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What Causes Persistent Shoulder Pain While Treating Rheumatoid Arthritis?
Question: I was diagnosed with RA the doctor prescribed the following sulfasalazine 500mg twice a day also hydroxychloroquine 200 mg twice a day also he told me to continue taking methylprednisolone 4mg once a day. I stopped taking the methylprednisolone for a couple of days and my hands became stiff and I had terrible pains in my shoulders. I contacted the doctor and he told me to continue on the methylprednisolone which i did and the pain subsided within two days. My question is, is there other medications that I can take to help relieve the pain in my joints without taking multiple druga for my RA. Also I had tried Methotrexate and it started to affect my liver so I was taken off that drug. I do not want to take medication that has to e injected I prefer medication that can be taken orally, what is your suggestion I am a 75 year old male and other than the RA I am in pretty good shape. Thankyou
Brief Answer:
Rheumatoid arthritis
Detailed Answer:
good evening
thank you for writing on health care magic
Well, we normally don't recommend lot of steroids for rheumatoid arthritis management. At your age lot of complications are known with steroids like cataract, osteoporosis ,high blood sugars...
As for your management of arthritis, I would like to highlight a few things
1. the best drug still remains methotrexate. We normally don't give Injectable unless you have nausea or intolerance to it. Mild elevation of liver enzymes is known with it when we start the drug but it recovers itself(unless it is long term one) .Do let me know if there is problem with oral drug and how high were the liver functions?
2. Sulphasalazine dose needs to be increased as well. It has to be 2 gms daily(rather than 1 GM) for it to have an effect. So if you are tolerating it OK we can step up the dose
3. As for other drugs, I am not sure if you have tried leflunomide. It is another good drug for control of disease. HCQs is mild and may not help control your disease that well
Do let me know these queries
regards
dr naval
Rheumatoid arthritis
Detailed Answer:
good evening
thank you for writing on health care magic
Well, we normally don't recommend lot of steroids for rheumatoid arthritis management. At your age lot of complications are known with steroids like cataract, osteoporosis ,high blood sugars...
As for your management of arthritis, I would like to highlight a few things
1. the best drug still remains methotrexate. We normally don't give Injectable unless you have nausea or intolerance to it. Mild elevation of liver enzymes is known with it when we start the drug but it recovers itself(unless it is long term one) .Do let me know if there is problem with oral drug and how high were the liver functions?
2. Sulphasalazine dose needs to be increased as well. It has to be 2 gms daily(rather than 1 GM) for it to have an effect. So if you are tolerating it OK we can step up the dose
3. As for other drugs, I am not sure if you have tried leflunomide. It is another good drug for control of disease. HCQs is mild and may not help control your disease that well
Do let me know these queries
regards
dr naval
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Above answer was peer-reviewed by :
Dr. Prasad
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