UKC

Can anyone recommend a strong arthritis pain reliever for osteo arthritis in the fingers?

The usual glucosamine/chrondrotin doesn't seem to be very effective anymore. I don't eat much acidic stuff and generally eat fairly healthily.

I'm aware there will be side effects to consider in any drug, so also open to holistic/alternative solutions that might've worked for you to be able to continue training and climbing and making gains.

Thanks.

Glucosamine and chondrotin never worked for me for OA.

I have a mixture of things including ibuprofen gel 10% on prescription, but also paracetamol and codiene as well depending on level of pain.  I also use, and much prefer, Deep Freeze and Biofreeze gels which work well for me.

However, I don’t like to use prescription painkiller drugs if I can avoid and generally only use the ibuprofen gel for other larger joints affected by OA and even then rarely. (I’m hesitant as I can’t have ibuprofen orally and I’ve had opposing opinions from professionals as to whether the gel works in the same way as tablets and has the same side effect risks!)

Specifically, for finger OA, and fortunately for me an excellent non drug treatment (and far better than painkillers in being quicker, more effective and longer lasting), I’ve used is cold water immersion. As cold water as you can get out of tap and add ice in a basin, plunge hands in and wait. The idea is to get the fingers really cold and then allow the body to reheat them which happens with a rush of warm blood; the cold reduces the inflammation and it’s the blood pumping back in that encourages healing. Repeat if necessary, but I find once now is enough that I have got  used to it!

Of course, this is certainly not a treatment for everyone, but works very well for me. Aching, stiff, swollen joints after some climbing sessions quickly relieved without need for painkillers. If only I could do other joints that way!

Massaging the finger joints to stimulate blood flow into the fingers with thumb and forefinger of other hand though is surprisingly effectively for temp relief of low to moderate level of pain/stiffness and can be done between climbs easily if needed.

I’ve heard some swear by magnesium gel and I am about to try it as an experiment for shoulder OA.

HTH. Usual disclaimer though - at your own risk and seek medical opinion.

Might be worth trying flexiseq gel. It’s a medical device that delivers nano particles to the joint that helps it run smoothly. The jury is still out on how good it is, but it seems to have some takers.

https://www.versusarthritis.org/about-arthritis/complementary-and-alternati...

Probably more accurate to say that the "jury hasn't been even summoned yet" since there has been no independent test conducted. Bag it with homeopathy.

After taking part in a research project, I greatly reduced the amounts of vegetable oils in my diet, and, for recipes which needed some king of fats used very small amounts of animal fats. Apparently, because we are not good at metabolising veg fats (hence their laxative effect as they try to pass straight through) any small particles that do get into the bloodstream can be deposited in the porous bone of the arthritic joints. After a while these fats oxidise. When veg fats oxidise they go sticky and cause the joints to be more painful, when animal fats oxidise we absorb and metabolise them. The results were never published as the sponsor of the program was a large producer of veg oil products. It is worth a try. It helped me. I went from being unable to close my fingers much beyond about 90* to being able to make a tight fist. 

In experiments which were widely publicised it appears that G and C is more likely to make things worse than improve them. And tumeric has no effect whatsoever apart from causing kidney inflamation in susceptible people.

Have you been through your doctor? My consultant is very supportive of my climbing and running. One of the physios at the clinic is a climber funnily enough, so they get it. 

In reply: Great. Thanks for all those suggestions. I will consider all the pieces of advice.

G and C?

On a more general note - and as someone with some fairly extensive health problems relating to nutrition - the more I read up on dietary "research" the more I simply throw my hands up in despair and give up.

Bit curious on how you found out the results - I imagine that results of trials aren't made readily available to participants, especially if the sponsor intends sitting on them if unfavorable.  Never been involved in such a thing, so genuine question.

Simpson oil.

I started suffering badly with this about 12 years ago. I tried GC after a climber i met recommended it as it had really helped him. I persevered for 6 months but saw no benefit. Ibuprofen helped but this eventually was insufficient and so my GP ,who climbs and understands my wish to keep going, prescribed naproxen and lanzoprazol for the potential stomach issues. This has worked well and allowed me to keep going. Fortunately no side effects after several years of very regular use. 

