I would like to know which pain medications work the best for everyone.
I was sent to a pain management doc about a year ago, but not for my PsA. Along with PsA I also have chronic intractabe migraines. I had been going to the ER so often for my migraines that my doctor sent me to pain management.
i see a neurologist as often as I see my Rheumy. My rhuemy was having me take naproxin for my joint pain. However, there was a month when my liver bloodwork came back very elevated, so my rheumy had me stop the naproxin and also had me reduce the pain medication that my pain doc had given me. The following month my liver was back to normal.
Because I am a teacher there are limits to what I can take for pain. My pain doctor has me on Nucynta. It has dramatically helped my migraines, and has dramatically cut down on my er visits. However, it doesnt seem to do much for my joint pain. If I stopped the Nucynta I could go back on naproxin, but then my migraines would become more frequent and worse.
I take 25mg of methotrexate once a week and my enbrel. Im also taking cymbalta. My neurologist has tried every triptan on the market to rid of my mifgraines, and ive failed them all except for Relpax, which only sometimes helps and my insurance only covers 6 pills monthly. I also take a calcium channel blocker and an anti- siezure med as prophalactic migraine meds.
To say Im frustrated would be a total understatement. My rheumy and neurologist are in the same group so they speak regularly to monitor my meds and my symptoms.
My neurogist recently referred me to UCLA where they have a headache clinic and a handful of headache specialits. Im looking forward to going there for some possible treatments that i havent yet explored.
So…what do all of you do for pain? Im at the end of my rope. Any thoughts would be incredibly appreciated.
My current favourite is Tramadol. Good pain relief without too much drowsiness or head fog. I know others have said that it does nothing for them, or it makes them feel awful. I guess I’m lucky, except that this is one of the few drugs my insurance won’t pay for. And they are expensive!
I'm not to sure about the headache thing, but you need to have a come to Jesus meeting with your Rheumy. Strange as it may seem it CAN be PsA related. Once I got the inflamation under control the migraines all but quit. Even now with a too thick pillow etc I find I wake up with that Oh Oh feeling, something is coming. Some massage, ice on the back of the neck etc sometimes stops it. And yes they were genuine certifiable migranes.
@tntlamb: this has been my suspicion all along. My rheumy said there may be a connection, the neurologist does not think so. However the migraines pre date my psa diagnosis by a couple of years.
@seenie: I have tried tramadol…wasn’t a good match for me. I did have many of those symptoms you mentioned and couldn’t function in front of a class of kids. Thanks for yo ur reply.
I had three shoulder surgery's, three knee surgeries, 2 heart caths. a death sentence due to congestive heart failure. (that one hurt - we blew a lot of retirement $$$ on a Mediterranean farewell cruise among others) Before I was Dx'd with PsA.... Now I'm broke, headache and heart failure free. I wouldn't worry about the order of Diagnoses. But you need better control of your PsA for your joints if nothing else.
Ibeth said:
@tntlamb: this has been my suspicion all along. My rheumy said there may be a connection, the neurologist does not think so. However the migraines pre date my psa diagnosis by a couple of years.
I've been on pretty much all the pain meds. Currently I find that Tylenol with Codeine works for keeping me functional during the day, and taking the edge off the pain so I'm not weeping, and can power through. It can seem like a baby aspirin for serious pain, but it really does work to take the very edge off without too much impact on function.
I can no longer take the Vicodin class of meds, because I developed heart palpitations after many years. So I have percocet for serious pain (I take it at night if I need it), and the Tylenol-3 for day.
I've tried the long acting narcotics, like MS-Contin, and that was helpful when my disease was out of control and I had an internal bleed and couldn't take any NSAID's. But I've found that overall the short-acting meds work better because I need that burst of pain relief more than a steady dose.
Hey Beth, I take Tylenol #4 and Percocet 10/325 for pain relief. I specifically asked for these do to strength and Acetaminophen content. The #4 work great for frequent use and are less likely to give a "re-bound" headache. Also, I can still function normally when I take them. The Percocet on the other hand are stronger.
Percocet are class II narcotics and are Oxycodone also NOT time-released. Not time-released meaning you get 10mg (if you're script is 10mg) all at once. Some people like Oxycontin, wich ARE time released. If you try percocet I would suggest getting the 10/325 and trying a half pill first. This way you get llike 5/162.5 but, still have a whole dose if you need more. They will give you more energy wich, is a good side-effect, IF you you don't over-do-it! The negatives I have found are; you will get rebound headaches and if you take them at night you WILL BE UP ALL NIGHT!!!!
Tramadol? I never tried it. I found out it isn't a narcotic so figured it sucked(haha). The thought of a pill telling my brain that I don't have pain doesn't make sense to me. I don't believe in hypnosis either. But, I believe things work for some and not others so, trying can't hurt.
I, too, have found that since I have been in treatment for PsA, my migraines have dramatically lowered in frequency.
tntlamb said:
I'm not to sure about the headache thing, but you need to have a come to Jesus meeting with your Rheumy. Strange as it may seem it CAN be PsA related. Once I got the inflamation under control the migraines all but quit. Even now with a too thick pillow etc I find I wake up with that Oh Oh feeling, something is coming. Some massage, ice on the back of the neck etc sometimes stops it. And yes they were genuine certifiable migranes.
Same here, Ibeth. In fact, I think it was related and an ominous sign that something inflammatory was smouldering.
Ibeth said:
@tntlamb: this has been my suspicion all along. My rheumy said there may be a connection, the neurologist does not think so. However the migraines pre date my psa diagnosis by a couple of years.
I’ve only ever been on anti inflammatories, but nothing ever really works that great. Currently on 200mg of celebrex, which makes me functional if achy. Everything else either didn’t work or gave my terrible stomach problems. In also in beta-blockers which is a good migraine prophylactic, though I take it for palpitations and fast heart rate.
I hope you find something that works for you! I’ve been on 3 or 4 diff ones this year before we finally settled on the celebrex, so I know it can take some experimenting to find something that works.
You mean all those headaches I had while I was on Enbrel could have been the PsA I did not know I have? Those headaches last six months after I stoped taking Enbrel. The only good thing narcos is sleeping and well headaches. I will stick to an occasional Celebrex for pain.