When does methotrexate start to work and how do I know
What pain meds have you tried for flares?
Background info:
I've taken 6 weeks of methotrexate and I'm still on 20mg prednisone along with 15mg MTX (injected). Weeks 5 and 6 of mtx I found myself craving the medicine. On Friday night my body was really sore and it felt like I really needed the shot (which I take on Saturday). This week I got that feeling on Thursday. Could this be a sign it is working? Or maybe I'm not getting enough of it? Hard to know if it is working because of the prednisone.
I had to take antibiotics last week and although I didn't miss my sixth week of methotrexate I think the antibiotics screwed things up as I've had a major flare in my back and my joints are swollen and fiery. My doc is out this week and his partner prescribed lortab even though I'm sensitive to codeine (vomiting). Thankfully I have anti-nausea meds if the lortab makes me pukey.
Looking forward to reading the collective wisdom of the group. Cheers!
Pain meds for flares....... That becoming a really interesting area, more and more Docs are NOT prescribing them. I have had experience with almost all of the Narcs in years past, and can be a testament to NOT taking them. the do not effect the cause and in fact with their effect on the endorphins can prolong a flare. Desensitizing can occur in is a little as a week. They may zonk you enough that you function minimally which is sometimes necessary But the pain still exists and over time (remember this disease last forever) you body becomes MORE sensitive to all pain. (Google hyperalgesia) Try everything else first
The use of a predi Burst (even if on a maintenence dose) often helps. Also effective are tricyclics (some docs will adjust the dose during a flare to allow sleep (amitiptyline) I have never failed to get relief from Torodol. Some docs won't let you shoot yourself, others will.
Thanks, lamb. I have a psych nurse friend who just mentioned tricyclics to me today. I had no clue. Will keep as a question for the rheumatologist in two weeks. I've been nursing my back for three days with rest and heat and the pain and tingling is very intense. I'm usually a two advil person but that's on the banned substance list and tylenol, well, you may as well give me nothing. I hear your point on not leaning on pain meds.
I dunno, I would think it would be worth a try if for no other reason than some (women especially) are more susceptible to UTI when on biologics. There is a group in OZ (I think) who have been trying for years to claim these diseases are all bacterial caused (leaky gut, std, etc) and have promoted low dose antibiotics over years as a "cure" I know that minocyclie is recognized as a DMARDS () by the American College of Rheumatology, which recommends its use as a treatment for rheumatoid arthritis. Its a fairly new so it would be off label, but it would be VERY cool to have an MTX alternative......
janeatiu said:
also, minocycline (antibiotic) is helpful with Humira for RA. Any thought about its effectiveness for PsA?
Dr. David S. Pisetsky, MD,PHD of Duke University Medical School is following this study. It was reported in the October 2011 issue of Arthritist Today. My internist is following it for me since I was just dx this August.
I've tried and used all the narcotics over the years. Right now I'm able to get by with Tylenol-3, whole or half. It allows me to function just fine without fogginess. I did take Oxycontin but as tntlamb explain, you can get MORE sentitive to pain on it, and that's what happened to me after about a year. Plus withdrawal sucks. I did fine with 1/2 or whole Vicodin, but after awhile developed heart palpitations.
So now if it is severe I take an Oxycodone, if not as severe Tylenol with codeine.
I have had zero pain relief from non-narcotic class of painkillers, and I've tried it ALL (acupuncture, topical stuff, you name it). If I take narcotics of any kind I also take an anti-nausea med at the same time, or else I throw up.
It is best to get control of your body, and then deal with breakthrough pain with the meds. Just covering up uncontrolled disease won't help much.
As tntlamb said, many docs no longer prescribe pain meds. Sometimes they refer to a pain clinic. I'm lucky my doc gives me what I need, and I just take what I need when I need it without any hassle.
My rheumatologist don’t recommend pain meds and I generally don’t take them…have tried co codamol and tramadol but neither help the pain. Tramadol just makes me feel like I’ve been drinking and let’s me accept the pain…I’d rather have a drink lol
Have been on 10mg amitriptyline at night for about 15 years for migraine relief and when pain prevents me sleeping I double the dose…doesn’t always help though.
