U.S. doctors online nowAsk doctors free
Los Angeles, CA
A 49-year-old female asked:

I am on orencia, (abatacept) 20mg methotrexate, 75mg fentanyl patch, 200mg celebrex, 250mg tramadol, 75 lyrica my pain is still severe? where can i go from here?

2 doctor answers7 doctors weighed in
Dr. Paul Grin
Pain Management 38 years experience
Sympathetic Blockade: Some continuous neuropathic pains are also maintained by the sympathetic nervous system and are designated as sympathetically maintained pain (smp). Sympathetic blockade can be accomplished using either regional anesthesia (e.g. Stellate ganglion block) or systemic intravenous infusion with phentolamine. Rec.: see an interventional pain management specialist.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Robert Lowe
Dr. Robert Lowe commented
Pediatric Rheumatology 19 years experience
If you still have joint swelling, you may get some additional pain relief if your are able to optimize your RA immunomodulatory therapy(increase dose or frequency or switch to another med). If you have generalized pain "all over" you may also have fibromyalgia that will benefit from improved sleep hygiene, light daily exercise, physical therapy, and counseling. I hope you can get to feeling better
Apr 26, 2014
Dr. Paul Grin
Dr. Paul Grin commented
Pain Management 38 years experience
Provided original answer
Great advice, Dr. Robert M. Lowe! Thank you.
Apr 26, 2014
Dr. Karen Sibert
Anesthesiology 41 years experience
Cause of pain?: First, make sure the cause of your pain has been properly worked up and diagnosed. Treating the source of pain is the only way to eliminate it. If you have chronic pain and have exhausted other treatment options, see a physician anesthesiologist who specializes in chronic pain mgmt. You may be a candidate for an implanted pump, regional blocks, or other modalities. Good luck!
Created for people with ongoing healthcare needs but benefits everyone.

Related questions

A 39-year-old member asked:
When treating someone who has CHF with the drug orencia (abatacept) are any diuretics be given?
1 doctor answer1 doctor weighed in
A 45-year-old member asked:
What is the difference between orencia (abatacept) and remicade for rheumatoid arthritis?
1 doctor answer2 doctors weighed in
A 42-year-old member asked:
How is orencia (abatacept) or arava for rheumatoid arthritis?
1 doctor answer1 doctor weighed in
A 28-year-old male asked:
What is the definition or description of: orencia (abatacept)?
1 doctor answer1 doctor weighed in
A 38-year-old member asked:
Is orencia (abatacept) a type of chemotherapy?
3 doctor answers11 doctors weighed in
Last updated Nov 28, 2017


Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Never disregard or delay professional medical advice in person because of anything on HealthTap. Call your doctor or 911 if you think you may have a medical emergency.