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Q. Kindly suggest an alternate medicine for Indomethacin for joint pain.

Answered by
Dr. Naval Mendiratta
and medically reviewed by Dr. Hemalatha
This is a premium question & answer published on Jan 08, 2020 and last reviewed on: Jan 10, 2020

Hello doctor,

I am suffering from chronic gouty arthritis. It started ten plus years ago, and now progressed to every joint in my body with multiple joint attacks at once. I have contant pain in joints, even if there is no attack. The attacks jump from joint to joint nonstop. I have seen many doctors; they can only give me shots and prescription of Indomethacin, which is not working for me as it has been taken for more than 10 years.

I have changed my diet to exclude a lot of food and drinks with sugar, purines, citrus, salt, etc. Right now, the pain is in my ankle, knees, and left arm (shoulder, rotator cuff, elbow, wrist, thumb, and neck). I have been very depressed and go to bed in pain and wake up in pain daily. My daily functions are limited.

#

Hi,

Welcome to icliniq.com.

I have gone through your history, and it is a bit unusual for a 40-year-old to have polyarticular gout, that is involving a lot of joints.

Firstly, I would recommend you visit a Rheumatologist near you to sort it out. Meanwhile, first, we should rule out if it is gout only or some other form of arthritis, which are intermittent sorts like gout such as Palindromic Rheumatism. I would like to know your last uric acid levels and if you have ever got rheumatoid factor (RF) and Anti-CCP (anti-cyclic citrullinated peptide) done.

If it is gout, then Indomethacin is just going to help the attack. You need to start on proper medications. The treatment would be to start tablet Zycolchine (Colchicine) along with drugs like Febuxostat or Allopurinol.


Investigations to be done:

1. 24-hour urine for uric acid.
2. Rheumatoid Factor.
3. Anti-CCP antibody.
4. Liver function tests.
5. Kidney function tests.

Differential diagnosis:

Palindromic Rheumatism.

Treatment plan:

Zycolchine.

Preventive measures:

High fluid intake.

Regarding follow up:

Consult a Rheumatologist at the earliest.


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