Painkillers for nerve pain / side effects

[BuckleyBoy]

I am a 71 yo male with PAF / exercise induced AF, which doesn’t overly affect me too much. I am fairly active and a regular cyclist. Recently I have been suffering with a trapped > irritated Femoral Nerve in my Left leg. This is quite painful at times and keeps me awake at night. I have been attending a private physio who recommended that I should have a prescription painkiller. I rang the GP who initially prescribed 10mg/day Amitriptyline, and then raised the dose to 20mg/day. The first pack of pills did not have the information leaflet inside (it was a split pack), but the second pack did and included warnings not to use for people with heart rhythm issues. Sure enough, I started having short bouts of AF, and during exercise AF kicked in at fairly low levels of exertion. I stopped taking these and told the GP I should never have been prescribed them. I am told there are alternative painkillers but without researching all the side effects I am current doing without any. All of which brings me to the point: do any of this AF community know of any effective nerve pain medications which don’t have heart related side effects (and preferably no other common side effects e.g. constipation!). Also, a friend recommended Tesco ‘Herbal Sleep Aid’, however the enclosed information leaflet mentions that one (!) patient experienced tachycardia. Again, has anyone any experience of this. Apologies for the long post.

[GrannySmithgs5]

I take Gabapentin for a sciatic type pain . The only drug my GP could find that wouldn’t give me a problem AF wise or drug interactions. Does need to be taken regularly rather than as and when ….. as I understand.

[Hidden]

Hiya,

My GP prescribed this for me (10mg/day Amitriptyline) for pain control for lower back pain and a trapped nerve emanating from the region of the Right Sacrilliac joint. I have ( now) highly controlled paroxysmal AF. I abandoned the Amitriptyline not because it aggravated my AF but because in a matter of an hour or so of food consumption it gave me quite dramatic diahorrea.

My only pain relief these days is CoCodomol 30/500 which is prescription grade. I have found physiotherapy as much use as a chocolate fireguard !

I attend regular maintenance sessions with a sports injury massage therapist and occasionally a Chiropractor but the sports injury lady is much more effective and this keeps my pains well controlled - to the point I now use the Cocodomol only as a back up.

Hope this is of some use.

John

[SuziElley]

I’m on gabapentin and cocodamol 30/500 for a rare disease, Dercum’s, which gives neuropathy as one of many symptoms. No interference heart wise from either. Gabapentin isn’t prescribed lightly though

[Ppiman]

The dose of amitriptyline is so low that it would most likely be safe. I have read that it is often given to people like us. There's such a dearth of drugs for people with arrhythmias or on anticoagulants.

You could try asking for diazepam (Valium). I take these for neck issues, and they do help (with sleep, too). Doctors are reluctant to prescribe it owing to a risk of dependency (I think it's a 1 in 3 risk) but taken as needed, it's entirely safe in my experience. Otherwise, it's good old paracetamol!

Steve

[KMRobbo]

I was also prescribed amytriptiline by the hospital for an issue with my neck which caused me major pain and prevented sleep but I questioned this with my GP saying we had spent a lot of time and effort getting shut of Afib, it would be a shame if this drug brought it back. He initially said it was fine, with Afib, at the low dose suggested, which was small.

However he must have thought about it and rang me back, saying he still thought it would be fine but there was another drug called Duloxitine, which was also slightly pro arrhythmic ( on the literature) which would be even less likely to cause issues at the dose required ( 30mg) so try that first to see if it did the job. I did get the prescription, but never actually took them, as while I was at the hospital being assessed , although the problem in my neck was not easily surgically treatable I was waking up with the spasms , and where the issue was , the physio suggested I was probably trapping the nerve worse in my sleep. So with 3 pillows arranged to suit and learning to sleep on the right side only, I was able to "stretch" the nerve on the right side rather than compress it and after a few weeks the excruciating pain and numbness had gone without using the drug.

So maybe Duloxetine could be an option for you ?( I am not medically trained).

[DevonHubby1]

Our GP wont prescribe Cocodamol any more as too expensive. We get codine on prescription and then supplement with over the counter paracetamol.

[BuckleyBoy]

Thanks for all your comments. All these drugs are very powerful and most of the side effects look quite alarming, to the extent I'm not too sure I want to request any of them. I'm currently doing without any painkillers but it seems it will be a long while before I see any improvement, and the pain and lack of sleep is quite wearing. Hopefully I can get some improvement with physiotherapy or similar.

[Bagrat]

Was going to suggest gabapentin and if you persuade GP it is an option, start low and increase gradually. It can be sedating at first but that usually wears off so worth persevering.

