Variable Asthma and pain medication.

[Shalz]

Good day to everyone,

I hope you are all taking good care, especially with the warm weather!

I would like to ask people from the community about pain medication and Asthma.

I have a variable asthma of 5%, diagnosed at the same time as copd.

6 weeks ago I ended up in A&E with severe pain in my leg. X-ray was done and I was told it was Bursitis. Due to the Asthma I am unable to use any NSAIDs. I am relying on paracetamol and a low dose of tramadol( dose being low due to alerts to other medications I am taking). I have exercises and hot/ cold treatments to help ease the pain. None of which has helped at all. I am reliant on a walking stick to get about now and the pain is not subsiding at all.

I recently saw a physiotherapist and he looked at the X-ray and told me there is nothing wrong with my hips and diagnosed that a nerve in my back was the problem. Go home, do the exercises etc and if no improvement to get in touch and he will see me again in about six weeks. No pain medication other than paracetamol. Use a heat pad in my back and continue to use the walking stick. No mention of an X-ray of my back to see exactly what’s what.

My Question to you as a community is:

Does anyone have the same problem about pain medications when it comes to Asthma.

I have severe pain and it seems to be getting worse, not better and no relief with paracetamol and the bit of tramadol that I am allowed to take 50 mg. Voltaire’s gel has done nothing to help.

The pain is constant, no let up and it is affecting my daily life considerably. Walking even with a walking stick is excruciating.

I would very much appreciate any input from the community regarding pain meds and Asthma.

Stay as well as possible everyone

Thank you

Sheels.

[peege]

I'm afraid I take ibuprofen even though I have asthma. (NOT recommending others do at all, personal choice & experience for me)...

With severe pain of rotator cuff injury the only relief I got was when taking co-codamol and using Voltorol on the area to get to sleep at night. Voltorol is Diclofenac rather than ibuprofen. I suppose it's still an nsaid but don't know, it was a temporary measure.

Nowadays for back & hip pain i take 2 ibuprofen with food first thing which helps me get moving. I have a therapist who does very good therapeutic massage who keeps me on an even keel, shows me stretches to help and I do them which really helps. My asthma is moderate and I also have Small Airways Disease .

It'd be nice if someone came on to explain why we aren't supposed to use NSAIDS with asthma?

[Shalz in reply to peege]

Thank you for your response👍😊

I just get so upset that there is nothing out there that really helps with the pain for those with Asthma! One would think, considering how many folks suffer with asthma, that by now some kind of progress would have been made in new pain medications for such cases! Dealing with severe pain for any person can be debilitating, however when you are not allowed to use nsaids and have to rely on paracetamol which doesn’t do very much in the way of pain relief, it gets very frustrating indeed. We listen to our doctors and try to follow advice, but really we are screaming for a decent pain relief!

Wouldn’t it be great if some kind of decent pain relief was available that is safe to take with Asthma.

[Patk1 in reply to Shalz]

Im on dihydrocodeine and gabapentin but both are prescription ďrugs.cocodamol can be bought & r much stronger than paracetamol so perhaps worth a try.id make appointment with yr gp asap or ring 111 for advice .heat and ice alternatel ea 20mins help x

[Ern007 in reply to peege]

Not safe to take NSAIDs with Asthma and Asprin just as bad. Both can cause "Bronchospasm"

I found a link you may find interesting.

medsafe.govt.nz/profs/PUart....

[Shalz in reply to Ern007]

Thank you for that, I will give it a read! 👍😊

[Yatzy in reply to peege]

I used to take ibuprofen for pain relief, it worked but I was definitely more wheezy (I’m asthmatic) Over a year or two, I became more wheezy when using ibuprofen, then eventually, the extra wheezyness didn’t shift, but carried on after I’d stopped taking the ibuprofen. I risked the ibuprofen again during one night with terrible toothache, and my, the asthma went into overdrive….I didn’t risk another dose.

For pain relief these days, I up the paracetamol to paracetamol plus caffeine, but go into orbit if take too often! For fractured vertebra and similar pain, I ask GP for codeine prescription and interweave the pure codeine with the paracetamol. Co-codamol doesn’t work for me. Too low a dose of codeine? Also can spread the different painkillers round the clock to provide more constant relief, hopefully. Codeine does clog up my system eventually so drink lots of water too and eventually have to stop for a while.

