Pain killers

[Scorpius]

Following a MRI scan it was diagnosed that I have 3 collapsed disks in my spine, this was approx. 2 years ago, the constant pain is not good but a week ago I fell and since then the back pain has been beyond belief, I believe the problem is severe bruising can anybody suggest what pain killers they would recommend.

[Barrister]

I wouldn't recommend anything as I don't know your medical history or whether you have any allergies/ intolerances. Really you need to speak to your GP, even in a telephone consultation, he/she will be able to prescribe. However, I have found for myself that taking ibuprofen and paracetamol helps my back pain. ( though some people who are sensitive to aspirin shouldn't take Brufen) Arnica ( homeopathy ) is excellent for helping with bruising so you would probably be alright with that but again, ask your GP.. Hope you are feeling better soon. Clemmie

[Scorpius in reply to Barrister]

Thanks Barrister, I am taking "Panadol" with little effect but I will follow your advice, no recriminations. Thanks.

[bassiefromholland]

If it can be combined with your other meds, ibuprofen can be a good painkiller. But I think you'll better ask your Rheumy or GP!

Wish you all the best,

Bas

[Scorpius in reply to bassiefromholland]

Thanks Bas, I have just started taking ibuprofen and hope it will help, this site is so useful for advice from fellow sufferers. During a consultation with my R/A consultant I give a copy of the medication that I take which was 6 tablets Prednisolone each containing 5mg, IE 30mg daily, this was taken for the previous 6 months on his advice I was told to reduce this dose to 5, 4 months later on my next visit he apologised, what he meant was reduce the dose to 1 tablet of 5mg, a breakdown in communication, little wonder that I have little faith in the system.

[PFKAAde]

Hi Scorpius

As a fellow back pain sufferer (6 prolapsed discs, so far) I can begin to imagine the pain you are in.

As has been said your GP is the person to say what to use, but from my own experience the only things that touch severe back pain are opiates.

GPs seem to prefer Tramadol IME, although mine gave me dihydrocodeine when I was in pain from needing a new knee (and having to look after two pre-schoolers) but this became morphine over time.

Which brings me to being careful with opiates, as you no doubt know they are addictive and your tolerance increases fairly rapidly.

Having said that I am currently weaning myself off a massive dose of morphine that I have been on for years, and for me personally it is no worse than reducing prednisolone after long-term use. YMMV.

After the acute pain has cleared up (and not knowing what you currently do), I can massively recommend doing lots of exercise to strengthen the muscles that support your back. Without this there is no way I would have been able to reduce the dose of morphine I was on so easily and quickly.

See a professional or risk making it worse, And be prepared for lots of pain. 😳 But you get that anyway...

Good luck, it really is constant pain, you have my sympathy.

Ade

[Scorpius in reply to PFKAAde]

Thanks Ade, my G.P. prescribed morphine in liquid form and patches the first dose made me violently sick which he put down to me being allergic to morphine, I don't have any knowledge of opiates, can you give me any advice on their usage and did they help with the pain?.

[PFKAAde]

Hi Scorpius

Opiates are just the class of drug that includes morphine and its derivatives. Dihydrocodeine, codeine (and cocodamol et al), tramadol etc are all opiates or synthetic opiates.

They do make you nauseous at first, but violently sick doesn't sound good. I would think, but don't know that if you are allergic to oramorph that may well rule out the entire class. Which is unlucky as they are the 'best' pain relief there is.

Morphine (IV) is what they give you after trauma to help with serious pain. We don't currently have anything stronger, apart from things like fentanyl (another opiate, but very strong).

Yes they 'work', but nothing will completely take away severe pain, it just kind of deadens it a bit and makes it more bearable. They also make you drowsy, which is good if you are trying to sleep but not so good if you are trying to drive, for example.

I would say you definitely need to see your GP, as they are the only ones that know your history and can prescribe most painkillers anyway.

They will also know if your previous experience rules out further opiates, and may suggest something like Pregabalin, amitryptaline or similar.

These don't work quite as quickly as the other drugs mentioned and are only effective for neurological (nerve) pain, but amitryptaline also makes you drowsy at first and can also help with sleep.

For me Pregabalin is not good when forgotten or trying to reduce. And I have no idea how effective it is, despite being on it for years.

As much as they may sound like hocum there are non-medical pain relief / management techniques that can actually help, like meditation.

Your GP has got to be the way forward.

Hope that helps.

Ade

[earthwitch]

Ice pack, but definitely not for more than 15 minutes at a time. Gentle movement to keep from stiffening up. Ask your GP about whether antiinflammatories would be useful (may not be if its bruising rather than swelling). If you can take ibuprofen, then I find alternating them with paracetamol (paracetamol every six hours, ibuprofen slotted in between to the maximum daily dose) keeps a fairly good cover. Paracetamol on its own never seems to do much for me, but its quite amazing how it seems to magnify the effect of any other pain med it is taken with.

[DC56]

Don't you think it would be best to see your Doctor, sorry your in so much pain

[BelfastHeather]

There's a new gadget called Actipatch. It seems to be like a modern version of a Tens machine. You set it round the area of pain using a belt or plasters. It sends pulses that relieves the pain. Know it sounds odd but REALLY works! I got one a few weeks ago and have since recommended to several friends who also report great relief. It costs about £20 but lasts for approx 300 hours. You can switch it on and off so I think it's good value-and no drugs! Worth finding out about. Take care.

[thelmar]

Do you see an orthopaedic consultant? I am now on a treatment programme of nerve block injections done under anaesthetic every 4 months and these really help, but they would only be available at the hospital. I do hope your pain eases - I do know how excruciating it can be.

