Prednisone combined with Tramadol

Eileen,

I understand your point, but I doubt an increase of 1 mg pred would make a difference.  I've had the sleepless nights for months, even with the higher doses of pred. 

So I guess you don't agree with my GP who says that "many people are on far worse drugs to help them sleep than Tramadol (paraphrasing)?"

Eileen, I agree with you, Tramadol here in the US is prescribed for intense pain and ONLY for a short period of time.  It is a Opioid drug which is close to heroin, so I just read in my AARP newsletter. 

It was prescribed to me when I had intense pain in my left hip due to bursitis. It certainly helped and made me feel "good", and I was able to sleep at night which I could not do while I had this pain.  I was told to use ice and tramadol at night.  But no more.....just for a few days, and the doctor only prescribed 10 pills with no refills.

Just thought to share my story. 

 

Hi Erika,as you say tramadol is a member of the opioid family but it is one of the milder ones and if you are aware of it'd potential for addiction and treat it with respect there usually is no problem.I was very wary at first but the slow release version helps me sleep as pain does not wake me as much plus if going out for a days walking on my husband's day off it means I can function without extreme pain so he does not keep saying "we are going home you are in pain.".In UK it is now a controlled drug so GPS only issue once a month and can keep a check on persons usage

Although it was in response to the suggestion that a low dose is non-addictive it is also more a comment on the attitude of many doctors to pred - they are quite happy to hand out drugs to all of us with PMR that have exactly the same or even worse long term effects as pred. Omeprazole, for example, also causes osteoporosis since it prevents uptake of calcium and is not necessarily needed. AA is implicated in many unpleasant things - including the femoral fractures it is supposed to be preventing. Pred may have 82 listed side effects - but no-one gets them all and many get almost none. 

But I would suggest you see a Bowen practitioner or maybe a physio if that doesn't appeal - because I'll lay odds the pain you are complaining about isn't PMR and it would be sensible to identify the muscular cause and work on it.

I agree,  I found Tramadol very helpful for the short period of time I needed it, but as you say this drug needs to be treated  with respect if it is used for a longer period of time and extreme pain.

Ptolemy,

In the beginning of my PMR, it didn't help a bit either -- the pain of the PMR totally overwhelmed everything.  But the pain levels are down enough that perhaps these other meds take the last bite out of it??  

The other thing that might be happening is the myofascia pain, or even arthritis in the spine.  Whatever it is, it slowly gets worse as the night progresses and the tramadol hits the spot.

Hi Bob,I HAD to come off steroids and cannot take NSAIDs due to reduced kidney function caused by them.GO put me on paracetamol plus tramadol for bad days.Mainly take it at night to allow sleep and movement while doing so.Rheumatologist has now got me on methotrexate with close monitoring and appointments.Touch wood it is starting to kick in but was told to stay on the painkillers till I feel I can cut down as my blood results are still rather high.It is a slow journey with stops and starts (12years).Different stuff works for different people and if pred +Tramadol works for you with no problems stick with it

If you are unlucky enough to start on Tramadol or any other such drug and then need to escalate the dose - as often happens as your body learns to tolerate them - you will have far worse problems stopping them that anything to do with stoppong prednisolone.

You do NOT become ADDICTED to pred, your body may resent it being removed if you reduce too fast but it is not true addiction - and by most standards reducing from 20mg to 3mg in 9 months when you have PMR is very fast.  Far too fast probably. 

Some people do not have problems reducing pred at all, others find that provided the steps down are small they have no problem either. Some people do not have significant short or long term problems with pred, most are reversible. However, I do hope your GP and rheumatologist don't have too many patients with PMR or, even worse, GCA. Pred is the only drug that manages them, without them their PMR patients will suffer unnecessarily if they are rushed off it and many GCA patients would go blind.

It isn't just the pain, which is bad enough but the long term uncontrolled inflammation levels in the body do untold damage, leading to increased rates of cardiovascular disease and even some cancers - so I for one will take my chances using pred which gives me a pretty much pain-free life in the meantime. I've had weight gain, muscle wasting, bad hair, skin problems - all reversed with lowering the dose and some hard work.

Jo, do you think it is the PMR that the Tramadol is helping or do you think you have pain from something else?

I think its Pmr but the doctor thinks its fibro. Both doctors believe that prednisone lowers my crp levels which are normal and that I should be pain free as long as these levels are stay normal. I also have pain and stiffness in my hands and wrist which both doctors have told me that it never happens in Pmr hence the Fibro diagnosis. The rest of my pain is in the shoulders and hip area. I just got my sit stand work station at work asI cannot sit for any longer than 15 minutes. I believe that I have reduced far to fast but out of the 80 side effects from pred

I experienced at least 40 of them. I will be glad to be rid of Pred. I will also strive to not take alot of Tramadol as i believe my gp will not go for long term increasing the dosage. Its for really bad days only. I see rheumy early Nov and im about a month behind in reduction as I just couldnt handle it