Thank you Michael. I already take Celebrex, Enbrel, and Methetrexate. The Fentanyl would be only for a week to 10 days. If PT hasn't helped by then I am getting the SI joint steroid injections that I got a year ago. I have Failed Laminectomy, SI joint disfunction, Piriformis, and bursitis. I have been in several car accidents, so some of my aches and pains are not a result of PsA.. This pain is constant and I tolerate it until it is unbearable because I had a reaction to steroids. My PsA is moderately controlled with flare-ups. The strongest medication I have taken is percocet after surgery and last year before I had the injections. I've had one hip replacement and if it would get rid of this pain, I would have another.
Well there is one, Don't know that works as a muscle relaxer........ Valium Muscle relaxents will knock you out, but honestly a relaxed muscle will cause increased nerve pain. Every surgical option, bracing option and PT goes to the same purpose to provide stability. A good muscle relaxant or valium does anything but.
The only thing that has ever worked for me is a tens unit.
I use a tens unit, my PT said I was using it too much.
Muscle relaxants will not cover this kind of pain, as it’s not related to muscle spasm. A medication like gabapentin/ neurontin might be a better choice since they are for neuropathic pain. Sciatic pain/ SI pain is usually related to nerve entrapment.
The injections, like you had in the past, can be given under light sedation. That would prevent the vasovagal response that you had before. The swelling in your face was very likely related to the steroids; it’s very common. There is another procedure that does not use steroids but will ablate the nerve endings at the inflammation site. That can also be done under light sedation. It usually lasts quite a while longer than the steroid injections do.
Andy said:
Well…my pain is getting worse by the minute. I have 3 different muscle relaxers, Flexeril, Robaxin, Baclofen and I have neurotin…all from various injuries and joint problems. I’ve looked online to find out which is best for SI joint pain, but I couldn’t find anything specific. Does anyone have experience with these muscle relaxers?
Andy said:has anyone found a muscle relaxer that helps?
Hi andy
So sorry to hear you are in so much pain at night. One word - SALONPAS ( if skin will allow ) - these babies really help for the daytime but I take it off at night so I can....
...use a heating pad, stretching and hot baths for this every night for so long I cannot remember. I now have an electric blanket and it is like the difference between night and day. I cannot sleep on my right hip. I just take that as a given and sleep in a different position for as long as my pain level will allow. Then I get UP! I have a huge variety of quiet things I can do in the spare bedroom such as reading, music, movies and crafts that are quiet. It seems to help just to know I don't need to just lie there and suffer. I have been in your shoes, it is not a pleasant walk,but you can do this thing!
When I get stressed over just retiring for the night, my entire outlook becomes a living hell. Try to think of pain time as reflection time or personal time and if you can--- fill it with something to take your mind and run without you.
I am at least feeling at peace with myself when I do this every night and the bonus is this is much less irritating to family members for me !! Besides hard narcotics make you wake up DEAD--------LOL
My husband had spinal nerve ablations for his severe bone spurs on the interior of his vertebrae and they helped for a long time. Over two years in a few of the areas. They are not at all fun but they kick in and you are not laid up following the proceduer. Check into it ...could be an option to discuss with your reumy/osteo Good luck!!
Andy said:
Well, it's been about a month since I posted this discussion. I didn't get to see my ortho doctor because his wife went into labor. I saw a resident and he sent me to physical therapy. I've been going 3 days a week for almost 3 weeks. The low back pain is easing up a little, but the SI, piriformis, hip...is worse. My family doc has increased my pain meds twice, they wore off after about 2 hours, so today she prescribed a Fentanyl patch for about 10 days. If I am not better I will HAVE to get an injection. But I will only get one this time, so hopefully I won't have the side effects.
The pharmacy said my insurance requires that I try either oxmorphone er or morphine er; I have never taken any of these drugs.HAS ANYONE TAKEN ANY OF THESE 3 DRUGS? Is the Fentanyl patch better for controlling pain than oxymorphone er or morphine er? PT says my leg is shorter on the painful leg. WOULD A HIP REPLACEMENT STOP MY PAIN? WHEN I HAD MY LEFT HIP REPLACED, THEY LENGTHENED IT; BUT NOW MY RIGHT SIDE IS SHORTER !##%!!...excuse my language.
I have frozen shoulder pain too, and my hands are getting numb. I am in for a painful sleepless night.My physical therapist believes the numbness is most likely from my neck instead of my shoulder. HOWEVER, MY CHOLESTEROL AND KIDNEY FUNCTION WERE GREAT. I am wondering if I want to keep trying to take care of my health so I can live longer--if I will be living with this much pain.
Sincerely,
Aggravated, Angry, Agonizing Andy LOL
I'm still having the same pain. I've been in PT a month or so. I have a pain evaluation January 8, 2014. They think I need a right hip replacement. I'm stopping Enbrel and methetrexate, because it does nothing for this pain and causes depression and fatigue.
