Arthritis relief?

[leebee]

DD29 was diagnosed with rheumatoid arthritis several years ago. She is currently having an awful time with pain and swelling at the base of her right thumb (she can't open jars, wine bottles, chop veggies) and it's moving up into her right index finger to the point where it's becoming painful to type. She's seen her PCP but before she can get a referral to a rheumatologist she has to go through 6 weeks of PT/OT and have a set of xrays done. She has been taking ibuprofen steadily but it's bringing no pain relief. We're not sure what else to try. I see "Arthritis Strength" OTCs (ibuprofen, Tylenol, etc) and wonder if they really work. Also has anyone tried anything else, OTC or by prescription, that has brought pain relief? DD is a grad student (8 months til she's finished), wife, and step-mom and needs to be able to use her right hand!

 

[unrequited23]

My stepdad swears on Tiger Balm and Aleve, but he doesn't have RA, he has osteoarthritis. An anti-inflammatory diet might be worth trying as well.

 

[anniemae]

Has she seen a rheumatologist in the past? If she was diagnosed several years ago she should be under the care of a board certified Rheumatologist. Why has she only been to her pcp? OTC meds will not stop RA. From what I understand, OTC meds are more for osteoarthritis. She needs RA meds. Immunosuppressive drugs. There are many RA meds but she needs to be evaluated by a rheumatologist. the longer she waits, the more damage is being done.

 

[Schneewittchen37]

My DH uses aspercreme. He says it helps with the tiny bit of arthritis in his hands.

 

[LuvOrlando]

Voltaren is helpful and just goes to that particular spot that's hurting at that moment, they started me with it when it was prescription and I still use it now that it's OTC.

Personally, I didn't have great experiences with the medicines anniemae is talking about (read those inserts) so I favor topical, but I also think OTC tablets make me feel worse, so there's that.

 

[auntfrannie]

I second Voltaren. I use it when the pain flares up in my hands and elbows. I only need to use it for a few days before the pain subsides then I stop using it until I get another flare-up months later.

 

[Dan Murphy]

I see "Arthritis Strength" OTCs (ibuprofen, Tylenol, etc) and wonder if they really work.

Sorry to hear this about your daughter, leebee. Always tough for a parent to see their kids hurting.

As to this question, 'extra strength' 'arthritis strength' and similar wording are simply an increased dosage. Sort of like getting the strength of 3 pills by taking only 2. But typically at a much higher price

Wishing your daughter better days ahead, leebee. 's

 

[bgirldeb]

Has she seen a rheumatologist in the past? If she was diagnosed several years ago she should be under the care of a board certified Rheumatologist. Why has she only been to her pcp? OTC meds will not stop RA. From what I understand, OTC meds are more for osteoarthritis. She needs RA meds. Immunosuppressive drugs. There are many RA meds but she needs to be evaluated by a rheumatologist. the longer she waits, the more damage is being done.

This. Whatever she needs to do, it is imperative that she gets on the right meds. I agree that “arthritis strength“ over the counter meds are more for osteo/ age related arthritis.

Your daughter has a serious autoimmune condition and needs to be treated appropriately. Even in the short term, maybe her PCP can give her some steroids or something.
Sorry she is going through this.

 

[Southernmiss]

Our local rheumatologist all have long waits (6 months +) to get in for new patients.

The quicker your daughter can get help for her autoimmune disease the better.

Our daughter has systemic lupus. We were told it would be 6 months to get her in. Our daughter was so very sick that she would have died in 6 months. Her pediatrician pulled strings and got her an appointment with a pediatric rheumatologist that she knew 2 hours away in 3 weeks.

Once she turned 18, we had to find a doctor who would see her. That one is an hour away. Now that one is retiring.

She gave daughter a referral and we found a rheumatologist 45 minutes away. She is booking appointments 4 months out.

Fortunately, our daughter's lupus is well controlled right now with hydroxychloriquine and she just needs to be sure her prescriptios are filled.

I'm appalled that op's daughter must do physical therapy first. I would be looking for a 2nd opinion.

Also, the OTC meds that daughter took before she got in to a rheumatologist wreaked havoc on her stomach.

I'd recommend aspercreme or something topical.

 

[Kae]

I use Voltatren and take 2 advil & 1 tylenol. I also take Meloixicam for Flare ups. I did try other drugs but I felt the side effects were not worth it.

 

[princesscinderella]

Have your daughter look into an anti inflammatory diet. It works wonders with all types of autoimmune disorders. Gluten would be the first to cut out.

