Can't use NSAID's...what are the alternatives?

Deedumdeedo Member Posts: 17
edited 30. Nov 2010, 08:40 in Living with Arthritis archive
Hi all,
I have just posted my introduction on the welcome forum but i will give a quick background for the purpose of this post.
I have recently been diagnoised with RA in my feet, ankles and knees, As far as treatment goes i have been on NSAID's (anti-inflammatorys) for years for another medical condition i have. I started out on Diclofanac, then swapped to mefanmic acid and then finnally this year i was swapped onto Naproxen to help with the pain of the RA and my other medical condition. I have ulcerative Colitis (a bowel conditon which causes small ulcers in the bowel) and un-fortunatly the Naproxen has caused my UC to flare. My colo-rectal surgeon has taken me off all NSAID's to prevent any further damage to my bowel.
I went to see the Orthopeadics docs yesterday and they said i didn't require any surgery (yay!). When i asked about an alternative medication to either help with the severe pain or halt the process, i was told i needed to be seen by rheumys and he would make a referal. The current wait for the referal is 18weeks.... I can't go on without any help that long!!
I saw the GP yesterday and she has placed me on Steriods which should help with the inflammation BUT not the pain.
My question is has anyone else not been able to take NSAID's for their pain, what is the alternatives?
Thanks in advance!


  • cebeem
    cebeem Bots Posts: 472
    edited 30. Nov -1, 00:00
    Hi Ddddoo

    did you have stomach protectors whilst taking Diclo?
    or are they not powerful enough with the colitis?
    If you haven't had them they may be worth discussing with the GP.
    Due to another abdo condition I was prescribed these..... closing the barn door after the horse has bolted was an appropriate phrase to coin regarding that!

    May be worth asking about for the interim period.
    Good Luck
  • Deedumdeedo
    Deedumdeedo Member Posts: 17
    edited 30. Nov -1, 00:00
    Thanks for the reply.
    The problem with NSAID's is that they have caused ulcers within my bowels. I was taking Omeprozole whist on them.
    They made me so poorly i have recently spent 8days in hospital due to bleeding from the ulcers.
    Due to my other medical condtions i am currently taking oral morphine and slow release morphine but un-fortunatly they have no effect whatso ever on the joint pain. Interestingly i never suffered with my knee's before this flare up and the doc's think they are linked.
    Thanks again for the reply.
  • dorcas
    dorcas Member Posts: 3,515
    edited 30. Nov -1, 00:00
    Hi deedum and welcome to the forum :D

    I don't suffer from your bowel condition but do know from others that sometimes Methotrexate which is a DMARD is prescribed to treat both the arther and bowel symptoms....
    It is very much an individual balance though in getting the correct meds and only the rheummy and docs know what is best for each of us. :wink:

    I do hope you hear soon from the rheummy department and that they can prescribe a combination of meds that will suit your individual needs.

    Nice to have you on the forum and I really hope to see you joining in and posting on the various threads and forum(s).

    Iris xx
  • coco67
    coco67 Member Posts: 2,374
    edited 30. Nov -1, 00:00
    hi Deedum and welcome from me also.

    sorry your having so much bother, i cant tak NSAIDS, severe allergic reactions to them, have you tried the anti inflamotary gels that you can get. they might be worth a try. sadly i cant use them either as i have a skin reaction but i know a lot of people say they are good. might be worth a try.

