osteoarthritis info/help/advice please

[Ditto]

I have osteoarthritis in my wrist (outer aspect, no cartilage at all).    I am in pain constantly and losing range of motion.  I use voltaran, tylenol arthritis (can't take NSAIDs), and a wrist heating pad.  I do basic exercises gently to try to keep range of motion and not stiffen up.    But nothing is helping.  The heating pad feels fantastic but I can't keep it on all the time, obviously.   I have a glove recommended by the arthritis foundation that I sleep in.   Do I just go back to my ortho hand surgeon?  Is there anything I can do?   Is this my life now and I just have to accept being in chronic pain?  I thought about asking my dr to refer me for PT.  Would that help or just be a waste of time and money?  I am miserable and so tired of hurting.  If I move it the wrong way the pain is almost unbearable.  

[Pawz4me]

I'm sorry. Arthritis is very painful.

Have you tried a corticosteroid injection? I'm not gung ho on them, but I do think there's a time for trying them, and it sounds like you may be there. I also think PT might help. Wrist replacement or fusion surgery may be an option, but I suspect approval for those would require first "failing" other treatment options. But definitely talk to your doctor about options.

[Ditto]

53 minutes ago, Pawz4me said:

I'm sorry. Arthritis is very painful.

Have you tried a corticosteroid injection? I'm not gung ho on them, but I do think there's a time for trying them, and it sounds like you may be there. I also think PT might help. Wrist replacement or fusion surgery may be an option, but I suspect approval for those would require first "failing" other treatment options. But definitely talk to your doctor about options.

I haven't had a cortisone shot in my wrist (have had several in that hand for tendonitis though).   He did mention when he diagnosed me about 3 months ago that, based on my x-ray, some surgeons would rush to surgery but that he believed it could create more problems than it solved and he didn't think it was something to consider yet.    Tomorrow I will call and make an appointment with him.   Thank you for your advice.    

[Pawz4me]

You might check into a referral to a rheumatologist for a second opinion and (perhaps) other avenues of treatment. They treat a variety of musculoskeletal conditions, including OA, as was as autoimmune and inflammatory diseases. IME overall surgeons like to do surgery, because of course that's their main thing (so it's good yours isn't rushing to that). Other specialists tend to recommend various other treatments, the ones they're primarily trained for. So in your case seeing a rheumy would be like getting a second opinion on other possible treatments. Around here most rheumies are swamped with AI patients, there are long wait times for new patients, and they have to have blood work showing AI issues before an appointment will be made. So someone with OA wouldn't even be able to make an appointment with a rheumy in my area. But that might not be the case at all in other areas, so maybe it's worth finding out? I started out with a rheumy for RA, but since starting with him I've also developed significant OA and osteopenia, and he treats those, too.

[Ditto]

9 hours ago, Pawz4me said:

You might check into a referral to a rheumatologist for a second opinion and (perhaps) other avenues of treatment. They treat a variety of musculoskeletal conditions, including OA, as was as autoimmune and inflammatory diseases. IME overall surgeons like to do surgery, because of course that's their main thing (so it's good yours isn't rushing to that). Other specialists tend to recommend various other treatments, the ones they're primarily trained for. So in your case seeing a rheumy would be like getting a second opinion on other possible treatments. Around here most rheumies are swamped with AI patients, there are long wait times for new patients, and they have to have blood work showing AI issues before an appointment will be made. So someone with OA wouldn't even be able to make an appointment with a rheumy in my area. But that might not be the case at all in other areas, so maybe it's worth finding out? I started out with a rheumy for RA, but since starting with him I've also developed significant OA and osteopenia, and he treats those, too.

