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Molly Maloof, MD

Director of Clinical Content
@DoctorBase

Rheumatoid Arthritis

I have joint pain in my hips, fingers, and knees etc. the only pain medication that helps me get through the day is one hydrocodon in the morning and one at bed time. During the day the hydrocodon helps with my pain and mental facaulties so I can think and function. At night it helps me sleep and tolerate the pain. No other pain medications help with both the pain and the ability to think. The hard part is getting the medical professionals to understand and prescribe hydrocodon. Your thoughts??
Poster
  • Male | 58 years old
  • Medications: Hydrocodon
  • Conditions: Kidney (illiminating too much protein in the urine)

Find low drug prices at local & online pharmacies

I would imagine your primary care would want you to go easy on the opiods. Pain is the end result of an autoimmune problem breaking down your joints. There are other medications that would help keeps your joints healthy. Couple this work s low impact exercise program, and things should feel better.
The primary treatment of rheumatoid arthritis is not with the use of narcotics. There are plenty of medications that treat rheumatoid arthritis including methotrexate,anti-malarial drugs,Cyclsporin, Etanercept Tofacitinib. Physical therapy can also be helpful. When there is an acute flareup of the specific joint Arthroscopic synovectomy is another treatment that is beneficial.being under the care of a good rheumatologist is of the utmost importance.
Steven M. Stoller
It is not surprising that a certain narcotic would work better than others; as they each work on a different pool of opioid nerve receptors.

RA is an autoimmune disorder -- meaning that your body is attacking its own tissues. Please do not make the mistake of accepting RA as something that you simply have to endure. Instead of taking medications which are toxic to your tissues, start on a healthier path by asking the question "Why is my body attacking itself?" Most often (even with genetic predispositions) autoimmune disorders are the result of a deficiency or toxicity. Seek a physician who is skilled in Integrative Medicine for specialized testing and treatment of your condition. For more information go to our website and click on "Integrative". I hope this helps.
Have you tried contrast baths (for your hands) or sought laser therapeutic treatment for your hips and knees? An orthopedic physical therapist in your area should be able to introduce you to these interventions, which would decrease your swelling and assist you in managing your pain level. These choices may be good alternatives to having to constantly take hydrocodone.
I believe that MDs may be very cautious about the amount of opioids that are prescribed and dispensed as the side effects are vast. Perhaps that could be one reason why they don't want to prescribe this continuously? Rather, there are alternate means of treatment that may help manage your pain and symptoms associated with this inflammatory process and you should discuss this with a rheumatologist. Gentle exercise combined with proper pain management is a possible approach that could help your pain and your mental status.
Tracy A. Urvater
Try aquatic therapy
Stavros A. Rologas
Rheumatoid arthritis is an inflammatory condition where your own immune system begins to attack your joints and cause symptoms such as pain, swelling, stiffness, and physical changes in the joints. Helping decrease the aggressive immune response by helping to actually support the immune system (versus suppressing it = the traditional way to treat RA) is the most effective way to treat the pain and lessen RA.

If your kidneys are not working adequately, your liver is now also at additional risk of eventually not working well. All pain medications have to be metabolized by the liver and/or kidneys. If these organs are not working well, you will suffer many medication side effects.

There is a great deal of non-invasive treatments which can be done to help support the immune system.
As I understand your question you are having trouble getting providers to prescribe Hydrocodone for your Rheumatoid Arthritis.

My first thought is that your RA symptoms should be managed by only ONE provider, your rheumatologist. If your rheumatologist is unwilling/unable to help you control your pain then I would politely seek the care of another rheumatologist, or possibly suggest adding a Pain Management provider to your treatment team to work WITH you and your rheumatologist.
Myles Whitfield
As a physical therapist I don't prescribe medicine or give recommendations about prescription medications. I would suggest seeking a specialist in therapeutic exercises for your condition assist in improving your muscle and joint function, with an emphasis on managing symptoms and improving your quality of life.
Dr. Nathan J. Savage
There was a study done at Stanford that showed opiate use in depression was helpful for patients. Print it out and bring it in to your doctor if this applies to you.