Rheumatoid Arthritis Pain at Night

Rest & Rheumatoid Arthritis / Disease have an illogical relationship

rheumatoid arthritis pain at nightRheumatoid Arthritis pain at night is ironic. Rest is one of the most crucial weapons in fighting Rheumatoid Arthritis (RA) / Rheumatoid Disease (RD). Adequate rest is an important factor for most people with Rheumatoid Disease (PRD) as they push themselves to continue doing as much as possible. We’ve talked about significant sleep issues with Rheumatoid such as the impact of sleep on RD disability and strategies to improve sleep with RD.

You know how children seem to grow an inch at night while they sleep? During a good night’s sleep, the body enjoys a cycle of repair and restoration – crucial for someone with a destructive disease. A Harvard Sleep Medicine article mentions a study on sleep that shows “animals deprived entirely of sleep lose all immune function and die in just a matter of weeks.”

Rest is also important to allow inflamed joints to calm down. In a Rheumatoid Patient Foundation (RPF) survey, 70% of PRD said rest is helpful to reduce rheumatoid pain. So it seems particularly unfair when sleep is interrupted by RD.

Does Rheumatoid Arthritis pain at night interfere with your rest?

Studies have shown PRD need more sleep, and that living with RD interferes with sleep, often because of pain. Many of my joints have been worse the past couple of weeks – it’s just one of those times the RD shows it has its own mind and just wants to act worse. There’s no logical reason my knees started waking me up a couple weeks ago with sharp pains along the side or in the front, when they are usually worse along the Baker’s cysts (in the back). This week it was my shoulder screaming all night long. Whenever I moved to relieve pain, the pain increased sharply so that I let out a little high-pitched “oww-oww.” Maybe the sound of my voice woke me up since the first thing I remember was being surprised to hear it. (Like most PRD, I don’t usually say “ouch” out loud.)

Have you used medications to help you rest with Rheumatoid Arthritis pain at night?

Sleep has always been my super power – I can sleep through almost any worry or pain. I remember dozing off during labor. Usually, I can get back to sleep with long deep breaths as long as I’m warm and my featherbed is well fluffed. But severe RD pain can jolt your mind awake so that can be tough. I’ve taken a pain medication or a muscle relaxer at night when I was in bad shape because I know how important rest is with RD. It’s good to have a plan for what to do if the pain gets very bad at night or interferes with sleep. What do you do?

NOTE: Rheumatoid Awareness Day is just two weeks away – February 2. This year patients and organizations across the U.S. and in other countries are observing the second ever awareness day for RD. For updates on RPF sponsored Awareness Day events – click here. If you have a blog of any kind, please join our special blog carnival – What Would Rheumatoid Awareness Mean to You?

Related to Rheumatoid Arthritis pain at night

Kelly Young

Kelly Young is an advocate providing ways for patients to be better informed and have a greater voice in their healthcare. She is the president of the Rheumatoid Patient Foundation. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. Through her writing, speaking, and use of social media, she is building a more accurate awareness of Rheumatoid disease aka Rheumatoid Arthritis (RA) geared toward the public and medical community; creating ways to empower patients to advocate for improved diagnosis and treatment; and bringing recognition and visibility to the Rheumatoid patient journey. In 2009, Kelly created Rheumatoid Arthritis Warrior, a comprehensive website about RA of about 950 pages and writes periodically for other newsletters and websites. Kelly served on the Mayo Clinic Center for Social Media Advisory Board. There are over 42,000 connections of her highly interactive Facebook Fan page. She created the hashtag: #rheum. Kelly is the mother of five, a home-schooler, Bible teacher, NASA enthusiast, and NFL fan. You can also connect with Kelly by on Twitter or YouTube, or LinkedIn. She has lived over nine years with unrelenting Rheumatoid disease. See also http://www.rawarrior.com/kelly-young-press/

38 thoughts on “Rheumatoid Arthritis Pain at Night

  • January 20, 2014 at 9:38 am
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    I was a light sleeper before RD and now I am an achy, light sleeper. We have a new memory foam topped mattress and it does not work for me, but puppy and hubby are in dreamland. I take my ipod to bed – listen to soft music or sermons. Somehow having something to re-focus on is comforting.

