Pain management

[sssglsjhs]

For my pain control I'm on gabapentin x4 daily and tramadol. I feel I am now addicted to tramadol as I am on the max dose but not feeling the benefits. I'm still in chronic pain and wondered if anyone has advice on pain control?

[Char81]

Hi you could add paracetamol it will help combined with the tramadol and gabapentin

[sssglsjhs in reply to Char81]

Aww sorry forgot to say I take paracetamol and ibuprofen but not often due to upsetting my stomach.

[Piscesgirl221 in reply to sssglsjhs]

Hi mind if I ask never heard of paracetemal? My Dr is so afraid of opiate addiction she has me taking everything but and then tells me the things she's giving me are addicting I'm so confused but I take Lyrica with tylenol plus tzinadine at night and my stomach hurts real bad too. And on top of it all I'm still hurting so much. Feel better soon.

[releasethemagic in reply to Piscesgirl221]

Paracetamol in the Uk but it is called Acetaminophen in some countries

[Badbessie]

Pain control can be very individual and what works for one is useless to another. Obviously if teamwork is not benefiting you it is pointless taking them. In my wife's case she changed from tramadol to a long acting patch which worked very well for her. In my case I could not tolerate the patch or tramadol and was placed back on opiates.

[sssglsjhs in reply to Badbessie]

Thank you. I think a long appointment with my GP is needed to try get all the options. No point in addicted to tramadol like smarties if they dont work

[Badbessie in reply to sssglsjhs]

My wife had real problems coming off tramadol. We were both seen in pain clinic and attended a pain management programme which went through both medication options and other ways of controlling pain.

[sssglsjhs]

I'm on the max but split over 4 doses etc.

What painkillers are good for fibromyalgia I have chronic fibromyalgia as well as chronic arthritis and recently had both knees replaced.

[Cathjamesandmatt20]

Tramadol is kinda useless, go back to either your GP or pain doc and request a change. If you’re on ibuprofen, are you on any omeprazole which protects the stomach? If you get that, and only take brufen when you eat, you can take it more regularly, which I believe is effective for fibro. Sadly i cant take it due to stomach lining issues. X

[sssglsjhs in reply to Cathjamesandmatt20]

That's my problem with ibuprofen, I take lansoprozol due to inflammation of the stomach lining so it's very rare and monitored. I've never been seen by a pain management

[Hidden in reply to sssglsjhs]

Hi

I think pain management should maybe your next port of call though I've been to about 3 pain specialists before I got a good one!! Take care Lynne

[Cathjamesandmatt20 in reply to sssglsjhs]

I’d stop taking the ibuprofen and ask about another anti inflammatory thats kind to the stomach. I cant remember its name sorry pain management might take months to get onto so I’d go to your GP. You can get a medication review with them. They can just as easily prescribe and be faster. Make sure you dont take no for an answer, anti inflammatory meds generally aren’t used for long term pain relief due to the risk of ulcers. I’m personally on dihydracodeine pregabalin paracetamol baclofen (sedative/relaxant) robaxin for nerve pains. Everyone’s pains can be different and it can be trial and error really x

[sidsue in reply to Cathjamesandmatt20]

My old Dr put me on slow release Dihydrocodeine,..2x60mgs morning and 2 x 60mgs at night for years these Dosulapin, also paracetamol and Pregabalin .. eventually the pain got worse, the meds stopped helping with the pain or I needed something different. as the Pain Clinic would not give me anything until I came off, dihydrocodeine ..I did what they said I ended up crying on the floor in agony I couldn't cope with the paid so had to up the dihydrocodeine again.. then I tried again ..it took 2-3 months to come off it the pain was intense and I truly felt like a druggy, my body shook constantly I had the runs my nose ran constantly cold turkey came to me...but did it without attacking anyone..the pain clinic put me on zomorph after 4 weeks they put it up, I am still in pain different pain sometimes I wish I had stayed on dihydrocodeine, but we see next time I go Back to Pain clinic

[Cathjamesandmatt20 in reply to sidsue]

Yes zomorph is even worse than the dihydracodeine tbh. And I didn’t find it as effective. I was on that a few years ago and the withdrawal was so bad I can’t remember two days! I’ve been on 8 DHC a day for 18 months and sadly that’s just gotta be the way it is for me. Maybe you’d be better off on spread out doses through the day? I have to take anti sickness and laxatives and I have insanely dry toes and fingernails but not being on them I’d be permanently bed bound.

