I'm wondering what the differences are between anti-inflammatory medications and what the options are for PsA patients in general.
I also have a question about my situation ... I have autoimmune hepatitis and cannot take NSAIDs. Are there options other than prednisone?
I’m afraid I’m not aware of any. I can’t take NSAIDs either, so I’m currently at the mercy of whether the biologic of the moment works, the very occasional bit of codeine, and the “I’m despaerate” 1 day prednisone (though this last time the day after was so bad I’m going to cease and desist from that unless I think my GI problems are about to land me in hospital).
And I should also note that warm spas, massage, meditation, and a number of other things (cuddling my daughter) are all very effective, but I’m talking about when more is needed. Anyone out there with a better understanding than us that can add to this?
I am waiting to go to the Rheumatologist but, I met someone the other day that broke her wrist and she cannot take NSAIDS and her doctor prescribed her this ointment that contained NSAIDS but, it bypasses her stomach and goes directly to her wrist. That's what I want!
I found this article: http://www.ncbi.nlm.nih.gov/pubmed/22972108
And this one states it would be difficult to use for pain that is deep: http://www.cfah.org/hbns/2012/topical-nsaids-provide-relief-from-arthritis-pain#.UhTbMNLVDVo
Well they don't go through your stomach true enough........ But they do go into your blood stream but only at 10% of the rate of oral.
There are NSAID creams are sold OTC (there are prescription strength such as volatarin) speak with a pharmacist they are blended in different base creams including menthol capiscan (which should be outlawed imo) etc.
I take a regular oral NSAID but I gotta tell you I love the creams for my hands and wrists. (I have one made for me which is dicloflonac, DMSO (horse linament) and lidocain)
When my shoulders are really flaring I skip the oral and use a Flector patch which is time release a NSAID it effects primarily the shoulders but is systemic much lower SE.
If a COX 2 works for you, you may be able to get a cream made. There were patches made (can't remember the name) They came off the market because of serious side effects. (Depsite all the hype research seems to indicateCOX2 aren't that much better for either SE and maybe not as good for relief
For what ever its worth NSAIDs represent 30% of all hospital admissions for drug related causes. Consdiering the number of people purposly doing bad things to their bodies with all manner of drugs, thats concerning.
OBTW Sublime your link : http://www.cfah.org/hbns/2012/topical-nsaids-provide-relief-from-arthritis-pain#.UhTjqtKG2uJ gave me a real chuckle. Sometimes you gotta wonder if the editors of these sites read what the put on them On the right with the addition articles they have two. The first: "Evidence weak for low Back Spinal Manipulation" the Second "Spinal Manipulation Holds its Own"
I will have to look into the over counter ones, I have only seen Aspercream and it doesn't work for me. I was actually seeing commercials for Capiscan and was going to try it, I am guessing there is some good research I need to do on Capiscan and that is is not good for us?? I will ask my doctor about the patches, I think you gave me a link to the patches before. I am just waiting for my appointment, not till Sept. 24th. I wish I could just take the oral meds. It would cover my entire body :( Oh and yes that is funny what they had on the side of that article!!
Is this the same cream? http://altmedicine.about.com/od/completeazindex/a/capsaicin_cream.htm
tntlamb said:
Well they don't go through your stomach true enough........ But they do go into your blood stream but only at 10% of the rate of oral.
There are NSAID creams are sold OTC (there are prescription strength such as volatarin) speak with a pharmacist they are blended in different base creams including menthol capiscan (which should be outlawed imo) etc.
I take a regular oral NSAID but I gotta tell you I love the creams for my hands and wrists. (I have one made for me which is dicloflonac, DMSO (horse linament) and lidocain)
When my shoulders are really flaring I skip the oral and use a Flector patch which is time release a NSAID it effects primarily the shoulders but is systemic much lower SE.
If a COX 2 works for you, you may be able to get a cream made. There were patches made (can't remember the name) They came off the market because of serious side effects. (Depsite all the hype research seems to indicateCOX2 aren't that much better for either SE and maybe not as good for relief
For what ever its worth NSAIDs represent 30% of all hospital admissions for drug related causes. Consdiering the number of people purposly doing bad things to their bodies with all manner of drugs, thats concerning.
OBTW Sublime your link : http://www.cfah.org/hbns/2012/topical-nsaids-provide-relief-from-ar... gave me a real chuckle. Sometimes you gotta wonder if the editors of these sites read what the put on them On the right with the addition articles they have two. The first: "Evidence weak for low Back Spinal Manipulation" the Second "Spinal Manipulation Holds its Own"
Capiscan is not necessarily bad for us, just keep in mind its SLIGHTLY diluted pepper spray/bear repellent which can bring a hardened killer or charging grizzly to their knees. Imagine accidently getting a slight bit in a P patch or your eyes. It doesn't wash out easily (which is why its used a defensive weapon) and imagine if you are sensitive to it. (Not that any of us have sensitive skin) There are better ways to produce heat (IMO)
I believe previously I gave you link to a trustworthy compounding pharmacy in case your doc and you come up with an NSAID solution
This is the OTC that helps me most
http://www.bing.com/shopping/sportscreme-rub-3oz/p/4E65C1F31122D72C...
