Reluctant to take pain relief - help me understand

[Womanofmanycoats]

Am I being unreasonable to expect someone to take or even try painkillers ( paracetamol or Ibuprofen) if severe joint pain ( arthritis)is distressing them to point they struggle to walk, are almost in tears and family activities have to be planned ( aka completely limited) around their lack of mobility?
Important to note the reason they don’t take painkillers is because they ‘don’t like idea of them’ and ‘I just never have’ ( not due to previous side effect or concerns re long term impact). Their Gp recommends pain relief and exercise.

I would highlight I do not want to leave anyone out if their mobility restricts them- I have other elderly relatives who have restricted mobility and am happy to limit activities for them. Push them in wheelchair, have them lean on me heavily etc. I myself have chronic pain/ health issues so in some incidents, I will encourage my partner and others to go ahead and enjoy the activity - I will sit close to the car ( I bring a book and reassure the family party I don’t mind missing out - even if that’s not true)
Maybe that sounds hypocritical- but difference is I sit out to try not to restrict others. In cases I can’t sit out I take painkillers to try and negate impact of pain- negate impact on others
As let’s be honest- if other people see you in pain, sweaty pale of course it’s concerning for them

Maybe I am being judgmental as I am more sympathetic /more motivated to limit family activities if the person themselves have tried to help themselves (in my eyes via pain relief)

I just don’t understand- can anyone who is adverse to painkillers please explain their point of view?
I understand pain is a symptom so sometimes it’s a warning sign you should listen to. But equally if everyone with arthritis declined pain relief and avoided movement as a means of management- surely that’s worse for your overall health?

I appreciate I am biased - as painkillers are quite normalised for me. I would have passed out from pain every month for over a decade - so relied on painkillers to help me get through the day

Also to note - I don’t expect someone adverse to painkillers to take them regularly but what would be harm in taking two prior to even the bigger special family day?

Can someone help me understand this family members position ? I want to be empathetic but just don’t get it

Also so I am not drip feeding I know pain relief if not a solution. I try to support the person - take to appointments, encourage their physio, became their carer after an operation while they rehabilitated.

I think a lot of older people feel that taking painkillers is a sign of weakness.

Im sorry that this is impacting everyone so much, including you when I can tell you are trying to do the best by everyone.

BTW it’s ok to feel pissed off about it and / or frustrated (as long as you don’t take it out on them of course) because your feelings are valid.

do you know what I’d do if I were you? I’d take myself off on the exact day out I wanted, by myself, once in a while. You deserve the day out you want as well sometimes.

Personally I'm reluctant to take painkillers. I worry about side effects and I don't want to mask a pain that's trying to tell me something and damage myself. I've also heard that if you take them a lot they become less effective.

I'm not saying I never take them - I've taken them regularly for a back problem in the past and they were very helpful in helping me get to a point where I could get mobile enough to recover - though I also think that my eagerness to get to a point where I no longer needed to take them helped me to do the work (lots of physio and exercise) that got me better.

I'll take painkillers if I think something's going to stop me sleeping, or if I really need to push through for other reasons. However if I've taken them to push through, I find I often pay for it by feeling even worse the next day.

What I don't do is not take them and then complain I'm in pain as I know how annoying people find that.

This is an interesting subject - I realise everyone is differant as regards the impact that pain has on them. We each have a level of pain tolerance that varies from person to person.

As I am in the 75+ demographic - I have vague aches and pains for which I am reluctant to take ANY painkillers.
Paracetamol upsets my stomach - so that is out.
It will take severe pain - raging toothache or bad headaches to make me take a painkiller.

It may be an 'age thing' and denial but I have been the same all my life. Your relative could be the same.

I am exactly the same, not deliberate just doesn’t occur. I think though it’s a subconscious rule passed on by my mum as someone said upthread, seen as being a bit weak - well getting ill was generally thought of as that.

@Womanofmanycoats Fair point about my making assumptions. Also I'm sorry I didn't realise you lived in pain, much of what I said you already know in that case. Some of the subsequent posts are very interesting.