Sadly Fibro can be resistant to pain relief, that’s when they knew for sure with me it was Fibro as the injections I had in my upper and lower spine didn’t work. They helped free things up a bit but not for pain 😔 And I’m on a tonne of different meds which work to a degree. it’s trial and error to find the best possible meds for each of us, we are all so different. Nothing will take all of the pain away but it’s what helps the most x

[CHutchinson0308]

I am the same I saw a pain consultant and have been told I need to ditch the gabapentin and then start pregablin some meds don’t work for everyone and I need to play around with them. I’m on a Tens machine constantly which is giving me some relief xx

[worried4me5]

Maybe you could just use the ibruprofen gel for your arthritis?

[sssglsjhs in reply to worried4me5]

I use a gel called Pernaton for my arthritis its brill and even my consultant did a trial with it and now recommends to patients

[worried4me5 in reply to sssglsjhs]

Is this on prescription?

[Hazel_Angelstar Administrator FMA UK Staff]

If you are taking pain medication at max dose and not getting relief, then it sounds like you need a medication review with your gp.

It is also worthwhile remembering that it is unlikely that any medication will take fibro pain away... At best you may find they help reduce it to a level you can manage.

Majority of pain medication is designed to help with short term /acute pain not long term /chronic pain. Some people find meds such as gabapentin or Pregabalin which work on neuropathic pain help more, or also anti depressants such as amitriptiline or duloxetine.

It can be trial or error finding a med combination that helps, and some people are unable to take meds for various reasons. Non medication ways of managing pain can also be used and a useful resource is the pain toolkit

[worried4me5 in reply to Hazel_Angelstar]

Yes. I have T2 Diabetes, arthritis, peripheral neuropathy, carpel tunnel, IBS with the Fibro of course. The Gabapentin is great for the neuro pain, ibruprofen gel helps a little with the arthritis and Co-codamol with some of the other pain. I've tried pacing but occasionally I forget when I'm having a low pain day and can overdo it, then I'm exhausted.

I think it's a fine balance and optimism and foolhardiness on my part can get in the way of managing it better - good job I have my trusty medications, regardless of the long term side-effects.

[Skylane2 in reply to worried4me5]

Have you tried BoswellIa, Black seed oil, Devils claw, MSM, Bromelain, Burdock root, or Hops? All are good for arthritis pain. And Hops will help you sleep better. All are on Amazon on line.

[worried4me5]

Thanks Zoonie

[johnsmith]

I could give my opinion in a gentle manner or I could be very blunt. My blunt approach is come off pain killers totally. However, you need to come off the pain killers very slowly to avoid nasty side effects.

Some people do need some form of medication because of what is causing the pain. Pain killers are for killing pain. This has the effect of dulling your sensitivity to tissue damage that you could do when engaging in every day movements.

Certain movements when engaged in cause increased discomfort. By changing the way the activity is done will lessen the discomfort. In some cases hard unyielding scar tissue is present. This type of tissue when engaged in movement activity will bruise surrounding softer tissues. So if a movement is carried out for too long inflammation will take place. You can compare this inflammation to the behaviour of a bruise. Swelling of tissue will reduce space for movement and cause escalating problems.

Every one needs to investigate themselves. Only investigating themselves can a person notice what things cause grief and what is helpful. Everyone is different so a regime of activity which is helpful for one person may not be beneficial to someone else.

I can say a lot more. What I have said may be a little bit too blunt and thus take a little bit of time to digest. I can give more detail regarding tools to investigate yourself if you request it.

[worried4me5 in reply to johnsmith]

johnsmith,

I totally agree with what you're saying and I for one, know how much damage I am causing my own body by taking 'temporary pain relievers'. I also think that if I wasn't taking them, then I would not be doing anything and end up in an even worse position and likely die quicker as a result.

Who knows how long our lives will be? How can we be sure when it will end? (Sorry to be so morose). I want to continue to do some of the things I enjoy now, in the way I know how to. It doesn't mean that relying on medication is entirely bad for however long you rely on it. It is a means, not a cure.

[johnsmith in reply to worried4me5]

Thanks for the reply. You are not being morose. You are saying how it is for you at the moment you wrote what you wrote. A lot of people on this forum can identify with your sort of feeling that cannot be put into words.