    I have also learned that when I am really tired in the daytime I will take a nap. I have my own business and work from home so I can adjust my schedule.

    Reply
  • January 20, 2014 at 9:39 am
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    I am way too familiar with the the pain – no sleep cycle. Like you, my knees bother me for a couple of weeks, then the toes take a turn or the shoulders and so forth. I just grab my prescribed pain cream, apply it and move to my reclinable sofa. It helps me to go back to sleep. I refuse to take anymore pills. I live in Central Florida and this time of the year is awful for me, but I am a warrior. I get up, get dress and off to work I go. I teach high school level and it is a challenge at all times, but specially the days when you lack sleep (most of them). Many times I function with only 3 or 4 hours of sleep. Do not ask me how I am able to do it. Only by the grace of the Lord I continue to stand up and move with a smile on my face and a positive attitude. Thank you for sharing and for your wonderful blog. It is comforting to know that I am not alone or making this up.

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  • January 20, 2014 at 10:01 am
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    Hi Kelly, yes pain regularly wakes me, often if I try and turn/move in bed. I have routines at night to help me get comfy and relaxed enough to get to sleep in the first place and those are to read until my eyes won’t stay open any longer and I often take up a hot drink with me too, occasionally a shot of Jack Daniels or such like if the pain is really bad. Also if I feel like I might have a really bad night, when the pain has been consistently bad I’ll take an Amiltriptyline for it’s muscle relaxing properties and to help me sleep better.

    Reply
  • January 20, 2014 at 10:21 am
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    Interesting topic. I’ve often found sleep to be my “reboot” and this explains why. I’ve had a prescription for a very low dose of Zolpidem Tartrate (generic Ambien) for years. I consider it to be my “painkiller” and I use it sparingly. On the very bad days when I’m in so much pain that I can’t sleep at all, I take one. It enables me to have restful sleep, and 99% of the time, the flare is over when I wake up. This only works because I use it sparingly. Frequent use of this drug will lose the effectiveness.

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  • January 20, 2014 at 10:27 am
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    Sleep??? This past month I seem to have forgotten what that was. I have been in an almost constant flare for about 2 months, my Rhuemy added Plaquenil to my Cimzia and MTX. I may just be hurting and stressed, but it seems like the plaq is keeping me awake. I skipped it for a few days and slept better, not great, but better. I have a 18 inch memory foam bed with a softer memory foam topper. I have tried sleepy time tea, a new pillow, meditation etc.. I try not to take any pain meds because I had an issue with my kidneys a few months back. Has anyone else had this issue with Plaquenil?

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  • January 20, 2014 at 10:43 am
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    I’ve recently started taking sleeping pills and using ear plugs or white noise to help me sleep. When I am tired I can’t deal with the severe pain as well so my rheumy thought it was the best way to go. I don’t really like taking any additional meds but after about 4 weeks of being on the sleeping pill I haver really become more rested and it helps deal with the pain as well as everything else that life throws you.

    Reply
  • January 20, 2014 at 12:58 pm
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    Oh yes, sleep (or lack thereof) is a big issue for me. I have Ankylosing Spondylitis with enthesitis being widespread, consequently most of the time sleep is quite elusive. Many times when I have gone into a deep enough sleep to actually dream I have nightmares that I’m being stabbed. Not exactly conducive to a good nights sleep in my opinion. Ugh. One thing that did help me somewhat was getting a Sleep Number bed because it seems that being able to adjust the firmness of the bed either up or down relieves the pressure on whatever is hurting at the present moment. Since nothing seems to be consistent with RD it helps me to have that flexibility with my mattress.