Pain is terrible and actually not something that can be effectively managed long term - not in my experience. And everyone's pain is different. Many older people are living in constant quite serious pain - yet get accused of irritability, unwillingness to do things, lack of engagement with young children - and it's frequently due to ever-present pain. (Some are just bad-tempered of course!)

I have a condition and like you had to deal with young children and work while barely able to think through pain, (luckily not constant but when it hits, it hits) - and no-one understood. "Just take a painkiller" (Subtext -"stop making it my problem"). I'm now able to hide away and be more private in pain which makes an enormous difference. And I rarely take painkillers unless I have to to get through something.

My aunt, (89) uses yoga breathing and meditation to help mange it - and "compartmentalises" it to help her cope - and occasional codeine to help her sleep. My cousin ruined his stomach lining - and now has to eat a very restricted diet, due to prescribed painkillers, (ibruprofen I think but don't know), after a serious car accident. It's a horrible symptom so even if he were 70 and was going to live to 80 it's along time to have to suffer that. He still lives with the pain - and takes nothing now.

So sorry if I came across badly and got the wrong impression from the thread. I hope you and family member find a compromise of sorts.

You've mentioned both your partner and an older family member but I can see that you don't really want to say exactly who it is whose view you are struggling to understand.

I wonder if it's not your partner, if your partner could help you understand their personal position and it might help you see the position of the other relative, if you can position this as wanting to understand your relative - like others have pointed out, people can feel defensive or wary about explaining their views because often the motive of someone asking "But why not?" is not to understand, but to find out what the reasons are so that they can "solve" them, because they think that they know what is best.

For example your partner said "Well, your view is skewed by seeing painkillers as normal" - could you ask him to elaborate on this and explain how he sees them, whether he can compare them to something else.

For example, I see surgery as not really being "normal" as in, it's not an everyday thing that I would expect to happen, I would expect most people to have surgery only a handful of times in their life, avoided as far as possible, and used when the risk/benefit calculation is clearly in favour of benefit, because of the fact that it inherently causes harm (cutting into the body) and introduces risk (general anaesthetic).

I don't see surgery as bad, it clearly has some really brilliant uses, and would never see it as something to judge, but if it was my choice, and I was unsure, I'd probably err on the side of not having it.

Can I be direct and ask how you manage pain without pain relief ? That is some feat.

I have TN ( trigeminal neuralgia) for which conventional painkillers do nothing. This probably feeds my deep subconscious belief that OTC painkillers are a waste of time and money. There are drugs that help some people but they come with significant side effects and risks of their own. The main one is contraindicated for me anyway.

How do I manage it? I avoid anything I know that will trigger it even if that means wearing a hat and/or scarf on a warm sunny but windy day. If I do have an attack I use heat packs and distraction techniques and hope it passes relatively quickly.

My then DP was really told off by his surgeon in the follow up appointment. As well as not healing you hold your body in a way that isn't natural when in pain, so that causes issues.
With many conditions it's better to take the recommended dose and walk/move.

I avoid painkillers because I'm on other strong medication and if I have a drink, my liver and kidneys struggle, so it's a drop of alcohol over painkillers. But If it was going to spoil family time, I'd take the painkillers.

What type of arthritis is it? Are they officially diagnosed? (and under the care or rheumatology?) Do they take any medication for their arthritis or other conditions?

Do they just like to moan and be the centre of attention? (Sadly some people do!!)

I am medicated for a type of autoimmune arthritis, it's not a nice medication. When I'm in pain or having a flare I take pain relief but I try not to take it too often.

Ibuprofen can be used as a "course" for its antiflammatory properties and this is usually the first thing my rheumatologist will recommend if I'm having a flare. I am advised to add in paracetamol if necessary. I've also been prescribed various pain relief over the years too. Personally if I'm in pain, I take medication.

