Whilst I’m not medically qualified, what you were told is incorrect: oramorph is not synthetic at all, it’s liquid morphine. Being a liquid it has a quick onset, which is why it’s considered good for breakthrough pain over tablets or some other medicinal forms. But it’s also therefore a strong opiate, and carries a significant risk of addiction and issues like respiratory depression. Opiates also quite frequently cause rebound pain in the form of headaches when taken regularly, and chronic pain has been shown not to respond well to painkillers in the long term. Any relief achieved only lasts for a relatively short period before breakthrough starts to occur again, assuming it ever does anything in the first place. I say this as someone that’s been living with severe chronic pain (including back pain from inflammatory arthritis) for the last 12 years. I completely get how exhausting, frustrating, and unpleasant it can be to constantly be in pain.
My best suggestion is that you ask to be referred either to a specialism that can diagnose and treat the back issue (if this hasn’t already been done) or to a pain clinic to look at whether some of the other options like nerve blocks might be more appropriate. Personal experience is that they would also be the ones able and more willing to go down the morphine route if they felt it was appropriate to your situation. In reality, though, the best thing I’ve found is mindfulness for pain management. It won’t take the pain away, but it does alter your relationship with it and enable you to better learn to live alongside it. If painkillers aren’t an option, or don’t work, then I’ve found that learning to meaningfully live with it is the only way forward, and it does really help.
Hi momander, I've had a bypass and am on the usual cocktail. I have been using paracetamol for my arthritis for some time. Recently, I spoke to somebody I have never met, who said they were a Dr. She prescibed Naproxin and said they would be fine as long as I took my Nexium every day instead of just when I felt I needed it. 2 x 40mg (I think) per day.
HI Woodsie,You are so lucky finding a GP that will precscribe you Naproxin. My GP will not!! I am on prasugrel, aspirin, bisoprolol atorvastatin. I was on clopidogrel but it was changed to prasugrel? My cardiologist is absolutely fine with me taking Naproxen short term when my back has a flare up!! My GP is not!!! So no Naproxin. I've read that another of people practice mindfulness to manage pain, and I have tried that but when you suffer debilitating chronic pain its not easy
I have severe psoriatic arthritis and NSAIDS are almost essential as part of its management but cardiology doesn’t want me to have them while rheumatology does. Both side are pretty insistent on their own point of view with me stuck in the middle. My attitude has become sod it. Without the NSAIDS I have no quality of life and it now appears that my heart issues may well have been caused by inflammation, rheumatoid vasculitis, anyway. My GP is stuck in the middle too not wanting to get in trouble for prescribing the wrong drugs. I’m doing what rheumatology tell me because at least I can get an appointment to see them and they’ll talk to me while my local cardiologists at The Royal Shrewsbury are still hiding behind the infection that mustn’t be mentioned and won’t even answer the phone.
I'm assuming it's clopidogrel you have that's being given as the reason for not taking NSAIDs (anti-inflammatories)?
There are plenty of warnings not to take the two together as they increase the chances of bleeding.
I've also found this quite frustrating as I'd normally treat inflammation (I've suspected myocarditis) with NSAIDs, but have been told not to take these while on clopidogrel. So I'm having to deal with the pain without relief just now (paracetamol doesn't touch it, and codeine isn't ideal to take with bisoprolol).
Normally I'd say run a dose change past your doctor, but it seems you're having no joy in that department. Have you spoken to a pharmacist to see if there are any alternatives they could recommend to your doctor? Pharmacists obviously can't diagnose or prescribe for this, but they might have knowledge of other pain relief that will be safe to take with the heart medication.
I've also found mindfulness to help, but appreciate its not a short term fix.
Hi, Yes it was clopidogrel bit now prasugrel. I know about the warnings but I find myself stuck as my cardiologist says Naproxin is the safest for short term use and my GP says No!!! I have taken co codamol for many years and there are no interactions with any of my heart meds. All my meds were checked whilst I was in hospital and before I left and none were ted flagged apart from naproxen!!!
Codeine can have a (small) effect on lowering blood pressure (can cause the blood vessels to dilate), which is something I've suffered from lately so for me it's just a precaution.
It's very frustrating to have your options limited, but it looks like there have been some good replies here!
