What pain medication works best for you?

General
1

I'm curious what your preferred pain medication is. It doesn't have to be something you're currently taking, and **I don't want this to turn into a debate about the merits or problems of pain meds**. Just curious what works best for you.

I've tried most everything except medical marijuana, and I find that Tylenol with codeine is best for mild pain, and Percocet (can have multiple names, non-time release type) best for pain that make me think I'm going to burst into tears. I'm always curious about what works for others, however.

I'd love if people would share their most effective / preferred pain medication, even if you currently don't take it / have access to it.

2

I'm curious too. I just started Naproxen last week. I find it helps most of the time but not all the time. I wonder how long I should give it or at what point I should speak to the Rheumy about other alternatives.

3

Mine was a patch which I thought was a fenyal patch. I also do better with Advil. Sleeve did nothing for me. I also found that a compound which I rub on just a specific area also works.

4

My doc has me on slow release morphine every night. I have a cream for ‘oh that is sore’ tramacet for ’ I had better do something cause that hurts’ and morphine for ’ ok, amputation would hurt less and might just be an option’. I also use a tens machine as needed to try before the tramacet. My doc and I are both in agreement with the approach although she wishes I did not ever get to the amputation as option phase.

5

Actually, I

6

Also, a good massage helps release the tension and pain in my butt and hips.

7

I use Percocet for really ouchie pain and it is by far my favorite of the opiate pain meds. The others make me a little whacky. With this, I also take ibuprofen, flexeril. There have been times when that will not work and I end up in the ER for some iv steroids and Dilaudid. I’m not fond of how either make me feel, but they do nip the pain very quickly.

I also just got a compound cream that is pretty wonderful.

8


What is the compound cream?


GrumpyCat said:

I use Percocet for really ouchie pain and it is by far my favorite of the opiate pain meds. The others make me a little whacky. With this, I also take ibuprofen, flexeril. There have been times when that will not work and I end up in the ER for some iv steroids and Dilaudid. I'm not fond of how either make me feel, but they do nip the pain very quickly.

I also just got a compound cream that is pretty wonderful.
9

I use Meloxicam for my NSAID and Lortab 5/375 for my opiate. I take it about 4-6 times a day most days. I found a homeopathic cream that works amazingly well. It's called Arnicare and they sell it at Walgreens. I'd like something longer lasting for night but we are waiting to see if Remicaide works so that I don't have to start another med for pain. Two infusions so far and just a tiny bit of relief.

10

I am using narcotic free pain relief (which is an entirely different conversation, and my doctor made the decision along with me). For pain I take Tramadol which is a synthetic opoid and Cymbalta daily. I also take Azathioprine and prednisone daily. I am on injectable weekly Orencia as a biologic (it isn't FDA approved for PsA so I am getting it off label). For flares I inject Toradol 30mg/ml IM and follow with 5 days of Ketorolac pills.

I know the prednisone, Orencia and Azathioprine aren't pain medications. They do however lessen pain from the disease.

I have a TENS machine as well, sometimes it is a real help with a pain in a specific area. I also wear wrist splints when I sleep at night.

This is working for me well enough, the pain never really goes away completely. I am on SSDI so I have time to take care of myself now, and that is a blessing.

11

I haven't found what works best for me yet :)

I'm curious to see what works for most people also.

1 Like
12

Hi Marietta,

I'm 62, was diagnosed with PsA when I was 18, so I have tried just about every treatment out there. The one and only pain treatment I've NEVER been offered is ANY type of opioid. I have asked for something to use on an "as needed" basis when the pain becomes unbearable, but all my rheumies have flatly refused! They want to put me back on prednisone or metho or one of the biologics or cortisone injections.............anything but pain killers. I understand that the pain of PsA is basically from the inflammation, and when I ask why can't they give me a simple anit-inflammatory AND a pain med to take until the anit-inflammatory kicks in, I'm just ignored. I also have CAD (coronary arterial disease) and have 2 cardiac stents. My cardiologist has told me that in his opinion, with my current heart condition, that medications like Remicade and Celebrex, plus a few others, are just not worth the risk. I tend to agree since the pain of PsA will not kill me, but some of these medications my rheumie doctor wants to put me on could. When I said "no" to Remicade, I have no doubt he wrote that I was "non-compliant" in my chart. I am angry and frustrated and currently take nothing for my PsA pain, which is, at times, as you all know, beyond bearable. I don't know where to turn. I will not go back on prednisone, metho or ANY of the biologics, and all these new drugs they're coming out with all mention in passing that if you have any kind of cardiac issues, you probably shouldn't take them. I have literally destroyed my stomach with OTC meds and can't (or won't) take them any longer. Besides, I had to take such massive doses for the most minimal relief, that's what blew my stomach out.

A few months ago, I was visiting a friend who had just had her second knee replacement. She gave me 5 of her fairly strong Vicodin tablets. I put them away because at that time my pain was "normal" and I was dealing with. But one day it was really bad and I decided to try one of her pills. It made me pretty tired, but I wasn't doing anything but laying on the couch anyway, and I will admit it made me feel a bit "loopy," but nowhere the point I couldn't think right or function. What I remember is that for the first time in what seems like forever, I had NO PAIN! ZERO! It was the most wonderful feeling in the world. I wish I hadn't slept through most of it! LOL But even after I woke up, the pain was virtually non-existant. My ROM was still as bad as ever, my knee was still the size of a small elephants, but I had no pain!