Pain medication can be a double edged sword.
for those in chronic pain they aren’t effective with time as the body becomes used to them -

for immediate pain relief anti inflammatory medication nsai can cause a lot of problems with stomach and asthma like symptoms - low dose steroids cause a lot of problems too

pain is caused by inflammation and there are non invasive protocols involving vibration, ice baths and low histamine diets that have been proved to alleviate chronic pain as well as using drugs without the side effects.

i was in chronic pain most of my life and used cold water immersion, and diet to alleviate it

I don’t take medications for pain at all - they don’t work for me anyway and give me stomach problems and asthma

I’m proactive about things though and can imagine how frustrating it may be to have someone who won’t help themselves and wants you to keep them company while they wallow in poor me behavior.

I’d just leave them to it and crack on with what I wanted to do!

I think you have been given a bit of a hard time actually OP.

You are in pain and take medication in order to be able to be this person's carer, but they will not take any pain relief to make your life easier???

So they want YOU to take pain relief in order to help them, but won't take any pain relief to help you or to make an occasional outing fun?

I'm afraid I would be calling them out on this.
They refuse to medicate so you have to medicate yourself. That is the bottom line.

They are 100% entitled to make their own choices around medication, but then they have to expect that you will do the same and you may not be able to help them as their carer.

I would sit down with them and spell some of that out to her.
And if she doesn't want to (and let's be clear you are suggesting that occasionally for the sake of a nice family day she might want to do it, not asking her to do it daily.) then you need to have the freedom to say fine, but then I cannot take you on our day out tomorrow.
Again, it is entirely up to her, her choice, but then her choices will impact what you are able to help her with.

Sorry to vanish, I've been out all day. I use an electric wheelchair to get out and about. I can walk, and I walk at home most of the time, but I have to be extremely careful not to overdo it or I can put myself in a position where I basically am in too much pain to walk at all.

I think I am fairly unusual among disabled people in that I didn't resist the wheelchair at all. Disability forums are full of people refusing to use a chair or scooter and living very limited lives as a result. A lot of people view it as giving up, and a lot are scared of the judgement of strangers that comes from being a wheelchair user who can walk and therefore being accused of faking it. I decided I want to get on with living my life as much as I possibly can so I got the chair and got on with it. I have had some negative reactions, but most people are actually pretty understanding about using a wheelchair when you can walk. And those that aren't , well I didn't want to know them anyway so it acts as a useful filter for ignorant arseholes.

I do still overdo it sometimes. That leaves me dragging myself up the stairs on my hands and knees crying in pain. I try really hard not to though, because that leaves my husband having to do all the childcare and look after me as well and that's not fair on him.

If I am in pain, hot water bottle is my go to. I will admit that I also resort to alcohol, which is not necessarily better than painkillers I know. I do very occasionally take painkillers. Some I have developed a nasty reaction to from long term use in the past so I have to make a decision as to whether the pain or the reaction is worse right now.

It's interesting reading some of the replies here.

I've always taken painkillers without much thought until my Dad died from liver cancer. It could be co-incidence but he'd relied on paracetamol and methotrexate for years for his arthritis.

Since he died, I've taken the paracetamol/ibuprofen out of the 1st aid box. And haven't missed them.

I hear you. This is me, too.

@Womanofmanycoats

It sounds as if you are caught in a dynamic of obligation and guilt.

Maybe sit down and take a look at your energy and time and enjoyment of life in terms of a pie chart or some other visual.

I have a suspicion that you deserve more 'pie' than you think you do, and certainly more than you allow yourself to have.

There are at least two people in your life who see you as a mug.

I rarely take painkillers. I just prefer not to.

for colds and flu they can prevent the body’s natural healing process- raising the body’s temp to where bacteria and viruses cannot grow, increasing blood supply (swelling, heat) to transport blood, platelets, white cells etc to where it’s needed.

like pp I don’t take meds for joint pain, injuries etc as I’d rather be guided by the pain- I’m less likely to overdo things and make them worse.

i don’t actually find they make much of a difference anyway. I had a really bad bone break in a traffic accident once any got given a shit ton of nsaids, paracetamol, and opioids. I just ended up vomiting. Same post c-section, whatever they gave me made me very sick (vomiting post section is not fun) and didn’t really make a difference to the pain.

so that’s my reasoning. If I take pain meds it’s usually for something like period pain (god bless mefenamic acid in my 20’s) or toothache where I know it isn’t going to affect my recovery.

i find hot baths and sleep better than painkillers.