I also suffer from chronic back pain and likewise was taken off naproxen etc... I was prescribed lidocaine patches and dihydrocodeine ( I am very strict re this strong medication). I find the patches suit me and greatly reduce the pain. However, I recognize that degrees of pain is an individual disability and b..... Blight. Just thought I'd respond to you as I empathize with your experience ( 2 'mild heart attacks). Wishing you well. Take care and regards
Thank you Etblue,I too have recently berm prescribed lidocaine patches. I'm only allowed to wear them for 12 hours though and just one patch at a time?? They do take the edge off.
Yes they do take the edge of the pain. I am fortunate that at times the patches and rest do greatly reduce the pain. I also place a hot water bottle at the bottom of my spine to reduce the tension. ...as you probably know you can't place over the patch...if the muscles spasm, which thankfully occur seldom since retiring, I take 2mg of diazepam. I am really pleased to see you have had such a good response to reaching out. It really brightens your day to see that others understand how difficult it is to experience pain with other complex health issues. Take care and I hope you have a good day 🙏
I also find mindfulness meditation, yoga and Tai Chi helpful. All to help me respond in a different way emotionally, to my pain.
I also use a (Transcutaneous electrical nerve stimulation) TENS machine. This helps with hot water bottles or ice packs to ease my pain
As Charlie_G has explained oramorph is morphine in an oral form.
I am given oramorph or IV morphine in hospital when I have flare of my symptoms. I don't take it at home routinely.
I also went to a Pain Management Programme which I found helpful. I was able to discuss all the options available which also includes other medication such as pregabalin.
I was even offered a Spinal cord stimulator which I declined along with the pregabalin.
I hope you are able to get some relief from your pain soon.
Hi Milkfairy,I attended a pain management clinic and was offered the same as you, which I also declined. I will try my tens machine again. I tried pre gabalin last year and was extremely unwell in it so had to be taken off it!! The woman I spoke to at my pain management appointment told me she didn't need to see me again? I then found out through my GP that she had taken it upon herself to reduce some of my medication without my knowledge or permission!!?? My GP was not pleased to say the least!! Luckily she changed it back!!
I have also seen a Pain Management Clinical Psychologist and attended a 10 session Pain Management Programme, run by a Physio, Clinical Psychologist and clinical nurse specialist.
This probably the most useful as I was in group with other patients and we're still in touch.
I was once given a low dose of imipramine. I just felt like I was walking through treacle. I still had my pain just couldn't be bothered complaining 😒
My pain " specialist" was an anethasist to trade but specialised in pain management. Thete was the option of attending a pain management group but for some reason she decided I would not go!!?? You jave no control whatsoever and are at times at the mercy of these so called professionals
My brother is on Apixaban for AF and has been told to keep of NSAIDs. This is an issue for him as he has extreme pain in his knees. Finding a remedy is an issue. It's definitely a case of beggared you do, beggared you don't.
I suffer from arthritis in my knees and find Turmeric helps considerably with this. I was told to take Paracetamol, but it just doesn't work for this pain or for the rare times that I get a headache. For a headache I am prepared to take Ibuprofen to get rid of the pain quickly. It's a case of quality of life balanced by the risk involved.
I have a lot of chronic pain issues, attended the pain management programme back in 2004, and have taken co-codamol 30/500 at maximum level for the best part of 20 years. It's now becoming less effective due to my worsening spinal problems. I can't take NSAIDs of any kind. I was given oramorph short term before a colonoscopy. I didn't find it very pleasant, and it was explained to me that oramorph was a synthetic form of opium whereas the codeine converted in the liver to a natural opium. That was why it didn't agree with me.
I've had chronic spinal pain for 20 years. I've been on oxycodone for it constantly- now suffering the long term effects but there's no alternative for me. I was allergic to oramorph . Oramorph isn't s ynthetic , it's just liquid morphine and like most opiates is very addictive and has horrible long term effects. GPs have been told to cut down on prescribing opiates but for some people there's no alternative. Have you been to a pain consultant? Mind you I've found they only ever offer gabapentin and amitriptyline
Hi,Yes I've been to a pain consultant and She did not agree with any drug intervention!!! So that was me buggered basically!!! She actually reduced my existing pain medication without my knowledge or permission. Luckily my GP reversed it!!
It's NHS here in Lancashire but here is a pain clinic in every area and we are quite free to go to other ones. I've been to Burnley, Preston, a private one and two in Manchester. Oh and Airedale which is out of the Lancashire area
You are very lucky. I would have to be referred to another one by my GP and because I have already been to one, I am not eligible to go to another one!!