[PFKAAde in reply to thelmar]

Yes I've had about 5 of those and they work overnight usually, in fact since the last one (about a month ago) I've had quite good lasting relief from the sciatic pain I had.

It still hurts after I exercise, but I am told the best results come if you take advantage of the pain reduction to increase core muscle strength.

Ade

[Scorpius in reply to PFKAAde]

Thanks for your comments regarding "nerve block injections" I have not heard of these, my history is that after trying to lift a very heavy object followed by 2 falls, a MRI scan diagnosed collapsed disks, my G.P. informed me it is operable but the success rate is no better than 50/50 and he would not advise it, the best available is pain killers. Regarding the injections you mention that these are done under anaesthetic is this local or general, at the moment the pain is bad to the extent that any movement is very painful and the chances of getting to the surgery are nil. Thanks for sharing your experiences, when mobile I intend to follow them up.

[PFKAAde in reply to Scorpius]

The procedures, as I've had them are called 'nerve ganglion root block epidural' or something similar. I have them done privately as that I how I am seeing the surgeon, however I believe they are done on the NHS also.

They are covered on most work related private plans, I believe.

They are done under a light general anaesthetic to minimise the chance of you moving and are injections (I'm not sure but I think it's lidocaine and steroids) guided by X-ray I to the precise spots they are needed. They numb the nerves that branch out from the spinal cord at the root and the steroids reduce any inflammation that may be present. They are usually a day-case procedure. But you can't drive home!

I don't know exactly what they are indicated for, but I have had them after slipped discs and spinal decompression surgery. They aid recovery and reduce pain, particularly referred pain down the legs (if done in the lumbar region), I assume cervical / thoracic region ones numb the respective pain caused by these nerves i.e. chest / arm.

With the greatest respect to your GP, he isn't a spinal orthopaedic surgeon and therefore may not be best person to say how successful surgery may or may not be.

Not sure what surgery exactly he was referring to - any idea?

You could always ask for a referral to a spinal specialist (i.e. second opinion) and either go the NHS route or pay to see one privately and then switch to their NHS list.

If he says nothing should be done, then it has cost you £200, if he says something can be done it has saved you a potential 3 month wait to see him. That's a long time to be in pain.

The other thought that occurred to me is that you are assuming it is bruising but haven't been checked by anyone - correct? If so you could always go to A & E and you would be seen instantly.

I got told off for waiting to see my GP and for being let out of the surgery not in an ambulance! But then I couldn't walk. Spinal health is not something to be taken lightly and any damage to the spinal cord can and does take years of agony and hard work to recover from, and I've been told to only expect 50% recovery.

I think my case is quite extreme, but even so don't take risks with it, walking is quite nice when it doesn't hurt with every step. I still need sticks now and my problems started in July 2015.

Good luck with it all!

Ade

[Sheila_G]

Hi. You have my utmost sympathy. I know what back pain is like. I am probably preaching to the converted but I found Ibuprofen gel and heat pads helped. I know paracetamol isn't strong enough but as others have said, get medical advice before you take anything stronger. Always bear in mind the fact that paracetamol is a very dangerous drug if not taken as directed or taken with other things like lemsip etc. Maybe when you fell something has swollen in which case you would need ice packs to bring the swelling down before using heat. Speak to a physiotherapist or an Osteopath if you are happy with them as I know some people don't agree with Osteopaphy and Chiropractic. I hope you find something to reduce your pain soon. x

[JudyW5]

Hi Scorpius

[JudyW5]

Sorry, Scorpius, I keepforgettingthat when I use mt tablet to comment then I can't correct anything without the whole lot freezing.

I ď have 5 disintegrating or prolapsed discs. No fun! It took the GPs some time to work out a good pain plan for me and I had to change GP within the practice. If you can't get to the surgery then a phone consultation or even a home visit can be requested legitimately. I would think that trying to put you immediately on straight morphine was a bit drastic and maybe why you reacted by being sick! Lower doses of opiate drugs might have been better. I had no relic on felt relief on just paracetamol or ibuprofen or even cocodamol or codeine. Am now on max dose of dihidrocodeine an paracetamol with 75mg of pregabalin and 25mg of amitryptaline extra to get me through the night.

A referral to an orthopaedic back specialist is imperative and you are entitled to a second opinion. New strides forward in treatment are always happening and your GP cannot possibly keep up to date. You can request transport to your hospital appointment.

I have had 1 injection in my back so far which has improved things.

You can also ask your GP to refer you to a pain clinic who will work with you to get the right balance of medication and my suggest other things to help.

With regard to other things. I have sometimes had treatment from a private physio. They have machines which use laser treatment and electromagnetic heat and can also use ultrasound as a treatment. All these are good if you are just in too much pain to move very much and maybe you can get there by taxi. Unfortunately NHS physios don't have access to the same equipment so you will have to pay (should be between £30and£35). Even one or two sessions will help although you may feel a bit worse before you feel the benefits.

Other than that I use an electric heat pad every morning before getting up and sometimes the chemical heat pads you can buy over the counter, which provide gentle heat throughout the day and help to stop my muscles sizing

[JudyW5]

Sorry - seizing up.

Can't think of anything else that helps - the arthritisresearchuk.org website have an excercise booklet you can download which has a poster with exercises that are ok for RA sufferers.

Hope things improve for you very quickly.

[pinksugarmouse]

I take paracetamol for headaches. There is a cream I have for my arthritis which is put directly on joints. The effects are short-lived but it still helps a bit. I have tramadol which I try to not to use to often because it can make me feel pretty woozy. But this is only available on prescription. There are other prescriptions medicines which have varying levels of relief and of course different side effects for different people.

Have you tried a heatpack or coolpack? Or a bath? I can't get in and out of one but some people find it helps with pain.

You clearly need something but you really need to talk to your doctor.