Amitriptyline

[Missus835]

Hi all. I have been suggested Amitriptyline by my pharmacist as GP won't prescribe anything other than an extra strength acetaminophen. I have PMR, severe osteoporosis, and most recently diagnosed with fibromyalgia. 10 vertebral compression fractures, maybe 11 as I had an xray this morning. I have been taking Tylenol 3 for about a year which is no longer offering much relief at all. I wanted to try transdermal patches, but oh no can't do that. Today my pain is at an 11. Anyone out there with recommendations or experience with amitriptyline for pain not depression?? I cannot take pregabalin or gabapentin due to the depressive side effects and Cymbalta causes heart and stomach issues. Thanks for your replies.

[Lilbil]

Hi Missus835

I have osteoporosis and 8 spinal fractures, before I was diagnosed I had severe back pain and was taking Amitriptyline 20mgs at night and Co-Codamo but this was not helping my pain, it did help me sleep. Lucky for me me GP agreed to put me on transdermal patches which are 10mgs and last for a week. They are much better than the Amitriptyline and Co-Codamol cause less side effect like constipation, had to wean myself off the Amitriptyline as you can’t just stop it. I’ve been on the patches for 2 years now and with the help of my Spinomed Active back brace I am much improved and can now function better and able to do daily walks. Hope this is helpful I know Amitriptyline can help with pain but didn’t work for me. Good luck hope you can sort you pain out soon

[Missus835 in reply to Lilbil]

Thanks so much for your reply. I will show it to her next week. She's dead set about anything that would conceivably help. What type of patches are you using if you don't mind me asking?

[Immelman]

I require a shoulder replacement due to no cartlidge. I took 5mg amatrypiline for two years and had to up to 10mg. This is not working anymore and I must either have the operation, drink painkillers or alcohol or medical Marijuana before bedtime. None of the options appeals to me. I am not yet experiencing pain from osteoporosis. Sleep is so important

[ABwn]

I've been on amitriptyline since last Christmas for pain in leg. Told to take them early evening to help me sleep as the pain kept me awake at times or would wake me up. I take 20mg, which works for me. It was the weekend emergency GP who first prescribed them. I class myself as being lucky!!

[Crystalbowl]

I was prescribed 30mg Amatriptyline for PHN (post herpetic neuralgia) pain over 5 years’ ago. I also have 3 fractured vertebrae. I didn’t find it helped the pain but it did help me to sleep which, as a lifelong insomniac, was wonderful. However, the effect gradually decreased so I weaned myself off it a couple of years’ or so ago. I have not found anything which helps with the pain despite trying a multitude of different things. Good luck!🤞

[Sunseaandsand]

Hi, Amitriptyline is given to help with the nerve pain caused by pressure on the nerves from fractures.

Buprenorphine patches are prescribed here in the UK for the Chronic Pain, like most medications they come in different strengths. ( They are not for Acute Pain)

It is down to the discretion of the doctor or consultant what is given for acute pain ( this can vary depending on who is prescribing) pain management Clinics and Consultants can give stronger and different medications. x

[Missus835 in reply to Sunseaandsand]

Thanks for the info.

[Lilbil]

Hi Missus835

The patches I am in are Reletrans 10 micrograms/hour which last 7 days you can get 5 micrograms patches. I would insist on trying them if you are in so much pain. I became very depressed due to the constant pain, these have changed my way of life hope you can get somewhere with your GP

[Missus835 in reply to Lilbil]

Thanks Lilbil. I'm going to show her your responses and yes it's very depressing and she seems to be getting frustrated with me, because nothing is working. I mean I have 3 potentially pain-inflicting AI diseases.

[Mavary]

Hi I can sympathise with you. My back has fractured seven times. I’ve not gone down the route of painkillers. I just do the necessary. Likegetting food and washing up that gives me a good deal of pain. I do find as long as I sit in my chair or lie in my bed I have no pain. I have tried to ring my Dr three times so I can go and see him about pain killers. He never seems to be on lately. I don’t know if my pain has got worse or I can’t stick it as much. If he does give me something I have to still be able to drive with it. Not that I go far.

[Missus835 in reply to Mavary]

Hi Mavary. Thanks for your reply. Same. Sitting and lying,pain is less. I do sleep well. From June 2023 to this year I spent most of the time on bed and am determined not to do that again. I'm fortunate to be able to get food and wash up, go shopping (although at present that has to be pretty quick). Can still do laundry. I refuse to be bedridden. Blessed to be able to walk at this point. Today at the store I thought my back was going to let go. Thinking of getting a back brace. Keep on the Dr. I find you have to keep at them. I get the driving part. My daughter does the driving now and I miss it. Take care and cheers!

