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flair ups
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navy8wifey posted:
I have been having my first official flair ups since being diagnoses. I have been having excruciating pain in my muscles. And of course my Dr has been sick for the past week and has not been able to see me. I went into my ER and they proscribed me a very low dose of prednisone (60mg) to take once a day and vicodin to help when I 'over do it'. But after about 12 hours the prednisone seems to wear off and the pain comes back and teh vicodin seems to do nothing to help. So my question is ... What else can I do to help the pain from returning? And how long do these 'flair ups' usually last? I have no idea what to expect and I haven't been able to talk to my Dr at all about it. Any advice is VERY much appreciated!
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deewalt2911 responded:
Hi navy8wifey, I am sorry to hear that u r in so much pain. I know what that feels like. I also have SLE and fibromyalgia. I was reading an article the other day about issues similar to your own; pain in muscles. I also wanted to know if that was the lupus or fibromyaligia? I spoke with my rheumatologist and she gave me some advice; she said if you are having pain and swelling in your joints, fever and flu like feeling, it probably the SLE in a flare. If you are having muscle pain with fatigue, that sounds more like the fibromyalgia. I thought that was a pretty neat way of being able to tell.
As far as the article goes, it also said that you can have a flare up of the fibromyalgia.
Ok, so what I am sying is if you have not been diagnosed with fibromyalgia, then you may want to discuss this with your doctor when he/she returns. There are some great medications on the market that are very effctive in treating firbomyalgia, Unfortunately, Vicodin is not one of them. All the best. Hope you feel better soon.
 
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R Swamy Venuturupalli, MD, FACR responded:
A flare up is different for every person. Some people will flare for a few weeks, others months, others years. It all depends on how you respond to your meds, and how you look after yourself (sleep, stress, etc). Firstly, it is important to confirm that this is indeed a lupus flare and not something else such as a pinched nerve from disc prolapse, shingles or other viral conditions etc. In case of a lupus flare, steroids are generally very effective. If the 60 mg does not seem to last all day long, sometimes I recommend going to 30 mg twice a day. A set of lab work and evaluation by your primary phyiscian may be helpful.

In addiiton to prednisone and pain medications, there are several other options for lupus patients to consider for pain management. This list is not exhaustive, but covers some of the basics.

Other Lupus Pain Management Options:

Some patients who have chronic pain that are not responding to medications should consider consultation with a pain management specialist. Some non-medical treatments for pain can also be useful, including acupuncture, biofeedback, massage, and physical therapy.

Physical therapy. Physical and occupational therapy can help control lupus pain through exercises designed to keep muscles strong and to maintain the full motion of your joints. Physical therapy can also teach you ways to protect your joints from injury.

Mind-body techniques. These treatments take advantage of your mind's ability to influence physical symptoms. Breathing exercises, relaxation training, and meditation are all good ways of lowering stress, which can be an important part of your pain management plan.

Massage. This treatment can be very relaxing and soothing, but it's important to tell the massage therapist about your lupus diagnosis first. Ideally, the therapist should have experience working with lupus patients.

Acupuncture. This ancient treatment has been used for nearly 2,500 years to help people manage a variety of health ailments. The National Institute of Health has concluded that acupuncture is effective in relieving many types of pain including pain related to fibromyalgia. Although there is limited evidence regarding the use of acupuncture to treat lupus pain specifically, a recent study published in the journal 'Lupus' found that even a few sessions of acupuncture may be effective in reducing pain in lupus patients.

Rest is important and controlling stress are also very important. Wish you the best!


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Dr. R. Swamy Venuturupalli is a board-certified rheumatologist practicing in Los Angeles. He is Clinical Chief of the Division of Rheumatology at Ce...More

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