[theohappy]

I get nerve pain in both of my legs. One leg from nerve damage from my ablation. My pain comes and goes. The drug I’ve found most helpful to minimize not eliminate the nerve pain is flexeril. It is a muscle relaxant but helps with the nerve pain and sleep. Does not affect my heart or AFib. Amitriptyline a sleep aid and once a commonly used anti-depressant. A couple of years ago I had severe nerve pain in my left leg. Flexeril was a huge help!

[arvine in reply to theohappy]

can I ask what is or was cause of your nerve pain in legs, and how does pain present, in my case, I went to pain clinic for pain, lower back, spinal stenosis, osteo, bulging disk , degenerative, so was hoping injections of bupavacaine, which dr suggested would help, ended up after 2 treatments, 10 needles, in lower back, and 2 in groin, with excrutiating pain in front and side of top of right thigh, needlles and pins , little relief when lying on opposite side, cant put pressure on the right leg, and at time, the needle, injection , one place, put me through the roof with pain at time of injection, 2 days later, end up with this pain, coming from back, down quadricep, unbearable at times, think dr actually hit the nerve in error, having MRI tomorrow, hopefully find out just what is damaged,

[theohappy in reply to arvine]

Hi Arvine, I know longer follow this group, but have come back on to hopefully answer your question. I never determined what caused my pain in the top of my left thigh. I had spinal xrays done that showed minor, normal age appropriate bulging discs in my lower lumbar area. It could be that I was tweaking those areas at the time causing the sharp pain. I've been told that can happen. I have not had the sharp unrelenting pain for a couple of years now. But every now and then I will get just a dull sharp pain in that area. Your situation does sound very much like sciatica. It's a good thing you are getting an MRI. I had more pain after a second injection into the groin area a couple of years ago. Thought they had really messed me up! Eventually it went away, thankfully. But won't do an injection like that again. I think my nerve pain was coming from the area where the femoral nerve branches. So they weren't really getting the right area anyway. Hope things will improve for you soon!

[arvine in reply to theohappy]

oh thank you , well yes Ive had the groin pain too, still think after having the injjections, something, ie, hitting nerve dead on with needle, caused this to happen suddenly 2 days later, have had lower back problems for years, but this is something never experienced, and it,s brutally painful, and yes, glad I get the MRI, they were very quick getting me that, so feel fortunate that way, but thanks so much for your input and well wishes

[theohappy in reply to arvine]

You're welcome! I know how truly awful constant pain can be! Also, it appears I did not answer your ablation question. The ablation is a heart procedure to stop AFib. They have to access your femoral vein to do this procedure. I had a lot of pain in my leg after the procedure for months! It is much better now, but every now and then I'll get a sharp nerve pain in my inner thigh from that nerve.

[arvine in reply to theohappy]

Hello theohappy, well had MRI done Sat afternoon, I have a site called "pocket health here which had to pay for, but gives me access to all my resullts, imaging, reports, etc from MRI< CT,s etc, so I was able to see a report from that MRI on Sunday, shows disc extrusion impingement at nerve root L2, just called the facility that does MRI, asking when my dr would have report, said more details, but almost completed, and would be faxed to my dr today or tomorrow, at my wits end with pain, so called my dr office, secretary said for me to call tomorrow,, so go from there I guess, don,t know what he will do but have done lots of reading and this is serious damage, read sometimes nerve will heal, with rest, med,s etc, but in 6-12 weeks! been in pain now , front thigh, back, groin for 13 days, I am really thinking the injections I had, at pain clinic, the one injection hit a nerve in lower back, think L2 , causing this episode of pain, also on reading suggested cortisone in back, around area, take down swelling and inflammation, I am shuddering at thought of another needle going into my back, but need to get relief from this pain, can,t stand, walk, or sometimes even sitting, like knife digging into thigh, been taking some tylenol, acetaminophen, with codeine, but trying to now take often, hard on liver, and causes constipation and have to say , hardly takes edge off pain

[arvine in reply to theohappy]

can I ask what ablation is, and why were you treated with that, and when you say nerve pain, what episode actually caused this nerve pain in leg, I think the dr who injected pain med, actually hit nerve directly in error, suffering now forover a week, excrutiating pain, from back and down right quadracep, cant stand or walk without walker, without feeling knife like pain in right quadracep and side of thigh

[arvine]

oh wow! have heard of ablation therapy, wasn,t sure just how it worked, and how related to nerve pain, well thank you, I will be so happy to get to bottom of what my pain is caused from it really brings me to tears at times