Pain management. New diagnosis

Hi all, I'm newly diagnosed with RA and have started on methotrexate and folic acid and know that it takes a while to get into your system. I was just wondering what people experience was on these tablets.  I have one symptom that is really getting me down and that is the pain I get along the side of my hand by my little finger. It gives a sharp pain when i twist it, pick anything up and just move it and just has a continuous dull ache. I take ibuprofen but that really doesn't take that pain away, any ideas what could be causing this.

i would really appreciate any advice.

kind regards

That sounds like neurophatic pain to me.  I think you should talk to your Dr.  Maybe it will go after a while. 

This probably hasn't helped much. 

Hi, If I remember correctly; it took a few weeks and an increase in dosage to 20 mg to make a difference. Plus I was taking around 15 to 20mg of prednisone and also changeing to a gluten free diet. I took arava for 3 weeks. That really helped with the pain but caused me wait loss and diarrhea so I stopped taking it. Different parts of my hands and wrists are still painful now, even though ESR and CRP are at normal levels. Everyone seems to experience this disease in different ways. I truly is a dis - ease.

Hi, you shouldn't realy be taking Ibuprofen with Methotrexate as aparently the two can react, I dont know how, but I was told this ages ago by a doctor. Ive just googled it and it is correct.

Thank you for your advice, I will discuss with my rheumatoid consultant next time I go.

Thank you for your advice. I haven't heard of Arava so will do some reading to see whether this will help me. I'm just so desperate to get this pain under control coz I'm fed up with telling people that I can't do something as its too painful and getting them to do it, although you probably don't need me to tell you how frustrating it is, hope you find some relief for your hands.

Hi. Thanks for your advice, I too had heard that you shouldn't take the two together so I asked my consultant whether I can and he said yes. I hope that is the case as I don't want other problems. I couldn't do without ibuprofen at the moment or I just can't lift my hands up. What pain relief do you take? 

Ha, pain relief if there is sutch a thing, I've taken from Paracetamol to Tramadol now on Oramorph but I only need pain relief when I get a bad flare. I take An anti inflamatory called Naproxin but again only when neccessarry. As you wil find everyone is different, try and find what suits you best, in my case I'm lucky I go from pain free to the feeling my wrists, arms, legs, have been broken, but I know I will feel better 48 hours later.

 

Hi Emma..my r.a started in my fingers. .with that same little finger pain. ..it seems quite a common "starting point". 

I have had the disease for nearly 27 years..and been on various medication. Having surgery on both hands and top of spine.

I have been on methotrexate and folic acid now for the last 6 years and the disease is currently under control. .this is the best medication I have tried altho im taking a high dose of 25mg weekly..

I would say just be mindful of your diet....try and avoid any orange and citric acid foods.

Hope this helps

Louise

Hi Emma..my r.a started in my fingers. .with that same little finger pain. ..it seems quite a common "starting point". 

I have had the disease for nearly 27 years..and been on various medication. Having surgery on both hands and top of spine.

I have been on methotrexate and folic acid now for the last 6 years and the disease is currently under control. .this is the best medication I have tried altho im taking a high dose of 25mg weekly..

I would say just be mindful of your diet....try and avoid any orange and citric acid foods.

Hope this helps

Louise

Hi emmaholder,

Ibuprofen is an anti inflammatory, it doesn't take away pain. You are better taking paracetamol, or asking you GP or consultant for pain killers. The pain you are experiencing is typical of RA, perhaps you can get hand splints either from your consultant, or buy your own.

I started on Methotrexate tablets, and as the dose increased I began to feel nauseous and have blackouts (fainting fits) so my consultant changed me to injections. Eventually I was having 25mls injections once a week, with folic acid every day except for Methotrexate day, and 10mg Leflunomide (Arava) every day. I had no problems after that and my RA was well managed.

I have tried methotrexate but when highered to 25mg caused liver to be irritated and was always breathless.now just been put on rituximab.I use ibroprofen gel which is brill when I cant stand the pain any longer.It does then dull the pain

Hi Emma,

I've been on 25mg Methotraxate injections for over a year now and although they are fantastic at controlling my RA they do provide some nasty side effects. The worst being sickness.

For pain I find the best drug is Naproxen, it is an anti-inflammatory painkiller and it brilliant at reducing swelling and ridding the pain. They work best if you take them early and every 12 hours. For example, if I know I have a big weekend ahead I take Naproxen at night the previous evening, and then again 12 hours later on the morning of the day I want to be pain-free. They do give a little indigestion, but I’ve found they don’t react badly with the methotrexate.

I’ve also been on Sulfazalazine and Leflunomide (I took Arava - nasty side effects), but out of all three disease controller drugs, I’ve found Methotrexate to be the best!

Hope you’re doing OK, Jen x

Hi

I was increased from 7.5 to 15mg of methotrxate coz my finger had swollen up quite a lot and I have nerve entrapment in the other hand/wrist.

At the moment I'm on ibruprofen and paracetomol as I took naproxin and it seemed to make me breathless but I'm not sure whether it was that or just coz I was having a flare up as I don't know whether that would be a symptom of that. I might try them again to see what happens. Is that all you take for pain or can you take paracetomol with them or don't you need it. 

Hi Emma,

Are you taking methotrexate orally? Hopefully the increase will help, it is a fantastic drug in my opinion.

I have been taking Tramadol for about 3 years also, but unfortunatelly I've become quite dependant on them and so I'm slowly coming off those. So for pain management I only taken Naproxen yeah. I'm not sure if I take the correct dose though, as my RA can be quite severe I take 3 x 500mg when I do have a dose. I think this is too much but it's all that works unfortunately.

Might be worth trying again and seeing how you are, if you're breathless again the doc might be able to recommend something else.. unless the increase in metho is working!

Jen x