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Diagnosed with scoliosis, fibromyalgia. Taking gabapentin. Any medication to relieve pain?

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Iam 66 yrs. old and recently diagnoised with scoliosis.I have had SEVERE RA for 35 yrs. Drs. are VBERY reluctant to prescribe Vicodin or similar drugs.I had fairly good results with Vicodin.Also Mayo clinic said I have fibromyalgia.WHAT DRUGS MAY I TAKE TO RELEIVE SOME OF THIS CONSTANT PAIN? I am taking ONLY gabapentin at present.
Posted Fri, 26 Apr 2013 in Arthritis
 
 
Answered by Dr. Balaji Chinnasami 4 hours later
Hi,
Thanks for your query to healthcare magic.

From your history, I understand that you are under a lot of pain due to fibromyalgia & rheumatoid arthritis. As your doctor would have explained that Fibromyalgia is a syndrome of persistent widespread pain, stiffness, fatigue, disrupted and unrefreshing sleep, and cognitive difficulties.

VICODIN belongs to a class of drugs called Opioid analgesics. The reason why doctors are reluctant in prescribing VICODIN or similar drugs to you is because Opioid analgesics appear to be of limited efficacy in most patients with fibromyalgia and are generally not recommended. In addition, it has habit forming potential & can lead to drug addiction.

On the other hand, gabapentin, which you are having currently, helps not only in relieving pain, but also improves mood, cognition & sleep. However, the drug dosage has to be titrated to individual patient. Titration to effect can take place over several days to weeks. Thus sometimes you don’t find immediate relief from the medication.

Also, you can discuss other treatment options like the following with your doctor
Lidoderm patch (Topical anesthesic containing lidocaine), Evista (selective estrogen receptor modulator raloxifene), Modafinil (Provigil), Beta-adrenergic antagonists such as pindolol or propranolol (Inderal) etc.

Hope the information was useful. I am happy to answer any further queries in this regard. If not, kindly close the query and rate it.

Take care,
Dr. Balaji Chinnasami, MD.


Above answer was peer-reviewed by
 
Follow-up: Diagnosed with scoliosis, fibromyalgia. Taking gabapentin. Any medication to relieve pain? 9 hours later
My RA seems to be the real problem. I have taken prednisone for 30 yrs. , methotrexate for 16 yrs. , Remicade for 9 yrs. and recently a pain Dr. tried 40 mg. of morphine daily[i quit it after 4 months as did not stop pain and Idid not like side effects. I apologize for not giving you more info.
 
 
Answered by Dr. Balaji Chinnasami 16 hours later
Hi,

The treatment of RA is aimed at
1. Decreasing the disease activity so as to prevent joint damage as much as possible.
2. Reduce pain and stiffness in affected joints as much as possible.

The drug treatment you are receiving currently for RA (ie prednisone, methotrexate & Remicade) decreases the disease activity & prevents joint damage. Morphine is aimed at reducing pain. Thus the medications prescribed to you is appropriate. But I understand that morphine has not helped you in pain relief.

As mentioned earlier you can discuss with your doctor about usage of Lidoderm patch (Topical anesthesic containing lidocaine), aspirin and ibuprofen(Non-steroidal anti-inflammatory drugs used to reduce inflammation in RA & decrease pain), Special wrist splints, footwear, gentle massage, or applying heat which may also help in reducing pain.

Also consulting a rheumatologist (specialist in treating patients of rheumatoid arthritis) will be of help.

Hope the information was useful. I am happy to answer any further queries in this regard. If not, kindly close the query and rate it.

Take care,
Dr. Balaji Chinnasami, MD.
Above answer was peer-reviewed by
 
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