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How Effective Is Morphine In Treating Arthritis Pain?
Question: Is there a rheumatologist available? Wondered about the effectiveness of morphine to treat arthritis pain? My 75 year old brother in Scotland has been diagnosed with osteoarthritis in his hips, but the severe pain came on so suddenly that I think it must be RA. (They didn't take any X-rays before deciding he had OA.)
Email address: YYYY@YYYY .
He is currently on 37 "micro-grams" of morphine, and it's supposed to be increased to 50 in several days. This is a patch applied to his arm. It has reduced the pain, but still too much pain to get out of his house.
Email address: YYYY@YYYY .
He is currently on 37 "micro-grams" of morphine, and it's supposed to be increased to 50 in several days. This is a patch applied to his arm. It has reduced the pain, but still too much pain to get out of his house.
Brief Answer:
Hi is most probably having osteoarthritic.
Detailed Answer:
Hi
Thanks for your query
I'm Dr Sudhir Kumar
I have gone through your query and understand your concern.He is likely to be having osteoarthritis as it is common in his age. It can be confirmed by x rays of both hips. It is unlikely to be rheumatoid arthritis as it generally doesn't start in his age. It starts in young age.
In osteoarthritic glucosamine is useful.Analgesics ( he is already on morphine patch) are taken for pain relief. Morphine is effective in reducing pain of osteoarthritis.
You can discuss with your doctor about it.
Hope your query get answered. If you have any clarification then I will be happy to help you.
Wishing you a good health.
Take care.
Hi is most probably having osteoarthritic.
Detailed Answer:
Hi
Thanks for your query
I'm Dr Sudhir Kumar
I have gone through your query and understand your concern.He is likely to be having osteoarthritis as it is common in his age. It can be confirmed by x rays of both hips. It is unlikely to be rheumatoid arthritis as it generally doesn't start in his age. It starts in young age.
In osteoarthritic glucosamine is useful.Analgesics ( he is already on morphine patch) are taken for pain relief. Morphine is effective in reducing pain of osteoarthritis.
You can discuss with your doctor about it.
Hope your query get answered. If you have any clarification then I will be happy to help you.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you.
I should have mentioned that I was diagnosed with RA last year, when I was 67, so perhaps late-onset runs in the family? Also both of brother's hips started hurting at the same time.
Regardless or whether OA or RA, my brother is wondering if, with the right dosage of morphine, he may return to a somewhat normal life. "Normal" for my brother, until three months ago, was ballroom dancing four nights a week. He doesn't expect to return to that life, but is hopeful of being about to walk a couple of blocks and take care of his own shopping, cooking, driving himself to doctor appointments, etc.
Another health factor is that after Wolff-Parkinson-White syndrome for many years, my brother now has a-fib -- in addition to an enlarged prostate which is being treated by medication, which has caused kidney function decline (checkup in the last couple of weeks showed improvement in kidney function).
Is morphine right for him? Is there another medication that might be more effective in controlling pain that would be safe with his co-morbidities? One negative effect of the morphine is that he falls asleep a lot, which he doesn't want.
PS Doctor (National Health Service) does not discuss options nor invite questions. He didn't even order diagnostic x-rays.
What would be the usual effective dose of morphine for a 170# man? As the dose increases will the sleepiness increase?
I should have mentioned that I was diagnosed with RA last year, when I was 67, so perhaps late-onset runs in the family? Also both of brother's hips started hurting at the same time.
Regardless or whether OA or RA, my brother is wondering if, with the right dosage of morphine, he may return to a somewhat normal life. "Normal" for my brother, until three months ago, was ballroom dancing four nights a week. He doesn't expect to return to that life, but is hopeful of being about to walk a couple of blocks and take care of his own shopping, cooking, driving himself to doctor appointments, etc.
Another health factor is that after Wolff-Parkinson-White syndrome for many years, my brother now has a-fib -- in addition to an enlarged prostate which is being treated by medication, which has caused kidney function decline (checkup in the last couple of weeks showed improvement in kidney function).
Is morphine right for him? Is there another medication that might be more effective in controlling pain that would be safe with his co-morbidities? One negative effect of the morphine is that he falls asleep a lot, which he doesn't want.
PS Doctor (National Health Service) does not discuss options nor invite questions. He didn't even order diagnostic x-rays.
What would be the usual effective dose of morphine for a 170# man? As the dose increases will the sleepiness increase?
Brief Answer:
More likely to be having osteoarthritis
Detailed Answer:
Hi
Welcome back
It can not be said that he has Rheumatoid arthritis as it starts in early age and effects small joints first and larger joints such as hip later. It can only be said after investigation such as ESR, rheumatoid factor test is positive and his small joints are having pain. You are correct that RA run in families.