[Ern007]

Hi. I have COPD and a breathing condition "Dyspnea"

I am not allowed NSAIDs because of a gastric condition plus, I am on blood thinners,

I have severe neck problems and shoulder pains. I had Dihydrocodeine + Paracetamol which was OK for a while..

I di not want more Gabapentin as doses can be high for this sort of pain.

My doctor prescribed Liquid Morphine along with Paracetamol - it does help and also it seems to help my "Dyspnea"

I have COPD and Asthma which is controlled - I would never take Morphine with a COPD or Ashma Flare UP.

This is me and I am in no way suggesting you take the same meds as me - There are options for your sort of pain and your GP will help. I have had Tramadol and did not care for it.

With all the pain you are in - see your GP, he/she will give you appropriate medication, a decent doctor will help sort your pain..

[Shalz in reply to Ern007]

Thanks Ern, I appreciate your comments!👍

[Patk1]

U shld go to gp

[B0xermad]

I use codeine with paracetamol for short term pain relief also have you thought about an inversion table that may help your back pain

[garshe]

I have severe COPD and was told by my Respiratory team not to take any painkillers ending in fen. For example. Nurofen, Ibuprofen etc . xxSheila

[Davegt in reply to garshe]

Quite right.

[Poppydaydream]

I have both. I take Gabapentin for nerve pain in back and leg.

[Mellywelly]

I have copd and high blood pressure and was told nurofen and paracetamol only. Used to take anadins but had to change when diagnosed. Seems to me quite a lot of the time doctors don't even agree with each other. 6 weeks is a long time to be in so much pain. I would go back asap 😩 good luck chook

[Shalz in reply to Mellywelly]

Thanks Mellywelly,

Yes I’m going back again! I did see a physiotherapist and he said nothing at all wrong with the hips. He said after examining my back that I have sclosis and this is causing the pain in my hip and leg. Six more weeks of stretching etc and then he will see me again. I’m certain I cannot wait that long and am calling my doctor again for pain meds! I am not usually such a whiner about pain etc, but this is incredibly painful!

Thanks again Mellywelly👍

[Davegt in reply to Mellywelly]

It isn't necessarily doctors not agreeing. There isn't a "one size fits all" solution. Gabapentin is a form of painkiller but only for nerve pain, not muscular pain. Some people cannot take any morphine type painkillers. Codeine is an opiate and converts to morphine in the body, so that is not available to those who have serious side effects with morphine. Aspirin, in larger doses and ibuprofen are not recommender for those who have had stomach ulcers. Those on warfarin for blood thinning have to be cautious with aspirin as that also thins blood.

These are just a few examples as to why dispensing varies from person to person.

[Ergendl]

I have COPD with asthma overlap, and take two types of pain meds for long term chronic pain: co-codamol (codeine and paracetamol, available over the counter from chemists) and the receptor specific NSAID Etodolac (prescription only). My GP prescribes both. I have not noticed any problem with bronchospasm.

[Shalz in reply to Ergendl]

Many thanks for your input. I am appreciative of everyone that takes time to write something. 👍😊

[Davegt in reply to Ergendl]

NSAID-induced bronchospasm commonAspirin and other NSAIDs can induce bronchospasm and, in rare cases, this reaction can lead to death in aspirin-sensitive asthmatics.1-4 This reaction is generally referred to as aspirin-induced asthma. The reported incidence varies widely affecting between 8% and 20% of adult asthmatics.5,6 The incidence is increased in asthmatics who also have chronic rhinitis or a history of nasal polyps.4 Aspirin-induced asthma is most likely to be encountered in the third or fourth decade of life although it may occur in childhood, albeit rarely.5,6

There is marked cross-sensitivity between most NSAIDs, even where they are structurally dissimilar.2,5

A report of worsening asthma, necessitating hospital admission, following the use of NSAID ophthalmic drops serves to warn that all routes of administration can precipitate bronchospasm in sensitive asthmatics.7

[Biker88]

I suffered from chronic leg/knee pain for a few months and nothing seem to help, my GP wasn’t particularly helpful so I asked for a second opinion. I was referred to an orthopaedic consultant who quickly diagnosed a “slipped disc “, these don’t show in a normal X-ray. As this was before the use of MRI imaging I had an X-ray with dye injected into the spinal column, which showed a burst disk pressing on the spinal cord and this was causing the chronic pain in the leg. Back surgery fixed the problem and the back pain disappeared, follow up with your physio, it is possible to get a disk to move away from the spinal cord with exercises but this won’t work if a disk has burst. In my case I was offered daily pethidine injections as even coproxamal wasn’t helping much.