I haven't taken any more of the pills as I am hoarding them for another really, really bad day.

My question, and I'm sorry it's taken me so long to get to it and there's been a lot of whining going on in between, is this. If you or anyone here has a doctor that prescribes pain meds for them, could you tell me WHY he/she feels that it's an OK option, but my doctor does not?

13

Metho works the best for me, however it’s not something I want use. Tramodol or whatever is ok, but kind of loses it’s effect if use it more than a couple days.

14

Thats a good question.It varies by state, but there are some draft proposals on federal level. Some of the provisions in the AHCA are designed to streamline the policy. I can only imagine these docs (rheumy and GP practices) must be running one of the few independent practices left (as the hospital based practice will rarley allow it), are operating without malpractice insurance or have their state practice commissions paid off.

There are circumstances where docs out side of pain management practices can prescribe controlled substances (in many states tramadol is considered a controlled substance and will likely be so on the DEA list by year end) They are however severely limited limited in the amounts and duration. Generally a written prescription is required (outside of pain management practices) every 7 - 14 days and the patient must be examined for each renewal. In most states the prescription must be registered by both the pharmacy filling it AND the healthcare provider. Pain management practices have a bit more flexibility but still operate under a lot of "rules" they are usually limited to 30 days, have to perform periodic surprise pee tests etc etc and can only take referred patients There are still a few states where these rules aren't mandated, but they will be shortly.

None of this is to deny pain meds to those who need them. In fact in MANY ways, it will insure a supply. Rheumy's are NOT TRAINED to use long term pain management drugs. Its not their job. Their only job is to diagnose and control disease/inflammation.

So I am sorry it took me so long to get there, but I have no idea WHY a doctor (Rheumy) that prescribes pain meds feels that it's an OK option. Its professional suicide and definitely not in their patients best interest. its about the same thing as asking your proctologist to take a peek at your heart while he is in there.


greenlydia said:

........My question, and I'm sorry it's taken me so long to get to it and there's been a lot of whining going on in between, is this. If you or anyone here has a doctor that prescribes pain meds for them, could you tell me WHY he/she feels that it's an OK option, but my doctor does not?

15

I just go to my GP for pain meds. A two month’s supply last me more than a year. Also, if you have to go to dentist or any kind of procedure, simply ask for them. My dentist seems to hand them out like candy.

16

Hi Greenlydia!

You've been at this longer than me (I've been at is only 31 years, dx age 10). The first time I took a pain med for PsA 14 years ago it was because I had bottles of Vicodin handed out like candy from my dentist. One day the pain was overwhelming (a post-partum flare), and I took 1/2 a pill. I couldn't believe how much better I felt even days later, just from having that short relief from the pain.

I talked to my rheumatologist about it and we decided I should have some meds for as-needed. He is trained in pain (medication as well as theory), and discussed how eventually like wearing grooves in a record, the pain will wear a groove in your brain making the pain path much easier to trigger. Taking the pain medication can short-circuit the pain response, which explains why I had less pain even days later. The studies on this are quite fascinating.

At any rate, fast forward a few years, when I had a very serious internal bleed (surgery, blood transfusions, the works). At the time, I was on my 16th year of high dose NSAID's (standard treatment at the time). That, combined with Zoloft (studies have since shown the combo can cause internal bleeding). Since then, I can only very rarely take an NSAID. By then I had had my 2nd child, and as many of you have experienced, a horrific postpartum flare. At that point, my rheumy. prescribed pain meds so I could, somewhat, care for my new baby and my toddler, since NSAID's were out of the question.

Then biologics came on the market. For the past 11 years I've had varied success with them. When my disease is more active, I take more powerful pain medication so I can do the bare necessity for my family. When my disease is more under control, my pain is significantly less and sometimes Tylenol is all I need.

Different states (and different dr's) vary dramatically in how they deal with pain medication. I'm not sure why your dr, if not willing to prescribe for you, has not referred you to a pain clinic.

I live in the Seattle area, and most of the people in my autoimmune disease support group get pain medication from their rheumatologists. There are a few dr's here and there who won't touch it though. The people in my group who do use pain medication, including myself, are able to get month long supplies with 3-4 refills without going in for a new appointment. I will be clear, it is never offered, patients have to ask for it, just like a disabled parking pass. When I lived in AZ, pain medications were much for tightly regulated (each month's prescription hand-picked up and delivered to the pharmacy).

Greenlydia, I wish you well in your journey.


17

Tylenol w/codiene takes the edge off of the pain for me -- but it seems it promotes a dull head/neck ache after a number of days taking it -- along w/the need for eating prunes ;)

Extra-strength Tylenol is what I use day-to-day.

MD asked me to keep a good handle on the dosage and number of pills to avoid hurting my liver.

18

I’m out right now, but should have it in a week or less. I’ll post it when I have the bottle.



Frances said:


What is the compound cream?


GrumpyCat said:

I use Percocet for really ouchie pain and it is by far my favorite of the opiate pain meds. The others make me a little whacky. With this, I also take ibuprofen, flexeril. There have been times when that will not work and I end up in the ER for some iv steroids and Dilaudid. I’m not fond of how either make me feel, but they do nip the pain very quickly.

I also just got a compound cream that is pretty wonderful.

19

Rebound headaches. That’s one reason I don’t care for narcotics. Tramadol seems not to give them, but stops working after a couple days of use.

20

Norco, tramadol for break through if its severe. However I often break the norco in half and add Tylenol.