You say: "I want to continue to do some of the things I enjoy now, in the way I know how to." I definitely identify with that. I have also discovered something else. Life can have moments of joy even when we cannot do things as we once could. These moments of joy come as a surprise unexpectedly. These moments are enabled by the techniques and practices of the religious traditions.

When it comes to a religious tradition one needs to find one that one can gel with. Then run with it. I have engaged with several different religious traditions over the last 60 years. What is right for one at one time may not be right for one at another.

I have been reading "Fascia in the Osteopathic Field Paperback by Torsten Liem (Editor), Paolo Tozzi (Editor), Anthony Chila (Editor)". It is modifying considerably my thinking on long term pain and what to do about it. The book is too much to take in. However, it can generate better concepts of what treatments we need in order to be as well as possible.

[Iceberg5241 in reply to johnsmith]

I agree here. Fortunately I am retired with not too much responsibility and live alone in a retirement complex at the coast in South Africa. However I am coming to a space where all the pacing, healthy eating, vitamins (homeopathic) and pain management is not helping as the major pain that has taken over is the nerve pain. I have had neuropathy in my feet/legs for some years, am not diabetic and live with it. In the past 6 months however the nerve pain in my toes of the right foot has become excruciating and I believe it is all from the sciatic/peroneal nerve. I also believe I developed FM through a car accident in my 20s, no seat belts or head rests in those days - so double whiplash in the neck and lower back compromised. The nerve ending pain has now spread to my ankle and I am unable to walk without aggravating that pain. Doctors do not want to know...basically because they do not know what to do. I regularly have pressure point therapy and needles with a Chiropractor which alleviates the knots in my neck and back.l

My plan of action now is: 1. Another podiatrist to assess heel and arch supports (I have several from years of visits but need feet reassessed). 2. An ankle brace that is soft and comfortable. 3. A biokenetist for programmed stretching exercises that I am unable to do on my own. 4. Neuro Surgeon (but ours so booked next appointment only July) for maybe an MRI scan. 5. No driving for the time being. 6. Soak Feet in warm Epsom salts.

I am already having another batch of sessions of laser for Trigeminal Neuralgia with my longstanding Orthodontist (not charging as can't guarantee result although the first two month of sessions worked , but it has come back).

I am sure you have further advice Johnsmith I would really appreciate it any suggestions you have up your sleeve. I do not want to go the heavy drug route as I know how I react following hip ops and Tramadol etc.......I soon ditched them. Many thanks in anticipation.

[johnsmith in reply to Iceberg5241]

It is difficult to offer advice. I live in the UK and you live in South Africa. The available therapists are different.

You are in a position where nobody knows what to do. This is not surprising when you consider the complexity of the human body. Therapists take a long time to learn particular understandings. You have reached an age where there are multiple things that are not going right and thus need a multi discipline approach that works in parallel.

No one therapy will work. The best one can hope for is reduction in discomfort that comes as a result of work and investigation on your part. It is also a matter of what funds you have available.

I have no experience of what "A biokenetist" is or what they do. I have googled it. Google gives me words not the experience.

You say: "I regularly have pressure point therapy and needles with a Chiropractor which alleviates the knots in my neck and back". This gives a clue that you have problems with muscle control and posture.

You refer to laser treatment for Trigeminal Neuralgia I have looked at:

ncbi.nlm.nih.gov/pmc/articl...

I suspect that the Trigeminal Neuralgia and the knots in your back and neck are related.

You say: " I have had neuropathy in my feet/legs for some years". I have no idea how this was diagnosed and investigated. The neuropathy, Trigeminal Neuralgia and knots in your neck and back in the back could be related.

See an Alexander Technique teacher. They can make you aware of things that at present you are not aware of.

alexandertechnique.co.uk/

youtube.com/watch?v=nZQFdh4...(Not working as expected?)

I have been reading "Fascia in the Osteopathic Field Paperback by Torsten Liem (Editor), Paolo Tozzi (Editor), Anthony Chila (Editor)". It is worth getting a copy. It is technical. It will help give an understanding of things that is now changing how the body and its functioning can be looked at. It can also aid you in your search for therapists who can help your condition.

Your "heel and arch supports" could be driving some of your problems by forcing you to modify your posture to the demands of the "heel and arch supports".

Hope I have been able to be helpful.