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  • January 20, 2014 at 1:53 pm
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    My RA pain definitely wakes me up. I talked with my rheumy about it, since I was either awake and in pain, or having very strange vivid dreams from prednisone. Either way, I was exhausted all the time.
    Rheumy recommended melatonin and I’ve found that 2 mg/night is enough that I sleep pretty soundly and I don’t fell like I have a “hangover” from it the next day.

    Reply
  • January 20, 2014 at 3:02 pm
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    I no longer know what it is like to sleep through a night, or even 4 or 5 hours in a row. What I would give to sleep a whole night through. I take Trazadone nightly and on occasion half of a Percocet and even that doesn’t buy me a full night of sleep. Generally I wake up within about 2 hours of falling asleep and then every hour or two after that I am up. All. Night. Long.

    Reply
    • October 19, 2014 at 7:04 pm
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      Get rid of the trazadone and try Lunesta.

      Reply
  • January 20, 2014 at 3:18 pm
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    I really miss a good nights sleep. It has been years since I have slept straight through the night. Pain is usually the culprit. It is usually my feet, ankles, and jaws but, at times it’s the knees and shoulder with the hands and wrists chiming in. I have taken Ambien in the past but, after a year or two I started some depression and having dreams of shopping on eBay. Buying rugs, when we had just sold or home. As you have probably guessed the dreams were real and I now own 4 lovely Gabbehs. Now I I have a sleep number bed with a gel matteress topper with a soft heating blanket and some Amitryptilline . I also keep a kindle and knitting bedside for the waking time. Thank goodness my husband, my grandson, and the dogs are heavy sleepers. I have also become open to afternoon naps. I wish pain free days and sleep filled nights for everyone.

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  • January 20, 2014 at 3:22 pm
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    Sleep? Can’t get enough of it! I have RD and sleep apnea and have used a C-PAP machine for 10+ years. When I shift position in bed, my face mask shifts as well, so I wake either from the need to change position because of pain or the mask starts leaking air, causing a whistling sound. I don’t remember the last full, uninterrupted night’s sleep. UGH.

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  • January 20, 2014 at 6:01 pm
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    Oh god them shoulders at night do drive me mad! I don’t drop off unless im on one side then I wake up having a bad dream cos I dream im being stabbed and burnt in my shoulder and hip, so I swap sides…zzzz.. I repeat this pattern 1/2hr to hourly like a ‘spit-roast chicken!’ haha! But seriously its awful, then the alarm goes off and I don’t want to move!
    When im flaring bad I ALWAYS FALL ASLEEP AFTER LUNCH,if im off work my partner gets frustrated cos im like a zombie and we have 2 young kids that want to play!:)(this is the one thing I wish I could change with a magic wand as I feel so bad about it) if im at work its a pain cos im fighting the urge to fall asleep for a good 3 hours after lunch,yawning and stretching! but then I seem to wake up in the evening and not want to drop off…aaaahh! Alas it’s 11[m and im typing away here now…..sleep well..:)

    Reply
  • January 20, 2014 at 6:03 pm
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    Does anyone have any tips for managing daytime fatigue???
    P-L-E-A-S-E do share 🙂 🙂 🙂

    Reply
    • January 20, 2014 at 7:29 pm
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      There are some posts on fatigue and lots of comments that you might find helpful . Just click where it says “Tags – list of topics” on the too right of the page and then click on fatigue.

      Reply
      • January 21, 2014 at 6:13 pm
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        Thanks RE: Fatigue
        Has anyone found Methotrexate helps ?
        I have been told to stop the hydroxychloroquine as it isn’t working and at my next appointment the rheum Dr will arrange for my to see the rheum nurse to start mtx. Apparently they have to run a few blood tests first, a few more wont hurt hehe!
        Fatigue is a pain in itself if you have a toddler bouncing around, its not fair on her, bless.
        Im hoping the different DMARD may be the answer.