    i hope you get something that works for you soon.
  • barbara12
    barbara12 Member Posts: 21,280
    edited 30. Nov -1, 00:00
    Hi Deedum
    Sorry I cant help with your question , but if I was you I would either go back to your GP and get an emergency rheumy appointment, you will have to get it across how bad the pain is.
    Your other alternative is to go for a private appointment with a rheumy, then they can refer you straight back to the NHS.
    I hope you get some relief very soon.
    Barbara x
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    I too am on slow release morphine tablets for joint pain: they don't remove it altogether but they do render it, for the most part, manageable. I think the term pain killer is a mis-nomer: the pain isn't killed, just dulled. I wish you well, you do sound as tho you are in a difficult position regarding treatment. DD
  • Deedumdeedo
    Deedumdeedo Member Posts: 17
    edited 30. Nov -1, 00:00
    Thank you all for the warm welcome!
    Yeah i guess with anything it is all trial and error when it comes to treatment. I think i pinned to much hope on the orthopeadic doc being able to wave a magic wand and put me on some kind of treatment to help but he litteraly said 'i am a surgeon, i do surgery not medicines, i can't help you'.
    Luckily the GP was a little more understanding when she saw how inflamed my joints are at the moment. She has put me onto predisalone 4mgs for a week and then hopefully cutting it to 2mgs next week but she has said that she will put me on a more agressive regeme if needs be...What might that mean?!? I am a qualified nurse but i must admit all of this is well out of my remit as i trained as an A&E nurse.
    The only thing the orthopeadic doc has done to help is give me a space boot which he said would distrubute my weight better and reduce the foot pain. The problems i have with this is- It helps with the worse foot but both feet are affected, it isn't helping my knee's at all in fact making my knees take the majorty of the pressure. He has also said if i want cruthes i would have to get the GP to make a referal to surgical appliences (despite the fact the space boot came from SA so he could have added cruthes to the bottom of the form!)
    I'm not even sure if cruthes would be benifical as i suffer from Muscule pain in my arms, neck and shoulder at certain times of the month ( i am yet to work the pattern out but is likely to be caused by nerve damage due to my pelvic condition).
    Oooo sorry i am rambling, it's just so good to be able to talk about it without being looked on like a hypercondriac, a good friend of mine even called me flid foot the other day, not very pleasent, needless to say she is no longer regarded as a good friend!
    Thanks again
  • Deedumdeedo
    Deedumdeedo Member Posts: 17
    edited 30. Nov -1, 00:00
    Ooo DD, i was meant to say, i have been on and off opiates for almost two years now, I started off on Tramadol but it lost effectiveness so went onto Oramorph and Zomorph in Nov last year, then went onto Oxycontin and oxynorm in Jan. I then had 3 months off opiates after an op but restarted Morphine (SR and MR) in June this year. I am on a fairly heafty dose of both (80mgs Zomorph and 150mgs of oramoprh) which i un-fortunatly have to use everyday so i think my body has become so used to them that it does next to nothing. Another friend i have with Arthritis said that sometimes a low dose anti-depressant can work, have you heard of this?
  • Africa
    Africa Member Posts: 22
    edited 30. Nov -1, 00:00

    Just wondered if you thaught about having a consultation with
    a Pharmacist, they study drugs for 5 years solid. Luckily I have one in the family and although they cant prescribe.. just knowing how they the drugs work and what interacts with what etc I find quite insightful.
  • Deedumdeedo
    Deedumdeedo Member Posts: 17
    edited 30. Nov -1, 00:00
    Thanks for the advice Africa,
    I did go and speak to the pharmacist at the local chemist the other day (i have a major crush on him so was the highlight of the week :D )
    I went really to ask him if i could use Volteral Gel as a pose to oral volteral. He was very helpful but said that NSAID's of any kind are a no-no as it can be absorbed into the blood stream and cause the ulcers but the risk is much less, i am seriously considering it today and i am very stiff and painful today.
  • ironic
    ironic Member Posts: 2,361
    edited 30. Nov -1, 00:00
    Hi Dee,
    Welcome to the forum. I’m so sorry that you are suffering though. Can you ask your Dr if they could hurry things along a bit?
    Have you tried heat pads on your knees etc? I find that the anti inflam gels can help a little. Good excuse for you to go back and ask the pharmacist as there are different types out there.

    I hope you can get some help soon.
    Lv, Ix
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Hi, I have read on here about amitryptiline, I think that's the drug you are referring to but as I am not a doc don't take that as read! Ask your own pharmacist or GP, they will have the info. I do recommend the use of crutches - they are there to offer stability and confidence, they do not take a great deal of gripping and beware of hunching your shoulders. I cannot move without mine - well, not stricly true, I can move around indoors without them - we have lots of walls to slump against and rest a hand on! - but outside? Nah, need ma poles! They do ease the strain on the joints very well indeed - so at the very least try two sticks. If both knees are affected you will need support on both sides to compensate. My toes, ankles, knees and sacro iliac joints hurt all the time, so I know the misery of it all very well. I wish you well. DD
  • frogmorton
    frogmorton Member Posts: 28,505
    edited 30. Nov -1, 00:00
    Hi Dumdeedum

    Welcome to the forums from me :)

    As the others have said painkillers are you on any and if so which ones. There are also anti-inflams which are kinder on the belly - I take arcoxia for instance.

    I do hope your GP might give you something else to try in the meantime.

    He is probably thinking he can't prescribe anything for the actual RA (disease - DMRADs).

    Good luck


    toni xx