Condolences - but don't leave yourself without simple pain relief; it's a known risk from RA/PsA/Autoimmune diseases. Like pretty much all DMARDs and Biologics, there is an increased risk of cancers (and in particular, liver damage with MTX going on to cancer), but on the whole, it's balanced pretty finely between

Taking medication to affect the immune system which may cause liver damage, ototoxicity/infections and/or assorted cancers

and

Increased risk of other cancers & cardiovascular events/strokes/cardiomyopathy/sudden heart failure/atherosclerosis, all directly caused by having uncontrolled inflammation rampaging around your body for decades

plus losing entire decades to pain, deformity and exhaustion/misery.

Or, as I've reasoned it when deciding to take the medications, accepting the risk of a shortened lifespan with the benefit of actually being able to have something resembling a life in the meantime.

To be able to function for years with MTX/Folic Acid and just paracetamol would be a very good outcome on the whole and I hope that he had been able to enjoy his life largely pain and exhaustion free.

Someone I used to know had an incredibly low tolerance for pain relief and would be completely zonked out if she took 1 paracetamol tablet.

I can sort of understand this if people are dealing with very long-term chronic pain and are scared of dependency.

I do find the machismo about taking OTC painkillers for short-term episodes like headaches/joint pain very irritating though.

My ex DH would always refuse to take paracetamol (and most pharmaceuticals) on the grounds that he didn't trust Big Pharma but drank like a fish. It was just stupid and illogical.

I take strong painkillers everyday, not that I want to, but if I didn’t I wouldn’t be able to get out of bed, work or function.

Ive tried all different sort of medications and some of the side-effects have been terrible. I’d say at the moment the painkillers take away 20-30% of my pain. Medicinal cannabis has been recommended to me now but I don’t know.

The worst thing is when you’re sitting in agony and someone say oh I hate even taking a paracetamol, I just work through it.

Paracetamol isn’t sedating in the slightest. So not sure how that one works.

I take them daily
Dihydrocodiene at night. Paracetamol weekly for the temperature/shivering/sweating another medication gives me. Naproxen for the bone pain also from the medication
Mefanamic acid all through my period

Nothing else brings my temperature down and when it gets to 40c I feel miserable

I can't cope without mefanamic acid, one of my periods resulted in paramedics with gas and air so I take that until I get to see a consultant (suspected endometriosis)

Impossible. There's nothing in paracetamol that's knocking anyone out. It's not sedating in the slightest.
Same goes for naproxen (which I've seen a few people say 'knocks them out'.)

I unfortunately have to take very strong painkillers and nerve meds every day just to get out of bed and function. Otherwise I'll be bedridden, writhing in pain and unable to get myself even to the toilet.

I don't have the option of just 'battling on'.

Fortunately, my GP put me on a long acting painkiller which I only have to take every 12 hours, my nerve meds I take 3 times a day, I have another med I take 3 times a day and then the normal OTC meds (apart from NSAIDS which I can't have.)
It's taken me and my amazing GP 3 years to get to this regime which actually keeps my pain mainly tolerable - however I do still have flare ups, and I try not to take any extra medication during those but I do have another strong** painkiller I can take as needed.

Would I rather not need all these medications every day? Of course. But when the choice is meds or screaming agony that leaves me bedridden, I'm always going to choose the meds for the sake of my family and my sanity.

My dad is one who won't take even paracetamol for a raging fever, yet he'll non stop moan that he feels shivery, sweaty and just crap. Offer him some meds though and I get 'no I'll just get on with it' before he starts moaning again. Drives me nuts that he won't even try to help himself.