        Reply
  • January 20, 2014 at 7:42 pm
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    I used to have a horrible struggle with the shoulders at night, those were the worst by far, never had such pain as that. Used a pillow (still do out of habit) to “support” the arms/shoulders. My flares usually lasted about 48 hours, and were always the worst during the night for some reason. I also used to wake up even when not having pain at 3-4am fairly consistently, usually with panic/anxiety that lasted for an hour or two. Never had that in the daytime. Once I got on my Enbrel/mtx combo that all went away, got great sleep after that. I’m now off mtx, just on enbrel, and things have creeped back some, tho not like it used to be thankfully. I will say that now at any hint of a flare, I concentrate on getting to bed early, as it really does help. Conversely, this weekend I had some fun, and got only 5 hours of sleep on saturday, and paid for it with the biggest flare in months. Happens to me every time I slip under 7 hours of sleep a night.

    Reply
  • January 21, 2014 at 3:15 pm
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    I have an Earthing sheet that I find is a big help. I often wake during the night with Sjogren’s and a dry mouth, but am able to get right back to sleep. It also helps keep my feet warm. I did find some medications gave me sleep/dream problems. If I’m really sore I will take 2 Tylenol or Naproxen. Often in the afternoon I will lie on the sheet for a nap. I have also used a pain bio feedback CD, breathing, and meditation; whatever works. I take my Earthing sheet with me if I’m away from home (they have a 1/2 size).

    Reply
    • January 21, 2014 at 6:05 pm
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      oooh what is the earth sheet?
      I find the snoring husband is also a bit of a sleep killer too…aww bless his socks..he’s snoring right now, lol!
      Not funny at 3AM however 🙂

      x

      Reply
  • January 22, 2014 at 1:28 pm
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    I’ve been in a really bad flare lately (basically 2 weeks stuck at home) and, on the worst of the days, I can’t even fall asleep. I do have a few tricks though: very, very hot baths with B&B “sleep” bath salts, very warm but light blankets, the comfiest pajamas, and a Tylenol pm.
    I discovered the bath salts when I went in to B&B to try and find some salts with mint and/or eucalyptus to help with chest pain but came across the lavender-vanilla “sleep” salts instead and they really do help!
    O and does anyone know of a pharmacy other than Accredo where you can get Enbrel from?

    Reply
    • January 22, 2014 at 11:46 pm
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      Oh Samantha massive virtual hug to you!
      I have been bad too in the last couple of weeks (steroid jab wore well and truely off)
      Ive been able to get about so i mustnt moan, work etc but just been like a zombie when at home. Im from UK so im afraid i cant help with the pharmacy issue however i have discovered a little gem.
      I live across the road from a public indoor pool and i drag myself across to it in my spare time (the kids never tire of it and it wears them out!! bonus!) And waw for that hour or so im in joint heaven, you feel weightless and for some weird reason i feel really well, so well i dont want to get out!
      Thats it …im turning into a mermaid..lol!
      But seriously though i know if you are laid up at home it might not be possible but if you get a little energy one day and its at all possible for you to get near a pool without too much hassle i really reccomend it, its a pain getting dry and all that afterwards ut you sound just like i was 2 wks ago and that was one of the few things that made me feel happy for a while so i just though id share.
      Hope you find some relief soon.
      Rest well *hugs*

      Reply
  • January 22, 2014 at 2:58 pm
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    The Earthing sheet is a cotton sheet with silver threads woven in for conductivity. It has a cord that plugs into the grounding port of a wall plug. It simulates walking barefoot on the ground which allows the body to absorb negatively charged electrons. These electrons neutralize free radicals (protect from EMF’s), enlarge red cells which allow for more oxygen uptake, and thin the blood, good for the heart. It promotes a deep sleep and feeling of well-being. When I had my last hip surgery I took a wrist band into the hospital and was “plugged in” the whole time. The difference was amazing; I healed in half the time with almost no bruising or swelling at the site. This is a very simple concept that most docs don’t get. I advise you to refer to the website Earthing.com for a comprehensive explanation of how it works. The Earthing book is co-authored by Dr. Stephen Sinatra, a cardiologist, who uses Earthing in his practice. Cheers.