My gosh I am so sorry for all that you are dealing with.  Not only is it a whole lot, but it is a whole lot of pain.     I saw my ortho hand surgeon this morning and we talked options at length.  First of all my x-ray is just awful.  Not only no cartilage but the bone (ball) has already "dug" a rut into the straight bone beside it (forgive me, I can't for the life of me think of proper names right now).   He is very much against surgery.  Neither of the two options are reliably good and he says both can lead to further issues.   He also said that depending on how things continue he wants and MRI to ensure nothing else is going on (my guess is he is wondering about bone mets from my breast cancer).  But there is nothing at all to lead either one of us to think this is anything other than osteoarthtritis based on my symptoms and his exam today.   He is not an advocate of PT because he believes that it is "like throwing gasoline on a fire" and will just inflame the joint more and lead to more pain.   As for a rheumatology referral, he doesn't think that will help much either (and agreed that getting in is unlikely at this point) due to the type and location of the arthritis and the fact that everyone's hands are kind of tied due to me being unable to take anything with an NSAID in it.    So the plan right now:  he gave me a cortisone shot (we discussed this at length as well and I fully agree it is my best option and my risk is very low) and he also is going to have me wear a brace at night to prevent me "using" my wrist that could be irritating it so much during the night that it is leading to a lot more pain during the day.   He also recommended CBD oil (he wasn't sure of a brand, so if you have one, please point me in the direction of where to get a good one).  He said his patients have had a lot of good luck with CBD oil (ugh, just realized, he does mean applied directly to the painful area right?).    His hope is that a cortisone shot several times a year will help with the pain and swelling.   He was very empathetic to how painful and bad this is, especially given my age, how quickly it came on and advanced, and the fact that for wrist arthritis there just aren't the good options that exist for larger joints.    Back in September at my physical I did ask my primary where to go to get help with this and he said my ortho hand surgeon.  When I have asked older ladies that I know where they go for arthritis help they all threw up their hands and said getting good help for it is hard and they kind of fumbled along in the dark and went to whoever was willing to help them.    So for now, this is where I stand.   I do appreciate you taking time to help me and if you think of anything else, please share with me.  I am also going to spend some time on the Arthritis Foundation website and see if I can get any good info/help there.

[Pawz4me]

I'm glad you got the cortisone shot, and I sure hope it helps!

Your doctor sounds very thorough. I'd hang on to him.

The only other thing I can think of is maybe trying something like Tramadol. My MIL has arthritis in her spine and hips (reading her scans and x-rays kinda makes me want to whimper). She can't take NSAIDs anymore after two serious GI bleeds. But she says Tramadol along with Tylenol Arthritis keeps it mostly tolerable. And FWIW, my rheumy is a fan of bracing as much as possible when things are flaring, but he says if nothing else use a brace(s) at night. And it really does help my thumb OA to keep things stabilized at night.

I'm so sorry you have to even consider a bone met. We think about that every time DH gets an ache. He had one bone met, but thankfully a short course of radiation seems to have taken care of it, and (knock on wood) it's been three years since he dealt with that.

[kbutton]

IDK the current data on effectiveness, but some people really like glucosamine and chondrointin for OA.

Any chance you have gout or something related aggravating the OA? Just another thing to rule out or treat alongside.

[Ditto]

@Pawz4me Once cancer has entered the game everything changes doesn't it?  I am glad that your husband has been stable and radiation took care of the bone met.  I pray he stays stable.   It is just scary and affects every corner of your life.

Thank you for the Tramadol info.  I will definitely look into it and also make mental note to mention it the next time I see my dr.   It is very reassuring to hear your rheumatologist's thoughts on bracing and that it has helped you.  Hopefully I will get the same good results.  The cortisone shot has already started working and I am in less pain than I have been in weeks.  I am sore and have some pain but it is such a low level and truly I forgot how good life good be without such horrible pain.   Your poor MIL!  I feel awful for her.   

I agree that my dr is a keeper.  He did my carpal tunnel surgery (both hands) a few years ago, which is the reason I have a hand surgeon in the first place.  It has turned out to be such a good thing and I am grateful for him.   I've had to see him a whole lot this year and he has never once been anything other than wonderful.   

[KatieJ]

Ditto, this all sounds so,painful! I’m so sorry.

 

I can recommend a CBD product.

Trim Healthy Mama has a product called Hemp and Blue in 2 forms. One is a cream and the other is a balm. The cream is faster acting but doesn’t last as long. The balm works more slowly,  but lasts longer, so it’s great for over night. 

My husband has very severe arthritis in his neck. When it flares, he uses the cream and is much relieved in a short period of time. We have been using this stuff for several years and I can’t recommend it highly enough. 

Shipping is pretty fast.

If Yiu have never heard of them, Do some reading on their website. They have an amazing company.

 

https://store.trimhealthymama.com/product/hemp-blue-cream/

https://store.trimhealthymama.com/product/hemp-blue-balm/

https://store.trimhealthymama.com/product/hemp-blue-cbd-isolate-balm-and-cream-2oz-bundle/

[Ditto]

@kbutton  and @KatieJ  Thank you both very much!   This is helpful and I will definitely follow through.

 

Happily, the cortisone shot and wearing a brace to bed have helped a lot.  Such a relief.  While not completely gone this is a very manageable level of sore (not actual pain).  The swelling is almost all gone, and my range of motion is improved.  I have a whole new level of empathy for those living with chronic pain.  It is really hard to imagine how horrible it is until you experience it.  I am so happy to feel better today.