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Medication for OA

woodbinewoodbine Posts: 140

I'm hoping you can give me a bit of advice - though I know you can't give a definitive answer based on an online posting!

I am 41 and have OA (generalised nodal OA, to be precise) in my lumbar spine, both knees, both thumbs, and in my fingers, and my GP thinks it's beginning in my neck too.

He has prescribed Ibuprofen and co-dydramol (10/500 strength). The problem is that the co-dydramol causees constipation and the ibuprofen upset my stomach and give me indigestion. I try to avoid taking either unless the pain is very bad because of this - I don't see that it can be doing my insides much good to be constantly upset one way or the other. Also, my OA is hereditary and my mum has ended up with chronic digestive problems because she's been on similar medication for almost 30 years - I don’t want to be in the same position as her as I get older if I can avoid it.

The trouble is, I’m finding it hard to cope because although no one joint is agonizing, having ongoing pain in so many places is really getting me down. I’m also finding that I’m waking up most nights because my little finger and the one next to it go numb, or because my back is so stiff. My GP insist that there is nothing else that can be done for OA, and no alternative medication, and therefore there is no point referring me to a specialist or to the pain clinic.

I was just wondering if you can tell me anything about my rights in this situation – i.e. can I insist on being referred or seeing a pain specialist- and if there is any other medication that might help. I feel a bit as if I’m fussing too much – after all, many people have agonizing pain, or joints that are completely unusable, but the all-over pain is getting me down and making me very naggy! My husband is very supportive and helpful, fortunately for me, but is bearing the brunt of the nagginess, so would probably be very grateful for any suggestions too. It doesn’t help that beyond some smallish lumps there’s very little outward sign of the problem, so I worry that my friends and colleagues think that I’m exaggerating the problem – especially as I’m relatively young, so as many who post here find, some of them seem disinclined to believe I can have arthritis anyway!

Sorry to go on so much, but I feel very much in need of advice!

Thanks in advance,



  • valvalvalval Posts: 15,897
    edited 30. Nov -1, 00:00
    hi the help line team will have some good advice for you but to keep you going you can get meds off your doc to help with stomache probs caused by ibuprophen go back to doc and tell them what going on i kept saying it ok can cope lol ypu know nothing to see so thought they would think it in my head but unless you keep going back they will not realise how bad things are the constant pain causes exhaustion tell the doc about it i did not even realise it part of it so till got umbarable did nothing about it go talk to gp
  • caterina57caterina57 Posts: 1,424
    edited 30. Nov -1, 00:00
    sorry to hear that you are not well at the moment. I too have OA/spondylitis and take co-codamol and Rhumalgan( Diclofenac) and have had some probs with constipation, and other gastric bits and bobs I also take Lansoprazole - which are Gastro - resistant and find that they help.

  • barbara12barbara12 Posts: 20,943 ✭✭
    edited 30. Nov -1, 00:00
    Hi Naomi
    Like you I have OA in multiple joints, I was prescribed anti inflam and a stomach protector, they really did work, but I had to come off them due to some high kidney reading....but hopefully in the near future I will be able to take them again.
    At the moment I take co codamol when I need them, also gabapentin for nerve pain due to arthur in my back.
    It really is swings and roundabouts...sometimes the cure is worse then the illness.
    I do take amytryptaline at night, now I couldnt do without this, it is a antidepressant in high doses, but low doses helps you to relax and get some sleep
    Has for the pain clinic. you must ask you gp, and get across to him how painful it is.
    One thing you will learn off here is be prepared to fight, for what you are entitled to.
    Good luck with everything
    and let us know how you get on.
    Barbara x
  • skezierskezier Posts: 12,150
    edited 30. Nov -1, 00:00
    Hi Naomi,

    just butting in for a min... The helplines will answer you better than I can but just know your not alone in all this.

    I think you can ask.... I sure you can. GP's very often don't understand oa pain and its restrictions too well but get a good pain clinic and they are worth their weight in gold.

    I also wonder if a drug review by either an ortho or the pain clinic could help you? See what your on doesn't work for me at all... i guess it used to back along but I wasn't on that for too long cus of a predisposition to sickness......

    You Certainly need a pump inhibitor..... lansoprazole seems to help me though i do have a suspected ulcer courtesy of either the diclo's or the crohn's (or maybe worry :wink: )

    They can help you with the not sleeping.... Naomi there are so many different combinations of drugs they could try.... you do need to see someone 'in the know'.

    I do have constant pain... it doesn't let go for an instant nowadays. I wonder if a nerve blocker could help you? See that's why you do need to see someone who knows what they are doing.