    Reply
    • January 22, 2014 at 7:41 pm
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      Thank Sue.
      That sounds really interesting , i’ll certainly be googling that, sounds heavenly! 🙂

      Reply
  • January 23, 2014 at 12:24 am
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    When I have pain that wakes me up, it’s odd, but I feel like I only get deep sleep from 6am onward. Lately I’ve been mostly stuck in bed with a big bout of uncontrolled disease(waiting on new meds), and sleep, especially late morning sleep, really helps the pain. If I don’t get enough sleep my pain is really intensified throughout the day.

    Reply
  • January 27, 2014 at 1:01 am
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    hi to all.

    sleep blessed sleep. the vicious circle. pain interupts sleep. pain slows you down in the daytime so not enough energy released for proper sleep next night. lack of proper sleep increases bad tension which can aggravate RD.

    yes. methotrexate helps . atleast for me.

    i bought a little back rest recliner for my bed. ( it looks sort of like a sand chair.) it folds easily and compactly when not needed. if my neck or spine are being highly vocal i “sleep” with ice packs against my back in a partly reclined positions. The first few times it was rather light sleep. as i’ve become accustomed to this bedtime novelty the sleep has become deeper. i still awake after several hours and let the ice packs fall to the side of the bed. shove the recliner over and snuggle in. the fire has eased and i don’t deal with clearing up till real morning.
    I had isomnia when younger. and then three kids close together. so i became accustomed to interrupted sleep.

    swimming. i purposely purchased the rental i had because of the unusually powerfull jets in the hottub and while small, a pool that can ease the fire in different joints. i can also do different exercises without jolting myself or use the water as abouyancy to take pressure off the knees as I walk around. i sometimes just float enjoying no pressure on the knees or hips.

    now about the charley horses and foot cramps when i forget that i can no longer point the toes, and give real kicks.

    I have yet to figue out when the jjaw starts announcing his needs. holding ice packs in wrist throbbing hands doesn’t ssem an option.

    I have noteced that if i’m having a bad time of it my best sleep ends up being between 5 and 8 Am. i refuse to make any commitment before 10Am now for fear of a bad night.

    To those who have mentioned different Rx for sleeping or anxiety etc… I am not sure why and neither did a psychiatrist. but for some reason some of the milder depression and anxiety medications ease RD pain rather well.. Some of these are milder to the liver than the NSAIDS. I noticed that the rheumy i see keeps quite the sampler section of these meds. pain increases agitation which effects sleep and back to the bad circle again.

    and to all a good night.

    NVk

    Reply
  • February 21, 2014 at 11:27 am
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    Hi, I’ve been smoking one joint of cannabis a day for 10 years now. I began using it regularly because the best, immediate thing it does for me is gives me a full night’s sleep. Sleep heals so it is a godsend that way. However, it seems to also reduce inflammation, maybe even disease progression. I had to stop taking it for 5 weeks in 2008 when visiting my parents in Arizona. I was fine for a couple of weeks (Cannabis is stored in the body in fat cells so it takes about 2-3 weeks for it to be completely eliminated from your system).

    At between 2-3 weeks after stopping use, my joints began to flare 1 by 1. It got so people were noticing my increasing debilitation and commenting. My ankles inflamed, then my wrists, then my knees. It was my mother who made the association between stopping cannabis and my severe flare up. By the time I got home to Canada I was a mess, however it only took a few days of resuming smoking cannabis to feel improvement. Within a week or two I was back to my usual activities and the flare was a distant memory.

    I understand it is not legal everywhere (I have my license in Canada and have since 2010) but it needs to be, as it appears to treat many inflammatory conditions and possibly some cancers. I recently stopped Orencia and prior to that, Humira. One or both may have either initiated or exacerbated Hashimoto’s, which I was just diagnosed with. I do take Mtx, sulfasalazine, gold and naproxen also but I feel the daily cannabis is what has kept me stable for the past 10 years. With the exception of the odd swollen joint here and there and the 5 weeks when I stopped using it, I really have not had a bad flare up in 10 years.

