GP says “Live with it”

[MissKittyBeaudelais]

I’m 57. My GP has recently reviewed my meds. He’s taken me off a non-steroidal anti inflammatory and because the X-ray showed I had “mild arthritic changes” he said for my age, it’s not bad and I had to accept it. When I was 32 (I’m now 57) I had an MRI scan which showed I had multi level involvement arthritis and spondylitis from C1 to C7. So according to him, it’s got better 😐. He says he has no record of the MRI scan, despite me taking a copy in for his records a couple of years ago. Having moved since, I can not find my copy of the MRI report so, it’s like he doesn’t believe me. He actually turned the screen around and pointed to the words “mild arthritis”.

I’m feeling a bit desperate as the pain and discomfort wakes me at night; I’m downing Brufen and Paracetamol at the allowed level for a 24hr period and I use Brufen Gel and Deep Heat 2/3 times a day.

Any advice? I’ve literally no idea what to do. I think he thinks I’m a hyperchondriac 😐

Get a second opinion. You are entitled to change doctors

Oh that makes me annoyed

can you see someone else at the same practice? If not, then you need to go back and demand that you get better treatment - complain to practice manager if you need to.

it is not up to him to decide how much pain you have.

Some doctors are useless. I went once with the worst sore throat I'd ever had. She never ever looked at me but said "what do you want me to do about it!!"
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Can I ask which non steroidal anti inflammatory (nsaid) medicine you were on previously?

You can go back to medical records at the old hospital and request another copy of the scan ..it might cost something but at least you have the proof.

Request a copy of the scan change GP and request a referral to a rheumatologist if the anti inflammatory meds don't work. If the pain becomes acute or you have altered sensation do not be fobbed off. Good luck OP.

It was Naproxen and I had to take Omeprazole with it. I didn’t take it all the time having short breaks from it as advised.

I will have this house upside down tomorrow in an attempt to find the letter. Failing that, I’ll approach the hospital records dept. Didn’t know I could do that so, thanks!

The surgery starves the town. It’s a huge facility so yes, I suppose I could ask to see someone else. I’m reluctant to complain to the practice manager as it’s not that long ago I had to see her. For nearly six months, every time I got my prescription the doseage on my blood pressure Tabs was wrong. Each time I told them, they said “we’ll sort it out” and then the next month, it’d be wrong again 😡

OK, well you should know that ibuprofen/brufen is also an nsaid, and if you're taking it regularly you should probably still take the omeprazole.

One option is you could keep a pain diary with a note of your pain score out of 10 (10 being the worst pain you've ever had) at different times of day plus a note of any pain medicines taken for say a week. Then go to the GP (same one or different one) and show them the diary. Have a conversation about the risks of continuing versus how you have found living without taking naproxen. I appreciate this will be difficult if GP is not on board.

You have been treated horribly by your GP! There are national shortages of Naproxen at the moment, which could explain why your GP was keen to take you off it. My surgery has been unable to get any for well over a month.

However, it would have been more appropriate to have explained that and switched you to another NSAID, if that was working for you. I have been given Diclofenac, but there are plenty of others too. In the mean time, you can get ibuprofen with 12.8mg codeine tablets over the counter, which could help with the night time pain.

If you have a large practice, could you maybe try an appointment with a nurse practitioner? In our surgery at least, they are all really lovely and would be very sympathetic about pain and happy to prescribe something like an NSAID.

Your GP sounds pretty ignorant about pain. Pain management 101 - pain is what the patient reports it as, not how the clinician thinks it should be.

It is well-known that orthopaedic pain does not correlate meaningfully with scan results in many, many cases. There are patients whose scans show their spine is shot to buggery, who feel little, if any, pain. Other patients, whose scans show at less damage, can be in agony.

I would go back and insist on proper pain relief. The way he has treated you is unacceptable. If he has no other options to offer, he can refer you to someone who does.

If you are interested in taking a different approach to the control of the pain, I would highly recommend Dr Sarno's books. I know two people with previously-crippling arthritis, who are now largely pain-free after following his method.

Medical gaslighting again.

Definitely see a different GP.