[Iceberg5241 in reply to johnsmith]

As you say, so much going on and at nearly 80 so much has gone on before. However,mi also think I have outgrown the supports and am seeing a podiatrist this coming week. The biokinetist is to help me with stretching to, at least, make me more supple and maybe ease a bit of the sciatic pain. I will look up the book you suggest but therapists and Drs who actually listen are few and far between in my neck of the woods. Thanks for your response. I will take what I can from it.

[johnsmith in reply to Iceberg5241]

Thanks for the reply. Sciatic pain can be caused by pressure on nerve roots in the spine or pressure from muscles near the hip joint. I have had both types of sciatica treated by a McTimony chiropractor.

All the best with your treatment regime.

[Skylane2]

Get off Tramadol. It’s an opioid and cannot be dispensed in the US without special permission. Nor I can substitute until you can withdraw from it SLOWLY!! This is important. Talk to your doctor and see if you can do this. Gabapentian is easier to withdraw from and is only used here for a few maladies. Like trigeminal neuralgia. It works in your brain and can make you depressed and you can have panic attacks and or anxiety attacks. It’s for nerve pain only. I had to have a brain MRI as my husband was convinced I had a brain tumor. Nope! It was the gabapentin . Please get off the Tramadol. There are better pain drugs out there

[Skylane2 in reply to Skylane2]

Nor could is what I meant to recommend. Vicodin with Tylenol. This is prescription only. See my other post above for OTC supplements. I’ll be praying

[Skylane2]

Ranitidine has been pulled in the US because of heart problems caused by the drug. Pepcid is still OK for OTC stomach problems

[Ani7]

I had tramadol and gabapentin. I end up with lots of pain in my chest. I also had Morphine for more than 6 moths with Zoomrofh Capsule. They make me dizzy and I was calm at least for few hours and I was back to the pain again. I am only having voltarol Emulgel. 4 times a day.

[moo196]

I'd never take tramadol again. The extra unwanted side effects - including addiction - were so nasty. Personally I went cold turkey and suffered withdrawal symptoms but for me it was the only way to go. I switched to a much kinder amitriptyline and never looked back.

I don't take any other pain killers now, just try and get some exercise daily (built up from 4 lengths of the pool gradually), good diet and the absolute best thing I have ever done wrt pain is to give up diet coke and anything else with artificial sweeteners in.

Good luck!

[Raggy-Anne]

I cant advise you about what is best for you, but I can share my own experiences & thoughts with you. I have been prescribed every pill that can be offered for pain relief, every one of those pills caused me to suffer horrible side effects but gave me no pain relief. I have concluded that since I am getting no pain relief then there is no point in taking them. I feel, in my case that the medication I was prescribed was doing me more harm than good. I get the feeling that some doctors also feel that these pain medications are doing more harm than good, both in the short term and the long.

Have you spoken to your doctor about becoming addicted to meds that aren't even helping you? Your doctor should be able to help wean you off them.

I'm now med free and use nutrition, CBT, Epsom salts, accupressure. Magnesium, zinc, vit D B12 supplements, meditation & aromatherapy, to help cope with the pain. I'm still yet to find anything that actually reduces the pain, but I feel that trying things which create health help me feel better in general & give me hope.

[cheeky2944]

I can only speak for myself. having felt the almost disabling effects of this condition, I now take no pain killers, Just a low dose of Gabapentin. I excercise now for 2 hours a day which provides natural pain killers. It has taken me over a year to build up to this, small steps from using equipment at the gym for 1 minute to now 50mins straight off including running and hill walking. I can now deal with every day living, claeaning house, most of the gardening and going shopping. I have also got my life back and go out regularly. Good luck with what you decide to do.

[Sleepnot]

Hi,

Ranitidine is no longer available like a lot of medications.

Sleepnot.

[Backbone38]

I too take Tramadol to the max. It doesn't help the pain any more, my GP is going to help me wean off it. I have fibro myalgia, polyneuropathy and spinal stenosis. I had to come off both lyrica and gabapentin due to unpleasant side effects. I use Lidocaine patches for the neuropathy in my feet. Awaiting a lumber fusion operation and we'll see what the surgeon tells me to use. Thanks for reading.

[sidsue]

I am on pregabalin the two often get mixed up as a relative once thought because she could take higher doses of Gabapentin she thought her pain was greater than mine ..( always got what I have but she is suffering more than myself, that type of relative..) I had to put her right Havent heard from her for a while.. must get the name right as one is stronger than the other one, just because somebody takes more than you do doesn't mean you should ..as different bodies also take different reactions.