[Shalz in reply to Biker88]

Hello Biker88,

I am also beginning to think something more is going on! Six weeks ago the a&e diagnosed Bursitis as the cause of the severe pain in my leg and difficulties walking etc. I have followed exercises for that throughout, to no avail and no relief whatsoever! A physiotherapist has examined me, looked at the X-ray of my hips taken weeks ago and has said, “ absolutely nothing wrong with your hips”. He examined my back and straight away he said I have scoliosis and the pain is due to that. Yet again, another 6 weeks of stretching etc. Then if it hasn’t helped he will have to look further. No pain meds other than paracetamol and tramadol, due to Asthma. I’ve been taking those medications since it started weeks ago and it doesn’t even touch the pain.

I do think I am going to push for an X-ray or whatever of the area in the spine that he has said. I’m not usually a whinging person, but this pain is taking over everything and no help with it!

Thanks again Biker, I appreciate your reply very much👌😊

[Izb1]

I sympathise with your problems Shalz. I had Bursitis a few years ago due to my hip. The physio went through movement exercises which didnt help much at all. I went though weeks of pain, l had a cortisone injection which really helped and luckily eased of. I would speak again with your gp or physio x

[Shalz in reply to Izb1]

Hi lzb1,

I was diagnosed at A&E weeks ago, they said after X-ray, I had bursitis and that’s why the pain and trouble walking etc. since then a physiotherapist has examined me, looked at the X-ray and said there is absolutely nothing wrong with my hips? He examined my back and straight away he said I have scoliosis and that is causing the deferred pain to my leg and hip! Once again another six weeks of stretches etc, paracetamol and tramadol, no other pain meds allowed.

I don’t think I can carry on with a full six weeks, the pain medications are doing nothing at all, so I’m pushing for a new appointment and an X-ray or whatever on my back to clarify and discuss some other kind of pain help!

Perhaps like yourself an injection or whatever!

Than you very much for your answer!👍😊

[Timberman]

I assume you are referring to extrema chest tightness? As I understand it paracetamol is fine for use by asthmatics. Better still of course to do all you can to avoid triggering an attack. By the way you may be able to NSAID in the form of body rubs - eg Voltarol - which keeps the active ingredients away from your alimentary system.

[Shalz in reply to Timberman]

Thank you! Yes I have volterol already. I have now been told I have scoliosis, not bursitis. Just need the right pain medication that will ease the pain! I am not usually a whinging person and just get on with things, but this pain is incredible!

Thanks Timberman for your input👍😊

[Maximonkey]

Hi Shalz, I have asthma and osteoarthritis I also suffer occasionally from sciatica, I use Co-codomol as my pain relief and it in no way clashes with my asthma or Bronch. There are different doses and the doc will probably start you off on the lowest but perservere. If the Physio is correct and it is nerve pain then Amytriptiline is the pain killer you need. Hope this helps. Take care, Maximonkey

[Shalz in reply to Maximonkey]

Thank you so much for your input! Much appreciated 👍😊

[Caspiana]

Hi there. Apparently "Asthmatics may experience bronchospasm following ingestion of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs)."

medsafe.govt.nz/profs/PUart....

Thought this might be helpful. Sorry for the intrusion. 🌻🌿🌻

[Shalz in reply to Caspiana]

No intrusion caused! Thanks for taking your time to offer input👍😊

[Davegt]

British Pain Society link:

britishpainsociety.org/peop...

[Mellywelly]

I meant out of 3 doctors they should always give that 1 person the same answer with what they can or cannot take with their condition in mind. My doctor put me on atenolol when I have copd and the other 2 said it has the opposite effect of ventolin and to stop it straight away. They should always agree for that certain person

[Coolcat6103]

I don't have asthma but I do have emphysema and I take up to 400mg tramadol daily with no problems.

[Buboo]

Hi shazamI have fibro, asthma and hip impingment plus knee issues. I like you use paracetamol and tramadol but it isn't enough to get rid of pain I now use 2 amitriptyline tablets at night and top ups when needed of cbd oil which I find helps without making my asthma flare up. Hope this helps.