[Mavary in reply to Missus835]

Me too. I can still walk but not very far. I can walk across the road to the butchers and back. If I want to go further I have to use my scooter. The first time I went out on my scooter I went to places I hadn’t gone to for three or four years. I felt so good to be able to do that. I miss the being able to walk all around places. I was always a confirmed shopaholic. I can’t carry shopping any more. I have been carrying my handbag more but it’s taken years to do that. I do get my own meals and wash up but that can be really painful as can be having a wash or a shower. Sometimes after a shower I sit down in my dressing gown to recover. I find that because I can walk people don’t believe me. I’ve been very hurt a few times.

[Missus835 in reply to Mavary]

I feel that. Because these diseases are more or less invisible, the don't get the pain or severity of it. I've been thinking of a scooter as well. Just getting out andbreaking up the day is huge. I know about the pain of cooking, doing dishes, etc. I have trouble doing the floors. I can sweep, but it's difficult getting it into the dustpan. Things that are simple, are often hardest. LOL.

[Snowybear]

hi missus835. I was prescribed Amitriptyline 10-20mg for back pain after possible fracture. I’ve stopped it now but I do think it helped, especially at night. It works as muscle relaxant and stopped the awful back spasms I was getting. It gave me much better sleep. Downside is I felt quite drowsy next morning even though took it at 7 pm.

[Missus835 in reply to Snowybear]

Hi Snowybear. I'm reluctant to take anymore pills, but absolutely need something to relax the muscles, plus my ribs are again pressing down on my stomach and diaphragm. Waiting to hear xray results, even though if there's another fracture, not much can be done. Possibly a brace in my future. Thanks for your reply.

[Snowybear in reply to Missus835]

Sorry to hear that. Hope you are able to try amitriptyline and find some relief.

[Anonimoveneziano]

Hi, sorry to hear you are going through pain and possibly vertebral fractures.I have OP too and have been bedridden for more than 5 weeks with debilitating back pain, would a appear no fractures but DDD from L1 to S1. In A&E they gave me morphine that did nothing for me. So 3 days after I called the GP and she prescribed amitriptyline in the lowest 10mg dose. Have you been prescribed the same dosage?

Being osteoporotic, I check everything in these days, because even ipobrufen if taken too often effects bone density.

So I searched for Amitriptyline 10 mg /bone health . The leaflet in the box mentioned bone health problems on lower doses, so I looked for the any studies. Infact the lower doses carries the possibilities of bone loss and fractures for some individuals according to the study I found.

ncbi.nlm.nih.gov/books/NBK5....

I would advise you that you take council from the gp or physician.

[Missus835 in reply to Anonimoveneziano]

Yes. 10 vertebral fractures. Even ppi's if you're on one, contribute toward brittle bones. Thanks for the link. I'll have a look shortly as it's almost bedtime here in Nova Scotia, where very few physicians are up to snuff on PMR/GCA, OP or Fibro and she tells me I read too much. No I've not been prescribed Amitriptyline as yet, but after the last few days (possibly another fracture), I need something more than paracetamol with codeine. I have a phone consult with GP next Friday. So sorry to hear of your pain and can completely empathize. Take care and thank you.

[Anonimoveneziano in reply to Missus835]

Good luck with everything.i was just wondering about your multiple fractures, I presume you are talking of all vertrebral?

Are you or have you been on any OP drugs?

I am 66 and I have been on Denosumab injections for a total of nearly 8 years. After the first 3 Denosumab (twice a year injections) due to skin reactions and muscles spasms, the consultant switched me to a Reclast/Zolandronade for 3 yearly infusions. Unfortunately during that period I gained on the spine but lost on the hip, so I was put back on Denosumab.

I regret it now, since during all this time he never mentioned of the rapid rebound on spine causing the risk of multiple vertebral fractures when stopping the Denosumab without a relay bisphosphonate drug, like Zolandronade

All I am told is to stay on Denosumab for life, worrying when there a no studies on the effect of suppressing both bone markers, bone resorption and bone formation, which is what Denosumab does. Not to mention tooth extractions; you may start the drug with a good set of healthy teeth at 55 like I was then, but now at 66 I just had my first molar extraction 20 days ago, due to severe infection and root fracture while under this drug.

This week I developed pain in my face, forehead and right eye, the gp thinks possibly sinusitis infection , migrated from the tooth socket, so now the risk of MRONJ is an additional worry. On antibiotics again since yesterday. Living by the day.

[Missus835 in reply to Anonimoveneziano]

Omg. That's scary! I feel so bad for you. I'm due for my second Reclast infusion. I wanted to try another injectable one, but too expensive and government will only cover the one you start on ( according to my OP ). Side effects are always in the back of my mind. Although they are said to be "rare". I've rarely had a cavity, but this checkup I have 3. Last checkup one. Teeth have become quite sensitive. So much pain from so many different places, it's difficult to tell the difference now. Maybe it's a flare, maybe it's a new fracture, maybe it's a pulled muscle, maybe yet another disease. Yes, vertebral fractures, another of which I may have done last week. Waiting for xray results. Not that anything would be done. I just am a "need to know person". One day at a time is right. 🫂