    There is no evidence it causes lung damage and might actually protect the lungs and provide a cancer preventive. I have smoked cigarettes for 34 years and cannabis for 10 and recently had a lung function test and my lungs are 100%. I have also used it right up until the night before surgery and immediately after, with no ill effects.

    I wish everyone with RA could try it without breaking the law, laws need changing. Cannabis is not the devil as it has been smeared in the media. Drug companies have the most to lose by its legalization. Just sayin’!!! 🙂

    Reply
  • February 21, 2014 at 7:32 pm
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    I have not been woken up by the pain, but I have felt it in my sleep during dreams. It has actually become part of my dreams.

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  • April 2, 2014 at 10:11 pm
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    I wake up every night with pain and stiffness in my hips.Have to turn over or get into a different position.Wakes me every night.Minimum of 3-4 times each night.

    Reply
  • May 23, 2014 at 2:01 am
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    Hi ,Thanks for being here.
    I have not slept more then three or four hours a night in the last five years.I rarely go to bed before one AM and am up by four or five at the latest.I am so tired of being tired that sometimes I pray for the end.I am trying not to be on the pity pot .I just get so tired .I don’t want to go to bed because its so painful to wake up.My Doc says you need to sleep more ,yea right I don’t know this .He also says my pain is not Rheumatoid because the blood work tells him so. I sometimes don’t know why I have a Rheumy because no matter what or were the pain is “its not RA says he “the blood work tells him so.

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  • September 20, 2014 at 12:04 am
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    How many people on this website have ever had mersa,got it cured and shortly after came down with RD? I’m curios.I came across many post that people had written on another web site that many of them had that exact thing happen to them.

    Reply
    • October 19, 2014 at 7:09 pm
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      I got diagnosed three yrs after MRSA

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  • October 17, 2014 at 8:15 am
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    screaming pain in my biceps and shoulders every night some of it definately in the bones..just starting methatrexate and just had steroids to help me move.

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  • December 29, 2015 at 11:18 am
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    Benadryl is a godsend. Confirm with pain doc, Rheumatologist & Pharmacologist that it’s safe for you. It is the most widely used sleep aid & doesn’t interfere with most of our RD meds.

    Reply
    • December 30, 2015 at 7:25 pm
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      I have the same problem sleeping.I have had RA for 15 yrs..My shoulders and neck and hands wake me up .the only sleep I get is when I take a valium before going to bed ,but I don’t take one very often because I don’t want to depend on them.I am on prednisone,lortab&plaquenil.doesnot help much.just in pain all the time.I cry every day just from depression.

      Reply
  • March 13, 2017 at 10:38 am
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    Yes my problem too. If I don’t take something to help me sleep the pain in my elbows shoulders and fingers wake me. Then I have to get up. Last night was very bad.

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  • November 27, 2017 at 2:26 pm
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    I am wondering if anyone else out there is or has experienced itchiness of the feet. I don’t have any redness or flaking skin and it isn’t “athletes foot”. It mainly happens at night and it will keep me from falling asleep and also wake me up. I’m on methotrexate and use Tylenol and codeine and Celebrex for the RA pain.
    Kelly this website and blog have been a Godsend to me. Bless you and all you do.

    Reply
    • November 27, 2017 at 5:44 pm
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      Betty, I can’t be sure of course, but it could be a side effect of the codeine or Celebrex. Some things you might try: rub them with some anti-itch cream so you can fall asleep. We use Chiggerex – it works really well. There’s also Benadryl cream or hydrocortisone.
      Also – just in case, keep an eye on liver levels and thyroid levels – 2 other things that can cause itching. Take care.

      Reply
  • July 28, 2018 at 7:52 pm
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    I so wish I could sleep. I get woke up with my hips hurting or my neck or shoulders and I will be so stiff I feel like the tin man needing an oiling. I take clonazepam to help me sleep and sometimes a flexeril with it but I have an adult autistic son who does not like me to sleep. Needless to say I do not get enough rest or time to recover. If I could just take a nap during the day that would be heaven! Honestly not sure how long I can go on like this.

    Reply

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