Apparently runnng out of options for pain relief???

I saw a gp today to say that the co-codamol I was prescribed last week was not touching the pain. My gp said to me 'well theres not a lot left to try now, you are running out of options'. This is the second time a gp has said this to me in the last few weeks!

The medication I have tried so far for pain relief is; ibuprofen/paracetamol, naproxen, diclofenac, amitriptyline (which I still take but for help sleeping), dosupelin (didnt even help with sleep so went back on amitriptyline), co-dradamol and methocarbamol, codiene and theb co-codamol. None of these have been effective in relieving me of pain and the gp has npw prescribed tramadol. Is there really not many options left for me? I thought there are many different meds for pain relief? Am I being fobbed off? Thanks in advance xxxx

31 Replies

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  • Ask if you can have a referal to the pain clinic in your area. That's if you haven't already seen them. Sorry am new to site in respect of posting any advice, but have found it very useful and made me feel less lonely. Sending you best of luck.

  • Yes the gp did say something to me about pain clinic but never gave me any details of how to go about seeing someone there. Any ideas how I would do that? What do they actually do there? Thanks xx

  • Hi Megs

    Sorry to hear you are not getting much help with your pain. Like you I have have chronic pain and put up with the same meds that never hit the pain. I finally went to my Doc and told him I was at the end of my tether. He prescribed gabapentin but that never helped so he then gave me pregabalin. I have been on the high dose now for a few months and I think my pain has been reduced at least 80%. The drug is an anti epileptic but works on neuropathic pain, I have no idea how :) Also He referred me to the pain clinic. The first visit I found the doctor very kind and gave me a brief physical exam. Asked lots of questions and has diagnosed fibromialgia along with the sle .He was going to prescribe the pregabalin but my GP had already done so. I am there again on Tuesday next week where I am seeing the nurse specialist( in pain I think)

    So after all that rambling I think basically they go through medication , life style, occupational therapy type stuff. They try to teach us better coping methods etc !! I will let you know how it goes next week. In the mean time get yourself to the docs and let him know you need help . Be brave , you aren't doing anything wrong asking for help x

  • Thanks for your reply. As it happens the gp suggested gabapentin today then quickly changed her mind to tramadol! As yet these are not doing anything but will give them a few days. You never know this might be the one :-/ hmm.

    I am definately going to contact my local pain clinic, I am guessing you

    just self-refer? Thanks for telling me about what happens, I was a bit anxious about what would happen when I got there! I am seeing new rheumie on 21st so I am hoping she may have some answers for me!!

    Maybe the pain clinic staff will be more understanding and kinder than the gps I have seen! Please let me know how you get on at your next appointment :-) xxxx

  • I use tramadol and top it up with oral morphine, co codamol upset my stomach. My local dr put them on a repeat prescription so I don't have to fight to get them

  • How did you manage to get oral morphine on script? Xx

  • I saw my dr and he said I shouldn't have to keep going to see them as I was suffering enough. So he put it on a repeat script. I don't need it all the time but I know it's there where I do xx

  • Wish my doctor was so understanding. I am sick of going back n forth and not getting anywhere! Xx

  • Megs I'm not sure but think you may, as yet, still be undiagnosed with SLE (?). I need to know whether that's correct before I can comment in a meaningful way ....

  • Yes that is correct, still no diagnosis of any sort :-( which I suppose does not help the gp when trying to prescribe as at the moment they are just trying to treat the symptoms xxx

  • if u ring pain clinic & explain the situation, they'll tell u whether u can self refer (luckily I can do it at mine). Try Tiger Balm (headaches & general aches & pains) but there r other meds u can try, just depends what u're GP's like. Maybe try a mix of CoCodamol & Ibuprofen (these can be taken 2gether) but check with GP first as I've known some Doc's will recommend a certain thing but the next will tell u not 2 touch that certain thing! x

  • I'll try that thanks :-) and have tried co-codamol and ibuprofen and that didnt work either (not on doctors say, I just tried it myself). Is tiger balm something you can buy over the counter? My partner has just suggested this patch for your arm that is meant to relieve pain, have you heard of that? Xxx

  • u should be able 2 get tiger balm near enough anywhere, a lot of Health shops sell it, some supermarkets even a few pound shops! U just apply it were u have the pain. I have heard of this patch but I'm not sure how availiable they r or which 1's u can buy over the counter. There is a Voltarol 1, an opiate based 1 (that u need 2 get on script as they offered me this instead of Oramorph, I think it is basically a morphine potch) which I think is called BruTan (or something like that) & Salonpas. Apart from 'Deep Heat' that's the only other 1's I've come across. Worth trying thou I guess :0/ x