 

[barkley]

i find topical cbd to do wonders.

 

[DaviVascaino]

Rheumatologist here.

There is no such thing that a patient with rheumatoid arthritis needs to do PT/OT before seeing a rheumatologist. There is no such insurance requirement. We also do not require any x-rays.

We only need a referral from the PCP, and if the patient is really in pain, we will try to see them ASAP.

If the waiting list is too long ask your PCP to call the rheumatologist and ask to be seen sooner. No rheumatologist will deny to see a RA patient no matter how busy we are.

 

[anniemae]

Our local rheumatologist all have long waits (6 months +) to get in for new patients.

The quicker your daughter can get help for her autoimmune disease the better.

Our daughter has systemic lupus. We were told it would be 6 months to get her in. Our daughter was so very sick that she would have died in 6 months. Her pediatrician pulled strings and got her an appointment with a pediatric rheumatologist that she knew 2 hours away in 3 weeks.

Once she turned 18, we had to find a doctor who would see her. That one is an hour away. Now that one is retiring.

She gave daughter a referral and we found a rheumatologist 45 minutes away. She is booking appointments 4 months out.

Fortunately, our daughter's lupus is well controlled right now with hydroxychloriquine and she just needs to be sure her prescriptios are filled.

I'm appalled that op's daughter must do physical therapy first. I would be looking for a 2nd opinion.

Also, the OTC meds that daughter took before she got in to a rheumatologist wreaked havoc on her stomach.

I'd recommend aspercreme or something topical.

I am wondering if OP meant to say osteoarthritis instead of Rheumatoid. RA is a serious autoimmune disorder, OA is more natural aging or "wear and tear." Many people mix up the two but they are very different and I would be very surprised if she was diagnosed years ago and has not seen a rheumatologist. PCP's can't really treat RA. It's like having a PCP treat heart disease instead of going to a cardiologist.

 

[DLgal]

Your daughter needs a new PCP. And a rheumatologist. If she was diagnosed several years ago, why doesn't she already have a rheumatologist? This is all so bizarre.

But if you actually meant osteoarthritis, then have her switch to Aleve Liquid Gels and take 2 caps every 12 hours. It will work much better than Advil and is more gentle on the stomach.

 

[leebee]

OP here. My daughter was diagnosed at the Cleveland Clinic in November 2019 with rheumatoid arthritis. She was living in Connecticut at the time and it was a six month wait to see a rheumatologist. Covid hit and her appointment was canceled. By fall 2020 she had moved back to Maine, not working, with no health insurance. Once she got a job, she had to go through the hoops for the insurance company (yes, the insurance company dictates who can be seen for what, and how to go about it) and when she was finally supposed to be seen by a rheumatologist (Jan 2021) SHE had covid and had to cancel. She dealt with the long-term debilitating migraines from covid for almost a year and finally scheduled another rheumatology appointment, but before the appointment came around she started grad school in the fall of 2021... again with no health insurance, so canceled the appointment. Once she had health insurance she's seen her PCP twice since Jan 2022 to be told both times as she wasn't having "a flare" they couldn't do anything about it. She finally was able to change PCPs (and health care conglomerates) and YES she has been told that she has to have xrays and blood work and PT/OT before she can get a referral to a rheumatologist- otherwise the insurance company won't approve the rheumatology appointment or anything that comes of it.

I am not sure why people don't want to believe that the wheels of medical care turn much slower in some places than others. It took me 22 weeks to get an MRI and into an orthopedist. Also, insurance companies DO dictate the pace and pathway of health care. Part of the hold-up was that my PCP requested an MRI, it was refused, and I had to have 6 weeks of PT and then my PCP had to find two more physicians to sign onto me needing an MRI before they'd reconsider the request. We are in a health-care desert here, with a significant lack of physicians (six hour wait at walk in care last week) and long, long waits for some appointments (seven months for a mammogram), even with a PCP (three weeks). Having lived in the Boston metro area for 30 years, this is extremely frustrating for me. Many people we know who have significant health issues drive over 2 hours to Portland ME or over 4 hours to Boston to see specialists for their treatment. One of the concerns DH and I have about our impending retirement is the lack of health care in our area.