It is non-greasy, non-heating, non-icing no odor. You CANNOT use with a heating pad though. Available in nearly all grocery stores and pharmacies.
The creams, including the OTC ones, always did a great job on my spine. As lamb says though, you do absorb some of them - I’m not even supposed to use the creams, as even topical creams can have GI side effects.
They still need to be used as directed like any other med - there was a case of a fatality some years back from a young girl who essentially overdosed on them through putting way too much on.
This is good stuff! That was the first one I ever tried :-) I loved it because I could use it at work and not smell funny!
SK said:
This is the OTC that helps me most
http://www.bing.com/shopping/sportscreme-rub-3oz/p/4E65C1F31122D72C...
It is non-greasy, non-heating, non-icing no odor. You CANNOT use with a heating pad though. Available in nearly all grocery stores and pharmacies.
Just bought these from the store! I got 20 patches for $3.20. So far they are working really well on my shoulder!
I have used lidocane patches in the past, and they did provide relief, but just read up on them and it says to let your physician know if you have severe liver problems,for which autoimmune hepatitis qualifies. Ugh. I can't seem to find anything I can take or use other than tramadol due to liver issues and would like to go to next week's rheumy appointment understanding my options.
Amiga, I have never tried these, but the gals on the Fibromyalgia site swear by them!
SublimeAmiga said:
Nym with all due respect, are you aware of the counter-indications of Tramadol related to both Kidney and Liver?? They are equal to if not greater than some of the NSAIDs
http://www.drugs.com/pro/ultram.html
"Tramadol is eliminated primarily through metabolism by the liver and the metabolites are eliminated primarily by the kidneys. The mean terminal plasma elimination half-lives of racemic tramadol and racemic M1 are 6.3 ± 1.4 and 7.4 ± 1.4 hours, respectively. The plasma elimination half-life of racemic tramadol increased from approximately six hours to seven hours upon multiple dosing."
I buy Salonpas in a big box at Costco for 7 something. I love them! My husband knows it is a bad day when I am papered in them!
I put mine on 2 hours ago and I normally have limited movement with my shoulder but, I can honestly move it around a lot more! I am loving this!
I have met A TON of people that claim really good results from these patches. They are definitely worth a try, and they are pretty affordable. For those who are intolerant to NSAIDs there are also Lidoderm patches. These work great for soft tissue pain (for me), but don’t do a lot for my joints. I use a topical compound cream that has fiopofen, lidocaine, gabapentin, cyclobenzaprine, and one other hing that I can’t remember off the top of my head. IT IS AMAZING. Better than any pain med I have taken, including the “big guns” like Dilaudid or morphine. Plus it doesn’t make me dopey.
SublimeAmiga said:
I found the Salon Pas patches at Family Dollar are the least expensive.
My next blog will be on topical pain meds, in case anyone is interested. I’m working on it now, but probably won’t have time to publish until this weekend.
It's been about 4 hours now and I can move my shoulder with almost no pain so they did work pretty well for me! I do have a clicking sound in my rotator cuff though. I wouldn't have known that before because I wasn't able to rotate it. I just hope there isn't too much damage to my shoulder by the end of Sept. :( my appointment is Sept 24th. I am going to keep using these patches and hope it helps more. The only other patches I saw at the store were Tiger Balm which contain that pepper in it, Icy Hot (several generic icy hot but, all had menthol), and heat patches.
What store did you find Lidoderm patches? I haven't seen those yet.
GrumpyCat said:
I have met A TON of people that claim really good results from these patches. They are definitely worth a try, and they are pretty affordable. For those who are intolerant to NSAIDs there are also Lidoderm patches. These work great for soft tissue pain (for me), but don't do a lot for my joints. I use a topical compound cream that has fiopofen, lidocaine, gabapentin, cyclobenzaprine, and one other hing that I can't remember off the top of my head. IT IS AMAZING. Better than any pain med I have taken, including the "big guns" like Dilaudid or morphine. Plus it doesn't make me dopey.
Tiger Balm doesn’t have pepper in it, unless it was a different formulation than I have gotten in the past. I tried capsaicin cream. I didn’t like it much. It made my hot showers very unpleasant.
I can't use anything with peppers (or capsaicin) in it, I get a rash. I like Tiger Balm too. Lidoderm is prescription only. I have not tried it.
