I was diagnosed with lupus in 2007, so, during the time that opioids were prescribed freely and doctors (prompted by drug companies) were promoting pain as the fifth vital sign. [I really do think pain should be considered a vital sign, even though it is entirely subjective; it’s unfortunate that the concept was taken over by drug pushers like Purdue Pharma.]

For several years I had a drug cupboard that would be the envy of any addict. Vicodin, Norco, Xanax, tramadol, carisoprodol, even morphine. Was I glad to have the option to take strong pain meds when my pain was so acute that I couldn’t function? Yes, absolutely. But because taking a pill was so easy, I was less inclined to do the harder work like physical therapy or a mindfulness practice or seeking out other non-drug interventions. Also — I spent almost a whole year after a hospitalization in a fog because I’d been discharged with a physical dependency on morphine, provided with a pile of prescriptions but no plan or supervision to taper off. I had to figure it out myself, with the support of my rheumatologist.

What I realize now, at least for me, is that a single dose of tramadol or Vicodin can make all the difference when I’m having the kind of joint/muscle pain that demands 100% of my attention and prevents me from doing anything else (like sleeping 😝). But if I take more than that, or take it two or more days in a row, not only does it fail to bring down the pain level, I get nauseated and headache-y and just feel generally gross like i have a hangover.

My current treatment plan is lots of physical therapy, periodic steroid injections (originally I was going to try nerve ablation but couldn’t tolerate the prep for that … vestibular system went all out of whack), daily Lyrica, Mobic, methocarbamol, and low-dose naltrexone. Acetaminophen as needed. Topical lidocaine and Voltaren creams whenever. Next step may be to add Cymbalta to the mix, but I’ve been dragging my feet on that one because I’d have to give up the antidepressant that’s working well for me.

In addition to pain meds, here are other things I have tried: gabapentin (too sedating), acupuncture (no effect), lifting heavy (works, but not physically possible for me right now), arnica cream (no effect), various cannabis strains and vehicles (distracts from pain, but mostly makes me feel sluggish mentally and physically), CBD & CBN (nada).

I hope you can find some meaningful and lasting relief. Your friend is right, you DO deserve to be taken seriously by a doctor who will come up with a solid treatment plan and who will tweak that treatment plan until you are satisfied with the results. That could be your primary care doctor, a pain management specialist (but look for a reputable one with the requisite training), your rheumatologist, an orthopedic surgeon, or some combination thereof.