  • I will have a look for it hun thank. My dad brought me this cream over that is a blend of rapeseed oil and petroleum jelly. He says it is similar to deep heat so was going to give that ago (though deep heat doesn't always work on me). The patch my partner was talking about was the opiate based one I think, but he said they are expensive so would probably be hard to get on script. Was just thinking with a patch it means I am not taking loads of pills that could be causing damage to my organs, thought it might be safer option maybe. xxx

  • Always worth giving things a go :0) U never know, the doc may be happy 2 do them 4 u x

  • Think I will ask rheumie about them and she can write to docs for them to prescribe them if she agrees with me about them xx

  • No it doesn't Megs but all anyone can do for us is try to allieviate the symptoms to some extent (if you do have SLE) - sadly, there is no entirely effective treatment. What we really need is someone with a magic wand! However, there is plenty more pain relief to try - other NSAIDs, steroids, anti-malarials are some. Not all drugs work for all people and some have no effect at all - it's very much an exercise in trial and error in the beginning. If your pain is being caused by an inflammatory process the opiods won't really help, nor will they be suitable treatment long-term. Aspirin and Nabumetone were the only NSAIDs that ever worked for me. You may as well try ibuprofen and aspriin now - which you can buy without prescription, if only to rule them in or out. x

  • A magic wand would be lovely, I might ask santa for one! lol.

    I have tried aspirin and ibuprofen in the past and had no luck with that. I think ibuprofen doesn't work on me now as I took it pretty much every day for about 3-4 years (for back pain) through my teenage years to the point it had no effect on me at all but docs wouldn't prescribe me anything stronger (probably due to my age). xxx

  • I always used 2 ask 4 a new body at Christmas, one that was healthier & actually worked properly (& maybe a little perter & sleeker if I'm honest!) that they could transplant my head on2 but now, with all the neuro problems too, I guess that idea has kinda gone out of the window. New body or new head? Which would I benefit more from? Guess I'm screwed either way ;0) x

  • haha, I think I might ask for a whole new me, new body, new head (and definately perter and sleeker!!) lol xxx

  • u make me laugh x

  • Laughing is good for the soul :D xx

  • Hello again

    I am not sure about self referring. My GP actually did that and the appointment came through quite quickly. Oh and I tried the tramadol and they have been the only meds that I haven't been able to stomach .....literally !!!!!

    I will let you know on Tuesday :). Take care x

  • Thanks, the gp looked shocked that I had not heard of it but at no point did she suggest refering me! Can't believe none of the doctors have ever suggested this to me before now.

    Take care xxx

  • I think GP needs to refer you and there could be a long waiting list so you want to mention it at next appointment. They don't talk about drugs very much though I found, it was all other "coping mechanisms" and things which are all very well but most of it was common sense and I had tried 90% of it before....

    Tramadol is OK, if it makes you nausous, don't give up, go back and ask for an anti-nausea drug to take at the same time (I don't have the packet with me and I definitely can't spell it without it....) DON'T drive after taking it! I find it does definitely affect my brain - I suddenly really can't spell for a start!

    You can take tramadol and gabapentin/pregabalin but it does make sense to try starting them one at a time and separately otherwise you wouldn't know which was causing any side effects.

    Hope the tramadol helps - it's a step up from the co-codamol at least.

    Don't be fobbed off - you have a few steps to go yet. Just because your GP isn't a pain expert and doesn't know about them, that isn't your fault!



  • Thanks Jennie. I have just phoned my local pain management clinic and they said I would need to be refered from gp or consultant so I am now really annoyed that the gp yesterday failed to mention that!!

    Actually the tramadol hasn't made me nausous as yet so fingers crossed it stays that way. It is hard to tell if it is working on the pain yet as each day the pain is different so don't know if today is just a better day or its the meds doing it. Luckily I don't have a car right now, as I think every med they have given me the box advises not to drive (not that any gp has ever thought to ask me if I drive!). I am hoping the new rheumie I see on the 21st will be more helpful (and definately more knowledgeable!) than the gp's I have been seeing!

    Take care xxxx

  • How's the Tramadol working out? x

  • Sorry didn't see this hun. Yeh its going ok I guess. It more effective than anything else I have tried to date so going to keep at it. I see my new rheumie next friday so they will keep me going until then I suppose! Tbh I just can't hack another appointment with a gp looking at me like I'm mad so going to speak to rheumie to see if she can at least write a letter suggesting what to prescribe. Thanks xxx

  • You shouldn't need a diagnosis to get good pain relief - I had oramorph and tramadol on repeat when I only had a diagnosis of fibromyalgia which is about the vaguest diagnosis of "you have pain but we don't know why" so don't let him stop you!

  • Thanks. Well gp's keep saying to me 'as you have no diagnosis all we can do is treat the symptoms' but yet they don't seem to of managed that yet!! Xxx

  • some symptoms can't b treated. Silly GP :0( x

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