Right dose of Morphine depends on pain. Probably he is taking right dose. As his kidney function is decreased so his morphine dose should be decreased according to kidney function. Buprenorphine (fentanyl transdermal patch) will be better and still effective as it doesn't depend upon kidney function as it is excreted by liver. For problem of sleepiness he can take Tramadol in place of morphine which causes less sleepiness but slightly less effective. He can be benefited by glucosamine as it improves arthritis condition.
Alternatively he can get hip replacements (THR) after getting his x ray. You can discuss with your doctor about it.
Rest is already discussed. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
More likely to be having osteoarthritis
Detailed Answer:
Hi
Welcome back
It can not be said that he has Rheumatoid arthritis as it starts in early age and effects small joints first and larger joints such as hip later. It can only be said after investigation such as ESR, rheumatoid factor test is positive and his small joints are having pain. You are correct that RA run in families.
Right dose of Morphine depends on pain. Probably he is taking right dose. As his kidney function is decreased so his morphine dose should be decreased according to kidney function. Buprenorphine (fentanyl transdermal patch) will be better and still effective as it doesn't depend upon kidney function as it is excreted by liver. For problem of sleepiness he can take Tramadol in place of morphine which causes less sleepiness but slightly less effective. He can be benefited by glucosamine as it improves arthritis condition.
Alternatively he can get hip replacements (THR) after getting his x ray. You can discuss with your doctor about it.
Rest is already discussed. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Tramadol not an option since it put him in the hospital a couple of weeks ago.
How effective is oral prednisone in reducing OA pain? How effective are steroid injections? How effective is TENS? All of these options MAY be available to him, but he would have to specifically ask. Would be most helpful to understand the effectiveness of each.
It is sad to see my very active brother now home-bound because of pain. Don't feel that his doctor is considering options with the goal of improving his mobility.
THANK YOU FOR YOUR PATIENCE IN ANSWERING MY QUESTIONS!!!
How effective is oral prednisone in reducing OA pain? How effective are steroid injections? How effective is TENS? All of these options MAY be available to him, but he would have to specifically ask. Would be most helpful to understand the effectiveness of each.
It is sad to see my very active brother now home-bound because of pain. Don't feel that his doctor is considering options with the goal of improving his mobility.
THANK YOU FOR YOUR PATIENCE IN ANSWERING MY QUESTIONS!!!
Brief Answer:
Oral prednisolon is not recommended in OA
Detailed Answer:
Hi,
Tramadol is not suitable for him then it should be avoided. Oral prednisolon is very effective but not recommend in Osteoarthritis due to its side effects.
Steroids injection in joint is very effective it can be considered as a option.
TENS has some effect in reducing pain. It is worthy of a try.
Additionally buprenorphine (fentanyl transdermal patch) and glucosamine will be suitable for him.
Rest already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Wishing your brother a good health
Take care
Oral prednisolon is not recommended in OA
Detailed Answer:
Hi,
Tramadol is not suitable for him then it should be avoided. Oral prednisolon is very effective but not recommend in Osteoarthritis due to its side effects.
Steroids injection in joint is very effective it can be considered as a option.
TENS has some effect in reducing pain. It is worthy of a try.
Additionally buprenorphine (fentanyl transdermal patch) and glucosamine will be suitable for him.
Rest already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Wishing your brother a good health
Take care
Above answer was peer-reviewed by :
Dr. Prasad
This is likely my last question, and the most important to my brother . . . what is the likelihood that the pain in his hips (very severe for about past three or four months) can be controlled so that he can resume a somewhat normal life?
Seems like he should ask doctor to switch him to buprenorphine to avoid kidney problems. Is it likely that dosage can be managed such that the pain will be controlled and the pain will not control his life?
Thank you!
Seems like he should ask doctor to switch him to buprenorphine to avoid kidney problems. Is it likely that dosage can be managed such that the pain will be controlled and the pain will not control his life?
Thank you!
Brief Answer:
There is good chances of improvement.
Detailed Answer:
Hi
Welcome back. There is good chances(above 90 percent) that pain in his hips will be controlled and he will resume near normal life. Buprenorphine patch is started with a 5 mcg/hour patch and gradually increased depending on level of pain. Glucosamine help increase mobility by reducing pain in long term.
He can get his x rays of hips and see conditions of hip joints and whether he require hip replacement.
You can discuss with your doctor about it.
Rest already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Wishing your brother good health
Take care
There is good chances of improvement.
Detailed Answer:
Hi
Welcome back. There is good chances(above 90 percent) that pain in his hips will be controlled and he will resume near normal life. Buprenorphine patch is started with a 5 mcg/hour patch and gradually increased depending on level of pain. Glucosamine help increase mobility by reducing pain in long term.
He can get his x rays of hips and see conditions of hip joints and whether he require hip replacement.
You can discuss with your doctor about it.
Rest already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Wishing your brother good health
Take care
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Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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