pacemaker and arthritis pain.

joint pain

by new to pace.... - 2022-04-11 18:33:15

Avoid eating what is called the nightshade plants.  White potatoes, eggplant, tomatoes, all peppers.  This should help.  I know there goes the pizza.

Otherwise get a cortisone shot.  Worked in my knee for years. 

new to pace

Pain Relief

by Gemita - 2022-04-12 05:48:31

Lucy, I also received a steroid injection into my affected joint.  I also received a nerve block and a referral to a pain consultant.  I would keep going back to your general doctor until you get your pain under better control.  

There are many different treatments available, but they need to be tailored to suit your particular needs.  For example is the pain nerve related or mainly inflammatory in nature?  If you are really struggling a pain consultant referral might be helpful.  They can also refer you for other treatments which can help with pain like CBT (cognitive behavioural therapy) and exercise therapies like Pilates, Yoga.  A warm shower or bath can work wonders for my joints too as can good hydration/diet.

I am on anticoagulation and I was told a short course of an anti inflammatory med could be safely given but you will need to discuss all your options with your general doctor.  I was recently given a topical gel containing Ibuprofen (Fenbid Forte 10% gel) to use longer term but of course there is the risk of systemic absorption.  I have also tried Capsaicin with some success.  It can be helpful for joint pain and for diabetic nerve pain. You may need to apply Capsaicin for a few days or longer before you notice any relief from pain.

I hope your symptoms ease 

For what it's worth

by Gotrhythm - 2022-04-13 13:59:20

I reecently added 1000mg Omega ( a fairly large dose) to my vitamin regimen for other reasons but was surprised after a couple of weeks to realize my joint pain was so much decreased that Tylenol was now effective.

I don't take blood thinners, so I don't have any issues with medication interactions.

You should probably check with your doctor before taking.

Pain and anticoagulation

by Selwyn - 2022-04-13 17:48:47

The use of aspirin and non-steroidal anti-inflammatory drugs (NSAIs) is a problem with anticoagulation as aspirin and NSAIs can cause bleeding - your anticoagulation makes this difficult to stop when bleeding occurs. Rubbing with NSAI creams and gels  is safe. There are counter irritants ( eg. capsaicin cream) - these are safe.  ( as mentioned above)

You can take paracetamol ( acetaminophen in USA). An opiate is possible ( anticoagulation can always be adjusted, eg. if on warfarin) though there is the danger of tolerance and increasing dosage.

Physical therapy is a help ( this includes heat, cold, massage etc).

There is acupuncture. I hope a TENS machine could be found that is pacemaker safe.

There are various patches from local anaesthetics to opiates 

Centrally acting pain killers include gabapentin, pregabalin, and to a lesser extent these days amitryptyline. 

Other things to try include turmeric, oil oregano, oil of cloves etc. 

Yes, steroid joint  injections are good for  some acute inflammations ( not infections!) , though no good for chronic conditions. 

Here in the UK we have specialist Pain Clinics. Here you find doctors that are expert at numbing nerves that supply pain impulses to the brain.

I hope you find something suitable in the above. 

Pain and Anticoagulants

by Marybird - 2022-04-13 19:41:36

I'm in the same boat, I have strict instructions to avoid all NSAIDs, as even occasional use of NSAIDs with Eliquis has left me with a drop in hemoglobin over 6 months from 12 grams down to 9.7grams, testing shows severe iron deficiency. No apparent bleeding I can see, no issues with Eliquis. Still working on figuring this out with my primary care doc.

Tyelenol hasn't worked as well for my arthritis pain ( mostly in the thumbs and wrists, sometimes shoulder bursitis), but them's my choices now. I've found fairly decent success at pain control taking two 650 mg tabs acetominophen when I get up in the AM- this can be taken up to 3 times in a 24 hour period, though I take just that one dose. I take two acetominophen PM tabs ( 500 mg acetominophen, 25 mg dihydraphenamine- benedryl) before I go to bed, this helps me sleep and keeps me from waking up with the arthritis pain. I've found keeping a steady systemic level of the acetominophen seems to help more with the pain than waiting till the pain is bad to take a dose.

My doctor also suggested using an over the counter Voltaren gel. This contains the NSAID diclofenac in a 1% concentration, less than the 10% I understand is in the prescription versions of the gel, so there isn't much of a risk of absorbing significant amounts of diclofenac into the system. I follow the instructions as to the amounts of gel, and limiting the application to two locations at a time. It seems to help with the pain.

My doctor also suggested applications of heat to the painful joints. I have iced those areas, haven't tried the heat but may do so one of these times.

I have also heard that taking Omega 3 or 6 products may help with the pain, but have taken those in the past ( before Eliquis) and found they seemed to cause easy bruisability and capillary bleeding- they tell someone taking those to discontinue taking those 5 days or so before endoscopic procedures or surgery. So I'd personally be very reluctant to add Omega products to the Eliquis I take. 

NSAIDs

by AgentX86 - 2022-04-14 02:19:20

I am also anemic and take iron suppliments but my cardiologist doesn't have a problem with taking NSAIDS once in a while. I sometimes get knee or foor pain.  Two 200mg ibuprofen almost always wipes it out "permanently".  I don't even take it for a day, just one dose.  He said not more than a couple of days. Is it a good idea?  No.  Is needless pain a good idea?  No.  What's more important? A day of possible bleeding, or constant pain for weeks? fielder's choice.

BTW, it's been a couple of years since I needed it but I' close now.  I walk a lot and try to walk through it.  Sometimes it works.  Sometimes, not so much.

Occasional NSAIDS

by Marybird - 2022-04-14 09:30:13

That's what the literature reports, and the conventional wisdom about occasional ( or once in a while) NSAID use with an anticoagulant being ok, I guess. And I'm like you, Agent, my go to NSAID to make those arthritic pain go away entirely, often with just one dose, has always been naproxen sodium. In my case it's mostly pain that can get gawdawful in my hands, mostly around the base of my thumbs, and sometimes pain from bursitis in my left shoulder.

I'm not sure just what "occasional" NSAID use means- I was hoping that maybe once a week wouldn't be too often, but it might be for me. What made me have to swear off it entirely was a drop in my hemoglobin of two+ grams, ( from 12.0 grams to 9.7 grams, discovered from bloodwork at my "semiannual" check/followup with my PCP. Further testing showed I had severe iron deficiency- which in an oldie but moldie like me, especially one taking an anticoagulant, most likely means a bleed somewhere. But I haven't had any bruising, or excess bleeding that I can see from the Eliquis, and no GI symptoms I can detect to account for that drop in hemoglobin. I have had gastric ulcers in the past, and gastric erosion sites from which there was some bleeding, and since I don't drink, smoke, do illicit drugs and didn't have H. pylori, the only remaining culprit was NSAID use ( this was pre- pacemaker, pre-Eliquis). 

So the only recourse at this point is for me to swear off the oral NSAIDs while I take the iron supplementation and see what the labs look like over a few months' time. Determining the cause of the hemoglobin drop is still a work in progress for me, and that's with my primary care doc. It seems from repeat labs one month after iron supplementation has started the hemoglobin hasn't gone up yet though the ferritin and serum iron levels have to some degree, so it seems to be a slow process. I wouldn't be surprised to see an endoscopy in my future, but we will see what future lab results show. 

I have to say I sure miss my naproxen, but if I'm not taking it at all I can't blame the anemia on the NSAID use. 

Like you I'm using other measures ( besides tylenol use) to keep the arthritis pain at a dull roar. I've found exercises that seem to help my shoulder and occasional hip bursitis, and applications of ice or heat help some too.