    I don't know if you can ask by right but you certainly can ask! Here we ask and get told funding is an issue but i was so lucky to find a rumo who understands pain and a fantastic pain consultant who is on a quest to find something that works :lol: She kinda has ish now :wink:

    hang in there cus help is out there and well the helpline people will be able to help you better just wanted to drop you in a ((( ))) and a hope you can get sorted. Cris x
  • woodbinewoodbine Posts: 140
    edited 30. Nov -1, 00:00

    Thanks for all your sympathy and suggestions - especialy welcome as it sems that helpdesk have nothing to say on this one!

    I wich that I had a gP who knew more about OA - one day when I arived for an appointment my GP was ill so I saw a locum who knew loads about it - it was briliant, but I can hardly ask the clinic to let me know when the usual Doctor is ill so that I can see the locum :lol:

    I'll get an appointment with my GP, and ask again to be referred to the pain clinic - if I keep asking he'll hopefully give in eventually :smile:

  • helpline_teamhelpline_team Posts: 2,067
    edited 30. Nov -1, 00:00
    Hi Naomi,

    I am sorry to hear of the constant pain you are experiencing, this must be very difficult for you, particularly when you are not feeling believed or listened to. I want to begin by reassuring you that you are not alone in feeling this way, and just because you are relatively young, this does not change the fact you are in pain.

    I am wandering whether your doctor is refusing to refer you on because they are not hearing how much pain you are experiencing and the worries you have over the side affects of the medication. I understand your fears around the side affects, your Doctor may be seeing these worries and is hesitant to refer you on to a pain clinic which may offer you more of the same with similar side affects.

    If you go to your local Patient Advice and Liaison Service (PALS) they should be able to advise you on your rights on this matter.

    You may also like to try other self management techniques to help with the pain, you can read more about this in our booklet ‘Living with osteoarthritis, and for alternative pain management techniques ‘Coping with pain’:

    Living with osteoarthritis booklet:

    Coping with pain booklet:

    I hope it has helped to let out the frustration you are experiencing, but please do remember that you can here at the helplines to talk it through.

    Best Wishes
  • woodbinewoodbine Posts: 140
    edited 30. Nov -1, 00:00

    Thanks for the suggestions - I'll have alook at the booklets on your site.

    I've also looked at the PALS site - there don't sem to be any in Wales unfortunately, which is where I live. Do you have any idea if there is a Welsh equivalent, or if they're called something diferent in Wales, please?

    Thanks again everyone - it does help to have people to 'talk' to who understand :smile:
  • helpline_teamhelpline_team Posts: 2,067
    edited 30. Nov -1, 00:00
    Hi Naomi

    The Welsh equivalent of PALS is the Community Care Council. See http://www.wales.nhs.uk/sitesplus/899.

    I hope this helps.


  • woodbinewoodbine Posts: 140
    edited 30. Nov -1, 00:00
    Thanks Nick - I'll have a look at that website now.

    I've just been to my GPs - but saw a not very sympathetic locum. She's suggested I take Ibuprofen regularly for a month, and has given me somehting to reduce the stomach upset this usually causes, plus a low dose of paracetamol to add to the painkilling effect.

    However, when I went to collect the prescription, the pharmacist told me that I should only take both maedications when absolutely necessary - I told him what the GP said, but he was adamant! Now I'm even more confused - don't suppose you know if this is a common combinaiton when people have OA, or can suggest if I should follow what the GP or the pharmacist said?

  • helpline_teamhelpline_team Posts: 2,067
    edited 30. Nov -1, 00:00
    Dear Naomi,

    I can quite understand that if you've been given conflicting suggestions that may be confusing.

    We can't offer medical advice I'm afraid.

    The NHS line on anti inflammatories is smallest possible dose for the shortest possible time. If you have a history of cardio vascular issues, stomach problems, or are a smoker then you are advised to check with the prescribing doctor that you are being monitored appropriately.

    In other words anti inflammatories have known side effects that they watch out for. People over 65 need to be even more carefully monitored for these.

    I hope that is helpful

  • oregonoregon Posts: 1
    edited 30. Nov -1, 00:00
    You can insist that you see a pain consultant (pain clinic), you will have to ask your doctor to get get you a appointment (usually at your local hospital), and if he/she refuses assert yourself.

    You cannot be refused treatment on the grounds of cost etc.
    Some doctors are just too lazy, and want a easy life, well don't we all!

    I suffer from 'cluster headaches' (as well as OA and other ailments :lol: ), and my doctor asked me to come to the surgery next time one occurs. If he knew what he was talking about he wouldn't have said that! :shock:
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