I am not sure if I take Celebrex since I am allergic to sulfa antibiotics but I was planning to ask about other NSAIDs like Diclofenac/Voltaren and can be very helpful for OA and RA. I would prefer to try something that doesn't cause GI bleeding risks or CV risks like Tramadol (as-needed) but I don't know how she feels about prescribing it. Since the other rheumy shut me down like I was drug-seeking, I am apprehensive about bringing it up. I don't even know if Tramadol is an option since I'm on two antidepressants - Wellbutrin and Effexor - for depression/anxiety AND an antipsychotic for mood swings.
My daughters both have sensitive stomachs and it took a LOT of trial and error to figure out which NSAIDs they could tolerate. Besides Celebrex (which you can't take), they had success with Relafen and Mobic. Both are much easier on the stomach than Advil, Naproxen (Aleve), Dolobid, Voltaren (caused horrible nausea), Arthrotec, Tolectin, Indocin etc. We tried a LOT of NSAIDs before we finally figured out what worked best for them.
They also both needed a PPI - they cannot tolerate NSAIDs at all without one. NSAIDs are actually considered better than pain medications if you have inflammatory arthritis (like RA) because they actually treat the inflammation vs. just masking the pain.
If you have osteoarthritis in your neck, there are some options for that. They can do various kinds of steroid injections and if those work, a radiofreqeuncy ablation may give you longer lasting pain relief.
As for pain medication, I would think carefully about bringing it up because of the hysteria around the opioid epidemic. Most rheumatologists will not prescribe pain medications anyway. They treat the disease - in RA, that would entail treating the inflammation. In Fibromyalgia, treatment would get over-active nerves to calm down. They tend not to prescribe opioids and if you need further pain management, then generally they refer you to a pain management specialist.
For Fibromyalgia, trigger point injections done by a pain management doctor might help - they helped my daughter a LOT.
In terms of actual pain meds, with two anti-depressants and an anti-psychotic, I don't know if they could even prescribe something like Tramadol. It definitely interacts with SNRIs - could cause serotonin syndrome. I am not sure about Wellbutrin or the antipsychotic.
Like you said earlier, Effexor is supposed to help with pain, so hopefully that will kick in soon.
For RA, Plaquenil is an option. Methotrexate is what is used most commonly. But I would wait and see, because while your symptoms may sound like RA, it's hard to tell without a doctor examining you. With rheumatic diseases it's hard to tell what is causing what because of overlapping symptoms.
Hang in there and good luck!