I have taken the oxymorphone ER. (Opana ER). I like it a lot. It controls my pain for a long period of time without making me feel “high” like one can from the shorter acting drugs. It will take some adjustment and will take a few weeks to figure out what dose will work for you. We started on a low dose and gradually tapered up to a therapeutic dose. It has truly been a life saver for me. I like feeling better, but not feeling dopey. I do have some probs with constipation so my doc added Clace which I take every other evening. Since I added it in, I have no probes straying regular in that department.
Has anyone on your care team suggested orthotics or a lift for the uneven leg? It is worth a shot if it delay or omits the need for surgery.
Andy said:
Well, it’s been about a month since I posted this discussion. I didn’t get to see my ortho doctor because his wife went into labor. I saw a resident and he sent me to physical therapy. I’ve been going 3 days a week for almost 3 weeks. The low back pain is easing up a little, but the SI, piriformis, hip…is worse. My family doc has increased my pain meds twice, they wore off after about 2 hours, so today she prescribed a Fentanyl patch for about 10 days. If I am not better I will HAVE to get an injection. But I will only get one this time, so hopefully I won’t have the side effects.
The pharmacy said my insurance requires that I try either oxmorphone er or morphine er; I have never taken any of these drugs.HAS ANYONE TAKEN ANY OF THESE 3 DRUGS? Is the Fentanyl patch better for controlling pain than oxymorphone er or morphine er? PT says my leg is shorter on the painful leg. WOULD A HIP REPLACEMENT STOP MY PAIN? WHEN I HAD MY LEFT HIP REPLACED, THEY LENGTHENED IT; BUT NOW MY RIGHT SIDE IS SHORTER !##%!!..excuse my language.
I have frozen shoulder pain too, and my hands are getting numb. I am in for a painful sleepless night.My physical therapist believes the numbness is most likely from my neck instead of my shoulder. HOWEVER, MY CHOLESTEROL AND KIDNEY FUNCTION WERE GREAT. I am wondering if I want to keep trying to take care of my health so I can live longer–if I will be living with this much pain.
Sincerely,
Aggravated, Angry, Agonizing Andy LOL
I WOULD NOT RECOMMEND THAT ANYONE ELSE DO THIS. I have no swelling and absolutely no psoriasis, and I haven't for a couple of years. It appears my current problems are mechanical ones, not directly related to my PsA.
Andy said:
I'm still having the same pain. I've been in PT a month or so. I have a pain evaluation January 8, 2014. They think I need a right hip replacement. I'm stopping Enbrel and methetrexate, because it does nothing for this pain and causes depression and fatigue.
What do you suspect caused the mechanical problems????
I needed a left hip replacement for about 6 years and I didn't have health insurance. I stood 8 hours a day at work. When I finally got insurance, I got the replacement, but I needed spine surgery too; because of the damage. I've been in multiple car accidents too! When I was young I thought I was invincible, my husband was a home builder and I worked just as hard as he did.
I found information about the drugs I take. I was never told about these side effects, I think everyone should know this is possible so they don't think they are losing their mind
http://www.ncbi.nlm.nih.gov/pubmed/23829886
Anxiety, depression and suicidal ideation in patients with rheumatoid arthritis in use of methotrexate, hydroxychloroquine, leflunomide and biological drugs.
CONCLUSION: Greater scores for depression, as a comorbidity of rheumatoid arthritis, increase the rate of suicidal ideation and depression also can worsen general pain, hardships, treatment denial, and prognosis, as well as cause a faster reduction in quality of life. Patients taking biologic DMARDs (drugs known as disease-modifying drugs) had the highest rates of depression, anxiety and suicidal ideation among all patients studied. The current analysis showed that psychiatric aspects such as depression, anxiety and even suicide ideation, may differ between groups of patients with arthritis according to the drug used, serving as an alert to the importance of considering also this factors in therapeutic decisions.
Perhaps one of the stupider studies in while. I think you will find that the levels of depression, anxiety and suicidal ideation in patients with these diseases are not much different taking the drugs or not taking the drugs. In fact it is one of the more common symptoms of these diseases.
The reason those factors were never explained to you as a side effect is because there is no evidence they are a side effect of the medication. I'm not going to launch into a long dissertation about causation and association, because frankly I'm just tired of it all. Everyone is free to do as they choose. If they want to make life altering decisions based on anecdotal information from strangers on the internet as opposed to face to face learning from folks (their physicians) whi spent 12 or so years preparing to offer information so be it.
I will repeat one more time, because you find a study in the NIH archives its not true (or even close) Had the study you are referring to been turned into me as a class assignment, it would have received a failing grade. Try this one
Thank you, I am trying to find a reason for the sense of doom I feel all of the time. I never felt this way, even when my PsA was not diagnosed and raging.
tntlamb said:
Perhaps one of the stupider studies in while. I think you will find that the levels of depression, anxiety and suicidal ideation in patients with these diseases are not much different taking the drugs or not taking the drugs. In fact it is one of the more common symptoms of these diseases.
