days, and the heat of the hot wax hurt so badly I just started shrieking and she had to run over and strip it off. The other arm was so happy in the ice bath, she did it for the poor arm that had just been with the hot wax.

She said people are usually one way or another, I guess I was the ice bath type. Except, I really don't like cold, I like heat. So any kind of pulled muscle, I heat, or at least alternate heat and cold.

I do use Diclofenac cream, but I don't find it helps the joints, although it can soothe tendon flares!

It will take a long time for this to gain wide acceptance, but medical marijuana will become our best solution for pain, in time, There is so much resistance from doctors, insurance and politicians for opioids, and NSAIDS are far more dangerous than you probably believe, but there have been great advances in MMJ. You don't have to get stoned, but even if it doesn't relieve pain, think how nice it is to not notice it. Seriously. You will see a great market-based influence to push MMJ. I think it's a good thing, but sad that it takes capitalists and corporations and politicians to make this happen.

It's been a long time, but I think I have a joint stashed somewhere...

to each their own. whatever supports you in your tool kit with this crappy disease. I have medical marijuana in my state. I have state medical and recreational use in my state. i support its use medically and otherwise for the world. some folks on here have to have their pred, others their nacotics of their nsaids. some have been cured with their biologics. some go to naturopaths.

I try to remember also that Biologics are not the panacea they are for some, in my particular case, only, because I have so many interruptions due to infections on them over a decade and consistently.

Currently treating another infection. I was on orencia for two years. the other biologics too many to mention.

it's a complicated disease with no one protocol. i think of the rheumatologists primarily as script writers and those protocols work for some and not for others, based on co-morbidities and just plain crappy luck I guess. My rheumatologist does not share my cynicism, of course. But she has not been the one enduring the infections and stops and starts and other weirdo reactions like hematology ones and the doubled cholesterol on actemra and the rashes on plaquenil and sulfasazline.

depot

Tramadol is working well for me for pain, and I've learned through trial and error that if I take two before bed and get a decent night's sleep, I can often forgo it entirely the next day. (My Rx was two tablets up to three times per day.) I take Celebrex for inflammation, and that seems to be most effective for me when taken in the morning. Some of my achy parts respond extremely well to chiropractic care. Some of them prefer a good soak in a hot bathtub. Most of them would really like to down a bottle of wine but I'm vetoing that for the time being.

My rheumatologist seems totally unconcerned about the Tramadol, but I have a family history of addiction and have seen a few little things in my own personality that lead me to believe that I could be at risk. So I'm not taking that pm tramadol automatically; I'm stopping and inventorying various body parts, asking them if I need it or not. ("Yo, shoulders, how we doin' this evening?") It's a majority rule decision based on assessing all of the achy bits. Lately I've needed it about four nights a week.

joline, no "you don't have to" but really if you must might as well have fun with it.

Oh, to the question...only thing I've not seen listed that I do or have tried (except joline's of course since this is a public type forum) is Frankincense as a topical.

Don't have to nns2, and haven't for longer than I care to admit. Sad to say for a child of the 60's.

Couple of things: people, be careful with NSAIDS. please. They will affect your liver and kidneys, and, even your heart. Be sensible.

Also, Katie... when I was in deep pain, sometimes between drugs, my doc prescribed what I needed. I immediately felt a stigma to taking opioids, so I took "as needed." It took 3 tries for him to convince me to take "as prescribed." I took a lot of pain meds, but said that if I became addicted, we could deal with that later. Great doctor. Anyway, that brings me to my point: I have two close friends who a hell of a time breaking from Tramadol. I'm sure you've got this, but just a heads up.

re nsaids: prescription only. i take em sparingly joline but I like having them in the house. and when I do take them I need narcotics, I just have, no choice, but to take nsaids - rheum and primary and pain management areas do not script for narcotics, period.

I have tried neurontin. too much of a sedating effect. nsaids are an option in the toolkit. nothing more. I also am off biologic and/or dmards for pneumonia frequently so I see-saw. having the nsaid around so I can walk is important. everyone on meds should know their most recent kidney and liver function numbers. you probably should be able to answer what your most recent vitamin D number was also if you are self dosing that vitamin

good advice. I feel that way about pred for myself BUT we have a ton of folks on here who do daily maintenance pred. every person has to weigh so much before carefully considering their poisons.

depot

Celebrex & opiates are the pain meds I use. But I also have a pain contract including pill counts & random drug test. My doctor really monitors her patients. Once we find a dmard/biological combo that works I hope I can get off the opiates. Without them I would be bedridden so I choose the meds. Especially since I have kids to keep up with the best I can. Neurotin & other nsaids didn't work for me.