I recently had surgery for Spinal Stenosis in my lower back, but on coming out of hospital developed a dvt in my leg. Due to this blood clot I have been put on Rivaroxaban (blood thinners). Because of this blood thinner I have had to come off of Naproxen (anti inflammatory) which I have relied on for pain relief for years. I also take Methotrexate and have Infliximab infusions every 6 weeks. I saw Rheumy last week and asked for an alternative to Naproxen but was told I had to go to GP. GP is reluctant to issue alternative without consulting Rheumatologist! Has anyone else had this problem and what alternative did you get? Thank you.
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dickfend
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Hi. I’ve had RA since about 2015, and two years ago had a heart attack. When I had a stent fitted they quizzed me on my medication, and immediately was told no more naproxen, as it could have contributed towards the heart attack. I asked about a replacement and my specialist, the hospital staff, my GP and all said just use painkillers.
Eventually my GP agreed to Zapain, 30/500 mg codeine phosphate/paracetamol as a replacement. I don’t think it’s quite as good as naproxen, but it does work as a painkiller ( not so much as an anti inflammatory). Hope this helps and you find a replacement.
Thank you for your reply Chris. Yes, I understand that Naproxen can be a bit of a problem. I have had RA since early 1970’s and been on Naproxen for a lot of years. Until my spine surgery it seemed to do the job. I had a lot of Codydramol which is a combination of paracetamol and codeine and started taking them, but they don’t seem to have the same effect as Naproxen. I am still trying to see the GP to discuss this matter with them. Thank you again.
You can always ask for referral to pain clinic. GPS will prescribe any drugs they suggest…and they may have other ideas. I use nefopam as can’t tolerate much apart from paracetamol.
Yes I did at one time belong to a pain clinic. Didn’t have a lot of success with them either. I hope to get an appointment with GP soon so hope they have some solution. I am experiencing a lot of pain also from the blood clot which doesn’t help either. Thank you.
I've relied on tylenol only for years. My naproxen was stopped for multiple reasons. On really tough days I take a tramadol in the morning. Here, in the US, the docs really don't like to prescribe any narcotics & they are monitored for that, so a pain clinic is typically where you're going to end up. A heating pad helps as well, but honestly, I think staying as active as possible is really important. Sitting around is the worst thing you can do, in my experience. I have spinal stenosis as well, in my neck, and my arms are really affected, but I'm not interested in surgery for anything at this point. (And I've been told I need both ankles and feet operated. I think I've had enough of surgery.) Anyway, good luck. I hope you find relief soon.
Thank you very much for your reply. I am taking a mix of paracetamol/codeine at moment which doesn’t seem to have the same affect as Naproxen. This is in addition to six weekly infusions of Infliximab and Methotrexate weekly.
Well, really, what you lost with the Naprosyn was an "anti-inflammatory " and perhaps your infusions need to be updated (larger dose or less time between infusions or even a different drug) or; it's also possible that the quicker solution is low dose steroids. I agree with you that Naprosyn was a wonderful drug, but I can't imagine that any doctors expect you to endure constant pain. I hope someone helps you soon.
Manufacturer advises use with caution! Gastrointestinal bleeding risk when used with Rivaroxaban as it is also an NSAID, as I’m sure your GP has taken note of and advised you accordingly, Spanelmad. Like you, I also have a degenerative spine and nerve damage and have struggled without using an NSAID, but I think I’m “getting there”, or at least able to manage pain levels a little better with 50mgs x 4 daily of Pregabalin with 1 x 500mgs Paracetamol between each dose of the Pregabalin, plus very gentle core strengthening exercises and keeping as mobile as possible. I have Inflammatory arthritis..25mgs subcut MTX but disease not controlled yet, so a discussion being had with team re another biologic (failed on 2).
Hi yes my op went really well. No more pain and able to walk properly. However after the op I have developed dvt in leg which is giving me pain but the spinal surgeon told me after that I needed the op otherwise I could have lost use of legs.
It’s difficult to get the combination of meds right isn’t it. I was on naproxen for quite a few years and changed to celoxicob for a while but was taken off them due to inflammation in my stomach. I now rely on zapain, amyltriptaline and gabapentin for pain and nerve problems. I have cervical myelopathy and stenosis and had surgery in 2020. However I began with more severe problems with my legs and balance and having falls. A new mri found more problems in my cervical spine so just waiting for more surgery 🙄🙄🙄 it’s scary to think I might loose the use of my legs too or worse!
Really hope you can find the right meds for you 🤞🏻🤞🏻🤞🏻
Thank you for your reply and wishes. Yes I had problems with my cervical spine and they wanted to operate but I wasn’t ready for op then but my lowe back op was a vital operation according to my surgeon. Thank you.
Thank you for you reply, its great to hear that you can walk ok. I am really struggling with walking which is a total [pain as I walked a lot. Hopefully my spinal injection will help. I hope things go really well for you
Hello dickfend……I had the same surgery as you at the end of last year followed by a DVT a couple of weeks later. I’ve recovered well post surgery but still experiencing burning griping nerve damage pain from lumbar spine radiculopathy, across buttock and down thigh into my foot. I was desperate to use my failsafe NSAID but of course, we can’t as they’re contraindicated, as you point out……See my reply to Spanelmad re Pregabalin, which is used specifically for spinal injury pain…still not an NSAID though! Best of luck to you; I hope your GP can help out.
Hi, I was in exactly the same situation and was told my rheumatologist to take paracetamol. If a particular part of by body was hurting I was advised to use ibuprofen jel. Hope this helps.
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