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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Damage In Joints, Chronic Pain, Knee Replacement Done, Had Rheumatoid Arthritis On Ms Contin And Vicodin. Not Helping?

I have rheumatoid arthritis..duration 35yrs. have drawn fingers toes..every joint has some damage, having 2nd knee replacement dec 2. have very bad chronic pain. take ms contin and vicodin for pain, have neurontin and indomethacin pred methatrexate also. is there any thing else to relieve the pain better? these meds seem to just take the edge off..not really help the pain, thank you
Thu, 17 Oct 2013
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Internal Medicine Specialist,  's  Response
Hi friend,

Thanks for your query.

You have not mentioned the doses of drugs, particularly ms contin and methotrexate.

You can try anti-TNF therapy, which is very expensive, but effective in majority of cases. However, efficacy is less in long-standing rheumatoid arthritis.

Alternatively, instead of indomethacin, take Leflunamide; dose of Methotrexate can be increased (under strict supervision) to maximum permissible dose; dose of oral steroids can be increased for a short period and then tapered off; HCQS and Sulfasalazine can be added if not used earlier.

I suggest that you consult a Rheumatologist, who knows what is best for you.

Hope I have answered your query.

Dr. Rakesh Karanwal
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Damage In Joints, Chronic Pain, Knee Replacement Done, Had Rheumatoid Arthritis On Ms Contin And Vicodin. Not Helping?

Hi friend, Thanks for your query. You have not mentioned the doses of drugs, particularly ms contin and methotrexate. You can try anti-TNF therapy, which is very expensive, but effective in majority of cases. However, efficacy is less in long-standing rheumatoid arthritis. Alternatively, instead of indomethacin, take Leflunamide; dose of Methotrexate can be increased (under strict supervision) to maximum permissible dose; dose of oral steroids can be increased for a short period and then tapered off; HCQS and Sulfasalazine can be added if not used earlier. I suggest that you consult a Rheumatologist, who knows what is best for you. Hope I have answered your query. Dr. Rakesh Karanwal