Only pain relief I used at the moment is a TENS machine for my SI joint pain at work…its still working well for me but I only use it when the pain is over a pain score of 6
Hello again everyone. As of my last posting here on this PsA site, tntlamb you had requested that I check back with my diagnosis from the university clinic physician. Well . . .no diagnosis yet since I haven't had the opportunity to see a Rhuematologist at the clinic. Last week I did have a trip to the E.R. (rolled/fell out of bed and couldn't do much else) mom, dad, wife, and son loaded me into a car and off we went. Anyway, my reason for replying to this disscussion is because of the narcotics subject. You mentioned that a lot of docs are not prescribing as many pain meds. What would you have to say if I told you, especially since I still don't have a diagnosis, my pain management Dr. has me on 6 @ 10mg oxycodone and 3 @ 20mg oxycontin (extended release) daily. Just kinda wondering what thoughts you might have?
My rheumatologist is another that says to avoid narcotics if at all possible and no Motrin/Advil while on MXT and Prednilosone. Tylenol does pretty much nothing but does take a tiny bit of the edge off if needed. Basically I have just been trying to listen to my body and rest when I hurt. Note: I have been resting a lot these days. :P
I dunno, I would think it would be worth a try if for no other reason than some (women especially) are more susceptible to UTI when on biologics. There is a group in OZ (I think) who have been trying for years to claim these diseases are all bacterial caused (leaky gut, std, etc) and have promoted low dose antibiotics over years as a "cure" I know that minocyclie is recognized as a DMARDS () by the American College of Rheumatology, which recommends its use as a treatment for rheumatoid arthritis. Its a fairly new so it would be off label, but it would be VERY cool to have an MTX alternative......
janeatiu said:
also, minocycline (antibiotic) is helpful with Humira for RA. Any thought about its effectiveness for PsA?
Sorry to hijack the thread but I can provide positive feedback for the use of minocycline for PsA treatment from my personal experience. If you are after more testimonials I suggest looking at the Road Back Foundation website where they can also refer you to treating Doctors in your area.
There is an alternative to MTX and it is Minocycline.
Minocycline has been used for many decades now as treatment for all of the inflammatory arthritis diseases. The original doctor Thomas McPherson Brown treated over ten thousand patients over a 50 year career before his death in the late 80's.
It is not promoted as a cure but it is promoted as the only current treatment which actually targets the origin of the disease in which the cause of inflammation is from an allergic response to bacteria from a mycoplasma infection.
It can be taken in conjunction with the DMARDS and Biologics with a view to weaning of the latter medications.
I suggest doing your own research on the treatment and I think you will have difficulty finding any persons who have used this treatment who have anything but positive experiences with no toxic side effects. People have used this treatment for decades and it does not stop working eventually unlike the DMARDS & Biologics.
There is a wealth of information in a book called The New Arthritis Breakthrough which goes into full depth all of the aspects of this treatment.
Thanks, Dave. Well worth doing some more research before my rheumatology check up. DaveAus said:
Sorry to hijack the thread but I can provide positive feedback for the use of minocycline for PsA treatment from my personal experience. If you are after more testimonials I suggest looking at the Road Back Foundation website where they can also refer you to treating Doctors in your area.
I think that is a lot of OXY. But as I recall you do have a firm Dx of Reflex Sympathetic Dystrophy, so all bets are off. PsA is hang nail compared to that. I hope you do get a firm Dx soon. Maybe a trip to the Clevland Clinic or Mayo is possible? You are susceptible to hyperanalgesia just as a a result of the Reflex Sympathetic Dystrophy with or without the pain meds. I would THINK you may be a candidate for a Intrathecal pump. It could give you pain control you desperately need with lower amounts of meds, maybe giving some life back. Coupled with some of the more modern pain management techniques, newer meds, you could be back to biking soon.
In the mean time, I know you have a great family. I don't know the ages of your kids. but I have taught young adults/teens for years. I have seen the very best make some dumb decisons or "show off" for the "bad boy/girl" who seems really hot (at the time) get a lock box for your meds. One of those OXYs could be traded for all manner of stuff especially the "club drugs" that are so popular now.
Please don't be a stranger, I miss you.....
BuickBoy said:
Hello again everyone. As of my last posting here on this PsA site, tntlamb you had requested that I check back with my diagnosis from the university clinic physician. Well . . .no diagnosis yet since I haven't had the opportunity to see a Rhuematologist at the clinic. Last week I did have a trip to the E.R. (rolled/fell out of bed and couldn't do much else) mom, dad, wife, and son loaded me into a car and off we went. Anyway, my reason for replying to this disscussion is because of the narcotics subject. You mentioned that a lot of docs are not prescribing as many pain meds. What would you have to say if I told you, especially since I still don't have a diagnosis, my pain management Dr. has me on 6 @ 10mg oxycodone and 3 @ 20mg oxycontin (extended release) daily. Just kinda wondering what thoughts you might have?
