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Wednesday, July 08, 2009 Lisa asks

Q: pain

I have ra and now my doctor says I have fibro also. They put me on lyrica does pain meds also help? My doctor says no

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Answers (2)
Brad, Health Guide
7/ 9/09 2:25am

Yes, pain meds do help! They are for pain, which is chronic with RA, dont know why some RA docs shy away from them, mine gives them to me. Ask for them, if he won't give you something to help with the pain, find another doctor! Quality of life is a HUGE thing to consider!

 

Brad

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Lene Andersen, Health Guide
7/ 9/09 10:36am

That depends on which pain you're treating.  Lyrica is a medication specifically for nerve pain, which is why it is recommended for fibromyalgia - as fibromyalgia is a neurological condition, other kinds of painkillers like NSAIDs, Tylenol and opiates don't work as well.  However, NSAIDs, Tylenol and opiates work better for RA pain.  Your doctor may be concerned about mixing other medications with Lyrica and may be trying to avoid drug interactions.  I would suggest you discuss this in more detail with your doctor, finding out why the hesitation to give you other types of painkillers. Is your RA controlled? Are you on one of the DMARDs (disease modifying antirheumatic drugs like methotrexate, Paquinil or one of the Biologics)? If your RA is still active, you should discuss changing your RA treatments, either by increasing your DMARD dose, possibly trying combination therapy by adding another DMARD or prednisone or trying another medication altogether.  This may decrease your pain levels, although you may still needsome additional relief.  If your rheumatologist continues to not take your pain seriously, you may want to get a second opinion.

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7/ 9/09 5:40pm

I live in a small town and there is one rhem. and there is 3 more a hr away. I was to one of them before I went to this one he did one test and said I did't have rhem. I went to this new one and she says I have rhem and fibro Im on Lyrica and cymbalta methetrexatre and plaquinal  she always want to give steroids and nothing else. They make me crazy and she doesn't seem to care. I live in fairmont wv but Im not sure who else I couls go to I would travel if I new where to go

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Lene Andersen, Health Guide
7/13/09 11:08am

I would suggest you go back to your doctor and talk to her about your symptoms, how they limit your ability to live your life and ask her to clarify why she only wants to give steroids. Steroids have a legitimate role to play in treatment of RA - they have been proven to reduce inflammation and protect joints from damage and can be used either alone or as a sort of "booster" for the meds, increasing the effecte the medication has.   I'm not a doctor, but I would expect a steroid-only treatment to be given to people with mild cases of RA. it may be that if your case is relatively mild, she wants to keep the treatment at the sort of metaphorical bottom rungs of the treatment ladder, leaving you plenty of options for later should your RA get worse.  However, there are other options, such as Plaquinil, which is also a relatively "mild" treatment which can be very effective and will also give you plenty of options should you need them in future.

 

In addition, with any treatment, you have to balance the beneficial effects with the side effects and if the side effects are unreasonable or make your life difficult to live, and then perhaps this is not the right medication for you. But how to make your doctor understand this? A few weeks ago, I wrote a post about being a self advocate and you may find some ideas in there about having this discussion with your doctor. 

 

I don't know much about locating doctors, but you can try the website of the American College of Rheumatologists to see if they have a listing of someone closer to you. However, if you only have few options, it may be worth it to try to develop the relationship with your current rheumatologist. What your family doctor like? Would they be able to help you with this, either by speaking to you rheumatologist or perhaps finding another one for you?

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By Lisa— Last Modified: 12/25/10, First Published: 07/08/09