The reason those factors were never explained to you as a side effect is because there is no evidence they are a side effect of the medication. I'm not going to launch into a long dissertation about causation and association, because frankly I'm just tired of it all. Everyone is free to do as they choose. If they want to make life altering decisions based on anecdotal information from strangers on the internet as opposed to face to face learning from folks (their physicians) whi spent 12 or so years preparing to offer information so be it.
I will repeat one more time, because you find a study in the NIH archives its not true (or even close) Had the study you are referring to been turned into me as a class assignment, it would have received a failing grade. Try this one
just hang in there.....depression is depression and you have to fight the battle every day. Everyone will tell you what to do or not to do but you must find a something "within yourself" to battle this . I fight every morning to find a good reason to start my day and every day I make myself win. I have found no person, drug, study or magic button that can fix this. Just me- I am in control of my every thought and I can choose to change it. It is the hardest battle you will fight and it doesn't end.
Keep yourself surrounded by things that make you happy and fight for your right to be happy!!!!!!!!!. If you have to scream at yourself in the mirror . Remind the person there that you are in control ... the disease just makes your choices different than they used to be. XXX and good thoughts coming your way
It's fatige too. It's been almost 2 weeks since I took PsA meds, and today I caught myself dancing! Even when PsA was at it's worse I could work 8 hours a day on sheer determination. I have not had any swelling or psoriasis in almost 2 years.
crazylady said:
just hang in there.....depression is depression and you have to fight the battle every day. Everyone will tell you what to do or not to do but you must find a something "within yourself" to battle this . I fight every morning to find a good reason to start my day and every day I make myself win. I have found no person, drug, study or magic button that can fix this. Just me- I am in control of my every thought and I can choose to change it. It is the hardest battle you will fight and it doesn't end.
Keep yourself surrounded by things that make you happy and fight for your right to be happy!!!!!!!!!. If you have to scream at yourself in the mirror . Remind the person there that you are in control ... the disease just makes your choices different than they used to be. XXX and good thoughts coming your way
It may seem really simple but hot baths, heating pads and tiger balm arthritic cream work better for me than t3s, morphine or any other pain killer :).
Good deal andi!
you are fighting and on the winning team for you again.West_ coast meg is right,, a good heating pad, a hot bath, your favorite rub and a good book can help more than any thing in any DR's arsenol. I am so happy to hear you felt like dancing!!! That is wonderful :) Good music helps as well, I don't know about you but a little Fleetwood Mac- way up LOUD can always fix my mood. Dance little girl dance....
I think my depression will have flown out the window pretty much. I came back form my Neuro appointment yesterday with a lot of news . First my new DR. didn't exactly apologize for the things his partner wrote in my chart last year about me being an, ""anxiety prone, menopausal woman with thyroid issues"", but he did rectify this with the correct diagnosis. I discussed this with him as I gave him the documentation from my REumy and we discussed removing these hateful words from my records. They cannot be expunged but they can be rectified!!!!!!
They have been replaced with the truth . I have extensive nerve damage in my legs and feet due to an MVA twenty-one years ago. I also have four eroded vertebrae and severe migraines. i am scheduled for a nerve mapping and a lower back MRI asap!!! All of this on top of the Psa , osteo and fibromyalgia!!!! Nice soup of issues but they are being addressed properly now. I don't care what gets dropped on me now that I have come full circle and that Humiliating/ embarrassing crap will no longer be an issue in this woman's life. I have found myself again... I am woman hear me roar!
Love your courage and keep on taking care of you....Roar with me Andi -you are makin' it girl!!!!
XXXXXXX Happy New Year
I have also used a S I belt. It's worn low on the hips and supports the pelvis. You can find them online.
Hi Mom5,
How did your doc diagnosis that your pain was originating from your piriformis? I'm having a lot of hip pain and sometimes goes down the outside of my thigh and top of my thigh.
How long did your injection work to eliminate the pain? Who administered the injection? Your rheumy?
Thanks for your help - I'm trying to get some relief.
Frances
mom5 said:
I had an injection to my piriformis Monday. It seems to have worked. It was my first piriformis injection. Have had several si injections, prolotherapy, and a nerve block. Was in pain management at one time. Not on narcotics now and am doing well pain wise. I wonder how safe these drugs are longterm but I will have to take them or live in misery. I am 42 and before I got on treatment felt much older. I'm gonna have to take care of my health and rest when I need to. This rheumatologist measured my buttock and did the injection. It seems to have relieved the huge pain in the butt I have had for so long. It was terrible 24/7 pain. Like demonstrated in the above picture my nerve runs through the piriformis.