What type of RX pain relievers are available?

[LisaR]

Tylenol 3 can't possibly be the only prescription pain reliever on the market, can it?

My mom is at a point in her life where she is having more bad days than good, unfortunately. She has severe arthritis in most of her body. She has had a knee and hip replaced but she still suffers in her other knee and hip plus her shoulders, hands, and even the replacement parts aren't pain free. She has bursitis in one hip and has gotten a few cortisone shots for that.

Tylenol 3 used to help but it isn't working now. I am sure her body has just gotten used to it. She had to go to her regular doctor today for a normal checkup and I told her to ask about other pain relievers. The doctor told her that there wasn't anything else on the market. I honestly find that very hard to believe. Maybe my mom misunderstood but she didn't walk out with any other prescription.

When I talked to my mom after the appointment, she was very depressed. She feels there aren't any alternatives left and she will have to live with this pain.

She goes to the orthopedic doctor on Monday for a cortisone shot and I am hoping he will have some alternatives for her. Am I crazy to think there are other options out there?

 

[golfgal]

I think your mom needs a new doctor-of course there are many, many other prescription pain relievers on the market, however, many of them are highly addictive so that might be an issue. Vicodin and Morphine are two that come to mind.

 

[MomRN]

Well, there are certainly other pain medications. There's a range of pain meds from aspirin to ones that are big time narcotics (Dilaudid, Fentanyl, Morphine...etc). The problem, and pro/cons, come with the increased risk of addiction and side effects. Davocet was recently pulled from the market, taking one of the more milder pain relievers as a resource.

Are you wanting something over-the-counter or presciption? If prescription, some docs just don't give pain meds as freely as others. Sometimes I have to pull teeth to get an order for a Vicodin on a broken hip, others I get morphine orders for infected splinters. If Over the counter, and there are no contradictions, you can try a rotation of ibuprofen and tylenol, but that is certainly not meant for a long term solution...even these meds have side effects.

Maybe a pain management doctor can help?

 

[flamingglobessigmund]

My mother has arthritis in her hands and her doctor prescribes prednisone along with her pain medication. He has her taper off the prednisone.

 

[asta]

I think you guys are talking stronger pain meds but I have a constant, severe pain in one of my knees and I find that Mobic (meloxicam) gives me some relief. Nothing gets rid of the pain but it does dull it better than tylenol or advil. I can't believe that there isn't something on the market to replace either Bextra or Viox. Those drugs worked so well at letting me be able to walk and function in a normal way. I know they had a heart risk but a sedentary life style has a heart risk also.

 

[LisaR]

Well, there are certainly other pain medications. There's a range of pain meds from aspirin to ones that are big time narcotics (Dilaudid, Fentanyl, Morphine...etc). The problem, and pro/cons, come with the increased risk of addiction and side effects. Davocet was recently pulled from the market, taking one of the more milder pain relievers as a resource.

Are you wanting something over-the-counter or presciption? If prescription, some docs just don't give pain meds as freely as others. Sometimes I have to pull teeth to get an order for a Vicodin on a broken hip, others I get morphine orders for infected splinters. If Over the counter, and there are no contradictions, you can try a rotation of ibuprofen and tylenol, but that is certainly not meant for a long term solution...even these meds have side effects.

Maybe a pain management doctor can help?

I am looking for something that is a prescription with the assumption that it will be stronger. She takes Naprosen (sp?) in addition to the Tylenol 3. I always thought ibuprofen was better for inflammation than acetaminophen? If that is the case, is there something like Tylenol 3 but made with Motrin or Advil?

Not to sound stupid, but what does a pain management doctor do? Obviously, they help manage pain but how? She has been to physical therapy multiple times and it hasn't helped. The physical therapists have all told her that they have never heard cracking and grating sounds that bad in any other patient. The doctors have told her that surgery isn't an option anymore because the arthritis is just about everywhere. She is at a point where they just need to find something to make her comfortable.

The weird thing is, she will wake up about every fourth day and feel fantastic. She is able to get around and she just feels so good. Sometimes that will last as long as three days. Other times, by that evening she is full of pain. She has kept a diary to try and figure out the triggers but after an entire year, none of us have been able to piece anything together.

 

[jaminmd]

She should see a rheumatologist & it would be best if someone could go with her to "listen" for her. Often patients don't know what to ask or they get nervous and don't absorb everything.