That seems to be a common combination these days: increasingly strong NSAIDs until the inflammation is brought under control, with antacids ditto to deal with stomach issues.  My Dad had similar prescribed for this arthritic hands.

I am perhaps fortunate in that I seem to be able to take ibuprofen without noticeable side effects - so long as I make sure to take them with or after meals.

I have recently been seen by both a private hand specialist and an NHS plastic surgeon (not cosmetic surgeon) and both were skeptical about ibuprofen and diclofenac gels.  Apparently there is no good evidence that it they provide a more direct for the pharmaceutical to reach the injured parts.  There may be some absorption in to the body as a whole through the skin, and thence via the same pathways as if taken orally.  The plastic surgeon's view was that one of the primary benefits of the gels is likely to be the massaging effect of applying them - hence perhaps why they can seem to be effective for soft tissue injuries, but not so much for arthritis.

AFAIK glucosamine & chondroitin are not intended to have an analgesic effect.  The way that chondroitin in particular is supposed to work has been likened to a bald man trying to treat his condition by eating hair.  They certainly made snuff all difference (except to Holland Barrett's bottom line) when I tried them with my first bad bout of tennis elbow.

Pharmacist here... obvs have no idea of your medical history so please consult your GP/Practice Pharmacist first, but here are some suggestions:

- paracetamol: need to take it regularly (2 tabs 4 times a day) but it can be helpful. If it works, and buying a packet from pharmacy every 4 days becomes a ballache, you can ask for it on prescription.

- ibuprofen or naproxen tablets: but not if you have any history of stomach problems. Best to take something to protect your stomach too (ask GP to prescribe) and look out for symptoms of indigestion/acid reflux. 

- ibuprofen or diclofenac gel: is fine to use if you can't take the tablets (eg previous stomach problems).

- what dose of glucosamine + chondroitin have you been taking? It might be worth increasing it either short or long term.

-.I'd steer clear of codeine (including co-codamol) and tramadol if possible. Especially tramadol: it's the work of the devil IMHO and difficult to stop taking. Codeine and the like is likely to make you constipated and/or drowsy.

- other suggestions so far in this thread also seem reasonable.

HTH 

Becky

I've had much the same advice from several surgeons and physios.

I've also now been warned off taking Ibuprofen orally at all - not due to the obvious stomach side effects which never particularly bothered me, but for more subtle long term kidney damage. The doctor advised sticking to paracetamol and codeine (despite the obvious side effects of this). No easy answers here!

Tramadol I agree - I've had it and it made me seriously ill. Codeine is now my GP's preferred (post-paracetamol) analgesic (FOR ME), but prolonged use tends to mess with my head in ways I don't like, so I'm careful to only use it when really necessary. No constipation or drowsiness, but mild hallucinations if I take too much for too long.

I think the main thing is to talk to your GP and go carefully with whatever meds they suggest. What works for other may not be the best for you. And assume that anything you take has some (short or long -term) downsides.

I found out some of the results because the doctors and their assistants were a 'chatty' bunch. They didn't give definitive results but said that preliminary results appeared to be as stated above. I accepted that it worked for me and therefore thought that passing on my experience may (or may not) help others.

G and C = Glucosamine and chondroitin.

Although it's only mild effect (but every little helps...), try turmeric extract taken daily. Works well for my Mrs.

Mine became quite bad and I still have permanently bent fingers. I was advised to squeeze something soft (you can get sponge pads but a sock bundle is ok) after climbing and to carry out very aggressive massage of the joints. I did both over a period of about 18 months. The pain is mostly gone other than in very cold conditions. I can’t take most pain relief after stomach surgery. 

In reply everyone: Marvellous!

Thanks for such a plethora of suggestions and personal experiences. Docs appmt it is then, and weighing up the best approach with my personal circumstances.

Cheers - tend to avoid asking these sorts of questions because they're usually taken as as a dig of some sort - probably because they usually are