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What can someone do when RA pain persists despite treatment?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have been suffering from rheumatoid arthritis for the past four years, and it was diagnosed six months ago. I feel excruciating pain in my lower and upper limb joints, and I am not feeling relief even after taking NSAIDs. I was given steroids and penicillin, and it did not work properly. The pain is mostly in the knee, hip, elbow, and shoulder joints.

Hi,

Welcome to icliniq.com.

A diagnosed case of rheumatoid arthritis on a biological agent, still having pain, needs to be evaluated in detail. Pain can originate from muscles, nerves, or joints. The odd point is diarrhea for a month, and it needs to be evaluated. It can be due to drug-related or disease-related diarrhea.

As per your information, you have been with RA for the past four years. Your present complaint is excruciating pain in the upper and lower limbs (duration is not mentioned). You tried painkillers, steroids, and antibiotics (the reason is not clear). Joint pain related to RA usually responds well to painkillers like Etoricoxib, Naproxen, etc. If not fully, then partially. It seems like your pain may be related to muscle origin or nerve-related, which is very common in a patient with RA and hypothyroidism. You may have fibromyalgia or nerve-compression symptoms, which need to be evaluated by proper history and examination. It may be refractory RA. For chronic neuropathic pain or fibromyalgia pain, you can try Pregabalin and Duloxetine. And others after consultation and evaluation. Check the following-

1. ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) for RA-related pain.

2. LFT (liver function test), KFT (kidney function test), sugar (fasting), and thyroid profile for assessment of the origin of pain.

I hope this helps.

Patient's Query

Thank you, doctor,

What dose should I take? And do I need any treatment for arthritis?

Hi,

Welcome back to icliniq.com.

You can try capsule Pregabalin 75 mg daily at bedtime. But the best thing for you is to meet a rheumatologist personally for a detailed evaluation of its exact cause.

I hope this helps.

Medically reviewed byDr. Vinodhini J.

Published At September 2, 2020
Reviewed AtNovember 14, 2025

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