Problems like your mothers often require a combination of medications, including those that aren't exclusively for pain. Seeing a specialist will help but she needs an advocate to go with her. My parents are 80 and they miss a lot when they go to the doctor.

 

[crz4mm2]

Get her to a pain clinic. There are lots of options available.

 

[lovetoscrap]

Not to sound stupid, but what does a pain management doctor do? Obviously, they help manage pain but how? She has been to physical therapy multiple times and it hasn't helped. The physical therapists have all told her that they have never heard cracking and grating sounds that bad in any other patient. The doctors have told her that surgery isn't an option anymore because the arthritis is just about everywhere. She is at a point where they just need to find something to make her comfortable.

The weird thing is, she will wake up about every fourth day and feel fantastic. She is able to get around and she just feels so good. Sometimes that will last as long as three days. Other times, by that evening she is full of pain. She has kept a diary to try and figure out the triggers but after an entire year, none of us have been able to piece anything together.

Could just be that the rest she gets on the days she is in pain (assuming she "takes it easy" on those days) is enough to ease inflammation and help her to feel better for a few days. And then she probably overdoes things those days to make up for the days she didn't feel well.

There are many prescription AntiInflammatories that may help her, with or without a narcotic also. And there are quite a few narcotics that may help her pain. It can be hard to find something that works but also doesn't make you loopy. Ultram worked well with me but left me so drugged I couldn't function so I choose to just go with the pain. You may need to try some different things in different combinations for awhile to try to get to the right thing.

There are many different prescriptions available and I agree that your mom needs a new doctor if this one isn't helping her. I think sometimes doctors get so bogged down with the "addiction" aspects of pain meds that they don't look at the practicality that the elderly population that is in their golden years are really not much risk. I was concerned about taking prescription "addicting" meds for my feet and my doctor explained that there is a big difference between an addiction and a dependence. He said that if they work then yes-- I may become dependent on them. Just like I am dependent on air and water! If they work, keep me pain free, help me live a normal life, and make things easier then that is fine. He said that addiction is really a whole nother sphere of problem and that most normal people, with no history of addictions, don't start knocking over banks because they are jonesing for a fix of their regularly and responsibly prescribed and used medication. It is when it is being used in ways other than how they are prescribed that it becomes a problem.

You can develop a tolerance to them and need to increase a dose or try another one. But that still is not an addiction to pain pills, it is trying to find relief for very real pain. Get her in with another doctor, or accompany her to her regular doctor and advocate for her if she isn't able to do it herself.

 

[MomRN]

Pain management docs, or pain clinics, often deal with patients with chronic pain that can't be/may not be/don't qualify for surgery. Physical therapy may be part of their plan, but they often treat with pain medication, epidural shots, treat the anxiety/depression that accompanies chronic pain.

Also, as a pp mentioned, there are pain meds that aren't your "typical" pain meds- like Mobic. I've heard a lot of arthritis sufferers swear by it.

You would have to ask the doctor about adding ibuprofen to her over-the-counter pain regiman. It may help, it may not, but it can cause problems if used long-term. Then again, everything can cause problems long-term, but ibuprofen has bleeding tendencies.

Is she comfortable with this doctor? One she has had many years and trusts? If so, I would recommend she get a specialist consult. If not she probably should get a new PCP, and get a specialist consult also.

 

[LisaR]

She should see a rheumatologist & it would be best if someone could go with her to "listen" for her. Often patients don't know what to ask or they get nervous and don't absorb everything.

Problems like your mothers often require a combination of medications, including those that aren't exclusively for pain. Seeing a specialist will help but she needs an advocate to go with her. My parents are 80 and they miss a lot when they go to the doctor.

I just talked to my brother and he is going to go with her on Monday. He isn't the best candidate for the job but at least he provides an extra ear - he is deaf in one ear so it is literally only one ear!

She winters with me and will be down here in a few weeks. I am going to try my best to convince her to see some doctors down here and get some different opinions.

 

[NotUrsula]

Just be REALLY careful of places that bill themselves as "pain management" clinics. Check the medical board and see if there have been ethics complaints or criminal charges filed against any of the staff. Some (not all, but an alarming number) of these clinics are essentially legal drug dealers; the kind that will fake paperwork and give out Oxycontin and Vicodin like chiclets just for the asking.