 

[DaviVascaino]

OP here. My daughter was diagnosed at the Cleveland Clinic in November 2019 with rheumatoid arthritis. She was living in Connecticut at the time and it was a six month wait to see a rheumatologist. Covid hit and her appointment was canceled. By fall 2020 she had moved back to Maine, not working, with no health insurance. Once she got a job, she had to go through the hoops for the insurance company (yes, the insurance company dictates who can be seen for what, and how to go about it) and when she was finally supposed to be seen by a rheumatologist (Jan 2021) SHE had covid and had to cancel. She dealt with the long-term debilitating migraines from covid for almost a year and finally scheduled another rheumatology appointment, but before the appointment came around she started grad school in the fall of 2021... again with no health insurance, so canceled the appointment. Once she had health insurance she's seen her PCP twice since Jan 2022 to be told both times as she wasn't having "a flare" they couldn't do anything about it. She finally was able to change PCPs (and health care conglomerates) and YES she has been told that she has to have xrays and blood work and PT/OT before she can get a referral to a rheumatologist- otherwise the insurance company won't approve the rheumatology appointment or anything that comes of it.

I am not sure why people don't want to believe that the wheels of medical care turn much slower in some places than others. It took me 22 weeks to get an MRI and into an orthopedist. Also, insurance companies DO dictate the pace and pathway of health care. Part of the hold-up was that my PCP requested an MRI, it was refused, and I had to have 6 weeks of PT and then my PCP had to find two more physicians to sign onto me needing an MRI before they'd reconsider the request. We are in a health-care desert here, with a significant lack of physicians (six hour wait at walk in care last week) and long, long waits for some appointments (seven months for a mammogram), even with a PCP (three weeks). Having lived in the Boston metro area for 30 years, this is extremely frustrating for me. Many people we know who have significant health issues drive over 2 hours to Portland ME or over 4 hours to Boston to see specialists for their treatment. One of the concerns DH and I have about our impending retirement is the lack of health care in our area.

We are not saying you are lying, but I am a rheumatologist and I am telling you the PT/ot thing is very weird and I have never seen this or heard before. Maybe it is the protocol of the PCP or the rheumatologist (either way, this requirement is absurd). Good luck and I am sorry your daughter is going through this

 

[lanejudy]

YES she has been told that she has to have xrays and blood work and PT/OT before she can get a referral to a rheumatologist- otherwise the insurance company won't approve the rheumatology appointment or anything that comes of it.

Has your DD actually contacted the insurance to confirm this? or is she relying on what her PCP says? It sounds more like they are working towards a diagnosis and ruling out injury or osteoarthritis. Does she have any documentation or records of her diagnosis from the Cleveland Clinic, and has that info been shared with the PCP and the insurance? Never just rely on what someone tells you the insurance covers -- make that contact yourself, more than once if necessary to get answers.

Sorry she's been through such a challenging situation with healthcare. Yes it can be hard at times. But she is now learning that putting off appointments for a specific condition can have a more negative impact than initially thought, regardless of the reason. She has a life-long condition and needs to learn to manage her healthcare needs in addition to life. She should be pro-active with her healthcare and rather than "cancel" an appointment it should be "rescheduled", and if appropriate attempt telehealth if unable to attend an in-person appointment. It at least keeps her active on the provider's records instead of dumping back to the "new patient" status which often has month-long waits to be seen. Once past that first hurdle, it is often much quicker for follow-ups. Good luck!

As to OTC -- most won't provide adequate relief for RA, as others have said those are intended for OA. My DH uses Voltaren (gel or cream?) for OA; he finds more relief from that than any oral meds.

 

[LuvOrlando]

Have your daughter look into an anti inflammatory diet. It works wonders with all types of autoimmune disorders. Gluten would be the first to cut out.

I always thought the whole wheat thing was silly, like any good cynic would, but relentless migraines made me stop even the small amount of baked goods & frozen I was having. Instead of bread-like products of any kind I switched to simple microwaved potatoes / corn tortillas & rice to avoid all the chemicals and junk flavorings (not likely high quality vanilla bean or real onions and fresh garlic like I use) a few weeks ago and while it took a few days there was a noticeable reduction in Rheumy pain that gets worse when I take chances with food. Switched to olive oil from other oils and only cane sugar a while back too and these small changes also helped a lot. Starting to suspect there is more to this debate than meets the eye, by most accounts the grains and products we eat now are not what they were when we were kids whether it's species of grain, treatments of the grains, how they are processed or the other junk mixed in the end result is probably now not the same.

 

[China Expat]

Mine flares up when I eat sugar. I take fish oil capsules in he morning and afternoon and it takes away my pain!