Agree that seeing a different GP is a good idea.
On of the OTC Feminax products is Naproxen 250mg

www.lloydspharmacy.com/en/feminax-ultra-maximum-strength-9-tablets

See someone else.

If you had private insurance, would you complain /see someone else?

The NHS is the same thing - you've already paid for it and deserve better.

Ask for a referral to a rheumatologist, if possible.

I was referred years ago (different GP) to a rheumatologist having a strong history of family auto-immune conditions. We have Crohns/psoriasis (mum and sister), ulcerative colitis and psoriatic arthritis also in the family. I personally have a history of full on anaphylactic reactions to a number of drugs.

The rheumatologist that I saw said my bloods were raised but on second “see” they were borderline.

Definitely see a different GP or make a complaint. Not acceptable to leave you in pain like this.

Ask to be rereferred to a rheumatologist by a different GP. The likelihood is you could have PsA or AS which often the bloods do not reflect the degree of inflammation or damage.
With a strong family history like yours you need to be seen and not brushed off with being an older female who should just deal with the pain.

There are national shortages of Naproxen at the moment, which could explain why your GP was keen to take you off it.

It also carries a low but significant risk of cardiovascular adverse events (heart attack & stroke), especially with high doses given over long periods. Doctors are instructed to use NSAIDs at the lowest possible dose for the shortest possible time, and to review long-term treatment periodically. This is a more likely reason for why the GP was keen to take the OP off it.

OP - as others have said, pain is your experience of it, not a state that can be assumed from your X-rays. If the arthritis is causing you pain you do need to get a doctor to discuss it with you. If your GP doesn't feel she/he can do anything, ask to see a rheumatologist.

Opioids aren't particularly effective for inflammatory pain, so don't just go for off-the-shelf formulations of paracetamol or ibuprofen with codeine or dihydrocodeine. @lyrebird1 - prescription of diclofenac for long-term management of inflammatory conditions is discouraged as it has a higher cardiovascular risk than naproxen. Switching from naproxen to diclofenac wouldn't be a likely outcome.

I get Naproxen on repeat prescription for mild arthritis. It has never been queried or reviewed. It helps so much when I have a lot of pain. I had no idea there were any issues with it.

I had no idea there were any issues with it.

All drugs have risks associated with them. No exceptions. Doctors have a professional and legal responsibility not to expose patients to the risk of adverse effects of prescription-only medicines unless the benefit from the treatment clearly justifies it.

Naproxen and low doses of ibuprofen carry a lower cardiovascular risk than most other NSAIDs, which is why naproxen has replaced diclofenac as the drug of choice for mild arthritis. Even then, doctors have to be convinced that the benefit the patient gets from it justifies the small risk.

I will try to make an appointment this week. That in itself isn’t easy, as we all know 😐. Where I live, unless it’s an emergency the wait is usually around three weeks. I need to get my finger out!

The odd thing is, it’s worse during the night (I lie there know I g I MUST turn over but dread having to do so) and getting out of bed in the morning, I have to use the side of the chest of draws to lever myself up. My back, isn’t up to the leverage and is excruciating. BUT... once I’m standing, within 20 mins or so, I can walk ok. It’s painful but not crippling. I can’t lean forward but I can walk. I’m beginning to think I may have a disc bulging/nerve trapping thing going on.

Anyone have experience of these things?

DOI - Orthopaedic surgeon...

1st - Forget about the scans, they don't tell you anything useful about what treatment you need unless your have very specific symptoms related to nerve roots or spinal cord compression, or, if somebody were to plan to do surgery...

2nd - Pursue and persist with a decent physiotherapist for at least 6-12 months

3rd - Failing physiotherapy, seek a referral to MSK spinal services who can then triage you to a rheumatologist / pain specialist / spinal surgeon as appropriate.

@Fix... thanks for that info.

What dies DOI mean?

@misskitty

Declaration Of Interest

Ahh. Thanks.

Interestingly, I went in the spare room last night where the mattress is considerably firmer. Slept with a pillow either between my knees or under them. I was able to lever myself up and out of bed a bit better than usual. Am wondering now about our old mattress (no idea HOW old as DH had it when we got together).

I might try a week in the spare room and see how I feel. I still woke in the night but could turn myself over more easily, very very slowly.