As PP have said, for rheumatological pain, simple painkillers usually are not the best course; a combination therapy that uses anti-inflammatories and sometimes steroid injections is likely to be more effective and less harmful long-term.

Most ethical physicians are very wary of prescribing narcotics for any kind of pain associated with chronic conditions for which there is no cure. They can lose their licenses if caught prescribing those meds too often. (Usually oncologists can do it for terminal patients any time they want, but that's about it.)

 

[Belle0101]

I agree with the PP. A second opinion and a second set of ears could all be very helpful.

As to a specific RX, I was prescribed Tramadol as was a friend of mine. From what I read it's meant for chronic pain.

Now the bad, my friend & I were talking about it one day and realized we each have really bizarre dreams when we take it. Not bad dreams but just extraordinarily strange.

It also causes me to have a twilight sort of feeling. I don't know how that would be for long term or for a senior. Personally that doesn't bother me. When I'm in the kind of pain that merits me taking a pill I want to sleep. Luckily I need it less often than when it was first prescribed.

Best of luck to you and your mom. I hope she can find a treatment or pain management program that works for her.

 

[LisaR]

Just be REALLY careful of places that bill themselves as "pain management" clinics. Check the medical board and see if there have been ethics complaints or criminal charges filed against any of the staff. Some (not all, but an alarming number) of these clinics are essentially legal drug dealers; the kind that will fake paperwork and give out Oxycontin and Vicodin like chiclets just for the asking.

As PP have said, for rheumatological pain, simple painkillers usually are not the best course; a combination therapy that uses anti-inflammatories and sometimes steroid injections is likely to be more effective and less harmful long-term.

Most ethical physicians are very wary of prescribing narcotics for any kind of pain associated with chronic conditions for which there is no cure. They can lose their licenses if caught prescribing those meds too often. (Usually oncologists can do it for terminal patients any time they want, but that's about it.)

That is so funny that you mentioned that. I just took my DD to a class and while we were sitting at the light, I see a handwritten sign stuck in the ground that says, "pain management" and a phone number. My first thought was that this can't possibly be the type of place the people on the Dis were talking about!

 

[NEVERENOUGHWDW]

Could someone go with your Mom Monday for another set of ears like so many have said & ask some questions.

Not sure how your Mom is but seniors have a much more difficult time on pain meds as far disorientation, bladder issues, etc.

Maybe a pain clinic could help her with getting the meds right as well as introducing message, tens units, accupuncture etc. Good luck to your Mom~

 

[bookgirl]

If your mom takes any other meds then Tylanol 3 probably is the only option. It had the least interaction with other meds. If she's already taking that and naprosen, they may be afraid to give her anything else for fear of it interfering with heart/BP/respiration.

 

[PatsMom]

I think you guys are talking stronger pain meds but I have a constant, severe pain in one of my knees and I find that Mobic (meloxicam) gives me some relief. Nothing gets rid of the pain but it does dull it better than tylenol or advil. I can't believe that there isn't something on the market to replace either Bextra or Viox. Those drugs worked so well at letting me be able to walk and function in a normal way. I know they had a heart risk but a sedentary life style has a heart risk also.

Have you asked your doctor about Celebrex? I was a long tim Vioxx user who is now using Celebrex, the last Cox-2 inhibitor on the market. It has some cardiac risk but I thought it worth taking. Because I have active ulcers Mobic and the other traditional NSAIDS are problematic. The Celebrex isn't great for my stomach but its a last ditch before we move on to narcotic pain killers medication!

 

[livie1205]

I go to a very good pain mang dr and I also do PT. My dr has never tried to get mt to take stronger meds.There is no reason EVER for your mom to be made to suffer,not when there are so many things out there!

 

[Pea-n-Me]

Lisa, if you don't mind me asking, how old is your mother? (Give a range if you want.)

 

[Inigo]

I agree with the PP. A second opinion and a second set of ears could all be very helpful.

As to a specific RX, I was prescribed Tramadol as was a friend of mine. From what I read it's meant for chronic pain.

I too take Tramadol for arthritis pain. I really like the name-brand extended release version (Ultram XR) but I'd have to pay a lot more to get it than I do the generic tramadol.