I would certainly be questioning that. I recently saw a very unsatisfactory spinal surgeon. It was my GP who suggested getting a second opinion which is in a couple of weeks time. When my dad was diagnosed too late with prostate cancer I demanded a second opinion for him too. It was my GP who sent me to all but one of my pain clinic appointments until we found one that could actually diagnose what was wrong. If it's your GP who says it's not possible I'm afraid I'd go over his head to your Health Trust and ask them direct.
I tried searching eh NHS constitution but it's impossible but I did find this article ( repeated on several hospital websites) which states that, although you don't have a legal right to a second opinion, no GP should turn you down without giving a very good reason. dailymail.co.uk/home/you/ar...
There ate a lot of these apps out there but sadly none of them are free!! I was recommended to try Tame the beast , by my GP, but, again, thete was a subscription
I use the Mindfulness app and there isa free course with Vidyamala Burch unlocked at present. She also has a You Tube Channel. She has suffered with chronic pain for years. Will try and send link. Hey I’ve been using Mindfulness Plus+ lately, you can redeem 30-days free with this link:
Indeed, sometimes it's not the physical pain, it's our interpretation of its meaning not just for now, but things like, "what if it's worse tomorrow, how will I.... etc" pain is a fearsome thing, the suffering our active minds induce, far worse.
Hi Momander
I know what you are going through, I had back surgery year's ago that didn't work. I've recently had 2 HA's ,triple bypass, 2 strokes on top of the Chronic back pain. I finally had to find a pain clinic Doctor who understood my quality of life was practically nothing. I'm on a very small dose of morphine and Hydrocodone that are extremely regulated and it's not enough to totally stop my pain, but I'm able to live a somewhat normal life. I had several doctors that didn't care about how much pain I was in, just worried about their reputation with other doctors.
I also know it's hard to find doctors that specialize in pain, but they are out there and are worth finding. There are many other medications that are less stigmatized like morphine and Hydrocodone that may work for you and they will know how to help you and it will give you brighter days.
Don't give up the fight, look to Cancer clinics for pain specialist or a pain clinic. You are Not Alone, Good Luck and Best Wishes,
Hi Dusty68I wish I k rw how to find such clinics?? I have been referred to a pain cli ic Ince by my GP and can no longer be referred again? I have asked for a second opinion and have been told I can't have one as this was it!!?? Where in earth do I go from here??
I'm thinking if you know someone in the medical field, like a nurse, or someone working in a hospital that could help you find a different way to get heard. I finally got an appointment to see an orthopedic surgeon and it took 2 years to see him, but he got me into the pain clinic. There has to be a way to be seen by a different doctor. Talk to people and eventually I think you'll find someone that can help. Just don't give up, you know what they say about the squeaky wheel gets the grease. There has to be a medical commission that hears hardship cases such as your own. Maybe an appointment with a psychologist that you could tell how pain is destroying your life? Just don't take No for an answer, there's always a way! Be strong and Determined. I have faith in you...Dusty 68...
Thank you so much for your support and kind words. It was an orthopedic surgeon that referred me to pain clinic as it has to be done through them apparently!? My GP is fantastic but her hands are tied . I do t know anyone that works in a hospital. I'll keep going though!!
Hiya , I’ve got chronic back pain as well , mine is due to the them removing spinal fluid when I was having a section, I take tramadol paracetamol, I also take diacodine medication as well , I take these every day.
It doesn't work for everyone, and nor is it suitable for all conditions [obvs. it's important to check with your GP first], but I suffer chronic pain caused by an arthritic spine, multiple disk-bulges, bone spurs and compressed nerves, and it works for me. The first time I tried one, I was suffering 10/10 pain and panicking. It didn't seem to touch the sides, and I almost threw it across the room in disgust. However, as time has passed, I've come to rely on it increasingly, and now wouldn't be without it. In fact, I've bought an emergency back-up!
It muffles rather than cures pain. I know this doesn't sound great, but I'd say it drops my pain-levels from between 8-10 to between 4-7.
Hi momander, i to suffer from bad back flareups , and on a cocktail of heart meds after many stents over the years , my GP gives me Tramadol which i find works, had them for years.
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Frustrated with hospital appointment 
Frustration with cardiologist, results of treadmill test
Frustrating! it's a little off topic but relevant 
So frustrated with the system!!
Between 2 appointments, frustration building!
