Impingement and anti-inflammatories

Have you had physical therapy for your shoulder? I had impingement in mine that went away after PT to strengthen the rotator cuff. I was popping Advils like nobody's business at the time but didn't have UC yet (or know it, at least).

Old fashioned iceing can be really effective as an anti-inflammatory locally. You can make a "sling" for your shoulder out of saran wrap with an ice pack wrapped in paper toweling, or if you have the time you can apply ice directly (freeze water in a paper cup, peel away the rim of the cup, apply with circular motions like a glue stick making sure no area gets completely numb).

I wonder if a topical cream would help? The one I just started using for osteoarthritis in my hands contains diclofenac (to treat inflammation and for pain relief), and bupivacaine - a long-acting anesthetic which helps to augment pain relief. I think it also contains baclofen.

I do believe a small dose of an NSAID on an occasional basis, however, won't harm you.

If you want details on the compounding pharmacy I use, feel free to pm me...

Rachel,
I have, unfortunately, been on various NSAIDs for over 20yrs...And in a non-stop fashion...I buy bottles of 400 gelcaps and bring them over (they sell them by 10s here!!!!)...
I am either fortunately or am awaiting the bullit...but I cannot get up in the mornings, work or got to bed at night without them...I take 400mg 2xs day and a 3rd in the afternoon if things are really horrible...I have sacroilitis and it makes my life miserable and without NSAIDs I couldn't survive.
According to my GP they are dangerous on a regular basis but my Rhumey says that I can take up to 1400mg/day without too much worry...and he agrees that we should put off the opiates for as long as possible...so, if you can take them without too much difficulty and have absolutely NO symptoms then reamin watchful and vigilant they should be ok.
I agree with alternate treatments too, acupunture, infrared therapy, deep tissue and PT or chiro etc can all help to improve your range of motion and decrease your pain...even a little but just enough to maybe help decrease your need for meds.
Sharon
ps...the topic creams work rather well

Not everyone has trouble with the NSAIDS, so it's worth a try, as long as you're careful. I echo the icing advice - doing that once a day could really lower your NSAID needs.

Thanks. I'm icing when I can, I'm being very careful with the amount of Motrin... And I looked up some PT exercises. I have a friend who's a PT who gave me a few tips, too. If it's no better this week, I'm going to see my PCP about a PT script. Always something! I'm *ok* by, like, now (8pm), then I go to sleep, and it starts over.

I have recently started using a pain lotion prescribed by my rheumy doc. It has to be compounded, but it does help. It has a mixture of 4 different drugs I think - there is an anti inflammatory, numbing agent, muscle relaxer and something else. It helps my bursitis and fibro pain. I too have to be careful taking NSAIDS.

I'm sure you know that NSAIDs are a mixed bag (sort of like prednisone). Lots of good effects, some not so great, and some really terrible.

I was one who tolerated them fine for years, and years, and years. High doses of ibuprofen even (which I guess is one of the worst for gut inflammation). I was on 800mg three times a day when I finally developed liver inflammation (turned out to be fatty liver disease), and the ibuprofen had to go. I also developed pouchitis. The good news is that these symptoms resolve after you stop them (unlike some of the prednisone side effects).

Then I wound up with my enteropathic arthritis diagnosis. Now that I am back on Azulfidine and also taking Simponi, I don't need the NSAIDs so much. If I have a flare, I take them for a couple of weeks. I currently take Relafen when needed on an occasional basis. Another one that is supposed to be "less bad" is meloxicam, which is a first generation COX2 inhibitor. So, less risky for the gut.

Part of my arthritis is bilateral rotator cuff syndrome. So, I take small amounts of Norco daily, Robaxin for muscle spasm at night, and try to maintain my range of motion with stretching and activity. I never found icing real helpful. Sometimes intra-articular steroid injections help me. If my arthritis gets into a real bad flare and 2 weeks of Relafen does not help, then it is a 2 week fast taper of prednisone.

My rheumy won't let me take Celebrex because of my strong family history of heart disease.

Jan