Pain management

ali87uk

Hi

Apologies if posted twice my phone is playing up!

I'm 26 and was diagnosed with PsA a year ago in my sacro iliac joint. I now have intra muscular steroid I injections to help with inflammation but still get pain.
Apparently mtx is not proven to help with spine involvement, more for other joins eg wrist etc.

I have tried amitriptyline for the pain but even on 5 mg experienced loads of side effects. Am now on nortriptyline but now find can't get to sleep and apparently this is a known effect.
Seem to have all the side effects from naproxen and co codamol too.

Have not had much luck with doctors regarding other options so would be grateful for any advice!

Boomer13

Hi;

What does your doctor suggest? Of course docs should, and most have, the best knowledge to make these recommendations based on you as an individual. Have you discussed all your concerns regarding side-effects with him or her? There are others to try. Maybe trying a different GP or a pain management specialist for help?

Generally, the time release ones are better for chronic pain.

Sorry I can't be more help.
xAnna

Boomer13

Time release medications that is.

A.

johnsouthwales

co-codamol 30mg i been taking, they make me sleep but in a different way than before, they are heavy, and either i fall asleep heavily late at night without realising, or gradually heavy eyes in the afternoon and slowly drifting off to a heavy sleep.. then i wake up thinking i been asleep for 3 hours and realise i only been sleeping for 5.

co-codamol isn't a miracle cure for pain as if it makes it vanish by magic, as i told this to my gp.. and he replied at least it is masking it

my next round of tabs is reduced dosage of co-codamol and amitriptyline

dreamdaisy

Hello, I realise that is tough for you and I empathise. I have PsA in both sacro joints (plus a fair few others) and there is no easy answer to finding relief from the pain and discomfort. I have found that the stronger the pain relief the more you are removed from the pain rather than vice versa. There is not an easy user-friendly answer to this conumdrum - if Apple could be bothered to invent a pain-gone app life could be simpler. They, however, have not so I reckon it is a case of learning to adjust and cope with the hurty things. I didn't find much relief after steroid injections, either in joints or a general depo-medrone - have you been prescribed either methotrexate or sulphasalazine? DD

stickywicket

I'm not sure from what you've written, if you're actually on a DMARD. If not, if it were me, I'd want to know why not as only they will slow down the disease process. There are quite a few different pain relief pills but that's all they do. They don't hold back the disease itself. I take very few paindullers but I do take my DMARDS.

trepolpen

stickywicket wrote:

I'm not sure from what you've written, if you're actually on a DMARD. If not, if it were me, I'd want to know why not as only they will slow down the disease process. There are quite a few different pain relief pills but that's all they do. They don't hold back the disease itself. I take very few paindullers but I do take my DMARDS.

got to agree with Sticky as always , you need two or more DMARDS + maybe a bio one to help control the damage & not just try to mask it ,

you could ask for a patch from your GP or consultant , they can work very well with pain

ali87uk

Thanks everyone. No am not on a dmard wasn't offered one!
Is the what methotrexate is or different? Apologies for my ignorance!
I am literally on steroid injections and nortriptyline for the pain but still in agony most days and work full time so I can't really take painkillers that would knock me out which is what I found the amitriptyline did!

Was told methotrexate gives lots of side effects and won't necessarily help my arthritis as in my spine...

Toots

Hi there! So sorry you're struggling at the moment. Have you had a rheumatology referral, or is this all coming from your gp?

dreamdaisy

I hope you have an appointment soon with your rheumatologist. I am surprised that you haven't been offered meth or even sulph, they are meds which suppress the immune system thus suppressing the activity of the disease. I was put onto sulph first, despite not having any formal diagnosis - you are ahead of me on that front. DD

stickywicket

ali87uk wrote:

Thanks everyone. No am not on a dmard wasn't offered one!
Is the what methotrexate is or different? Apologies for my ignorance!
I am literally on steroid injections and nortriptyline for the pain but still in agony most days and work full time so I can't really take painkillers that would knock me out which is what I found the amitriptyline did!

Was told methotrexate gives lots of side effects and won't necessarily help my arthritis as in my spine...

I find it odd that your rheumatologist hasn't suggested a DMARD. (Yes, methotrexate is one. So is sulphasalazine.) Steroid injections can seem to provide short-lasting miracles but they're not a good long-term solution as they bring their own problems.

Many people have fears about meth and sulph. I never see why. Potential side-effects are only potential whereas disease progression, without them, is inevitable.

I don't know whether they would help your spine or not but PsA is PsA and I'd want to ask how they can help it elsewhere but not in the spine. There might be a good reason. I've not heard of it before.