Options for pain relief what are there?: I've been on... - NRAS

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Options for pain relief what are there?

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I've been on 30/500 cocodamol for 5 years now. I went straight from a back injury to RA. Last time I saw the GP I asked to stop and go on to something else but he refused.

Needless to say it is no longer wo Int for the pain and I only take it out of desperation to get the even a small benefit.

What are other people on? I'm allergic to tramadol. Nortriptyline and amiltryptiline and feel like there is nothing left?

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What about pain patches ? X

Just a note to say that some CCGs are anticipating that some pain patches (such as lidocaine) will be excluded after the current consultation on prescription items so they're not permitting GPs to start new patients on some of the medications included in this consultation: england.nhs.uk/wp-content/u...

I don't take anything. I don't have allergies to medication but I am sick within 20mins of taking tramadol and NSAIDs ramp up the tinnitus to the point where it sounds like a car alarm plus, over the course of a few days, they cause a visual distortion that means I can't see out of my right eye.

My fantasy is to have a sauna that's large enough to exercise in. :) I think that would help my mobility and pain relief. :)

If I win lotto ..........

I'm buying a really big spa !!! (To exercise in with my friends ),

A big sauna , and donate $$ to help find a cure .



Transdermal pain relief has made the biggest difference for my OA pain as it's constant delivery. Maybe you could ask your GP if they may be suitable for you, if you think it could be an option of course. When my GP & I were looking for pain relief I'd already decided I wouldn't try tramadol & the usual suspects so after saying I had to have something she suggested BuTrans patches. It's one you titre up, I started on 5mcg/hr, then 10 & currently on 20... butrans.co.uk/what-is-butrans/

After being diagnosed with ra in January I was put on butec patches ( same doseage as above ) and I can tell you after trying nearly every pain killer going ( like you tramadol was nightmare and all other similar ones had terrible side effects ) these patches work I've started on 5mcg and been told I can still take co-codamol 30/500 mg on bad days or if I feel I need a little more relief . I was a little doubtful to start with but I can assure you these work better than pills and don't have many side effects , after a few weeks doctor reviews you and if you need a stronger patch then you'll get the next one up and so forth till you find the balance right for you . So don't give up hope there are a few things out there you can still try xx

If you are only on painkillers fir diagnosed RA I'd get back to your doctor to discuss Dmards!

I'm on dmards , but like so many had severe reactions with the routine normal ones they give you so eventually got placed on salazopyrin , what a huge difference , not so harsh with side effects and does the same job x

My GP has refused to give me trans patches (morphine?)

At first he said he wanted time to lookup the correct start dose then he said he couldn't as hospital hadn't said so.

I'm allergic to tramadol and all NSAIDS he said I had to continue cocodamol

As per the consultation, GPs are not permitted to prescribe some items in primary care unless it's been authorised by someone in secondary or tertiary care (like a consultant).

However, NMH's Butrans transdermal patch looks like something that can be prescribed in primary care tho' it's opiate-based and aimed at moderate+ continuous pain etc. Perhaps your GP would be open to discussing Butrans?

The patches are first prescribed by the pain clinic after that your local gp can up the disease should you need it and monitor you as pain clinic issues the authorisation for the gp to continue with them . X

Both BuTrans & Butec (which I'm currently prescribed since the patent protection ran out on BuTrans, Butec being Β£10 per 4 pack of 5mcg cheaper than BuTrans, nearly Β£33 less for the dose I'm on) are buprenorphine. I see no reason for prescriptions to be initiated by the hospital, unless he means he needs to take the lead from your Rheumy, in which case I'd check that & if necessary ask your Rheumy if he thinks transdermal pain relief would be appropriate. The daft thing is that I'm pretty sure he'll request your GP monitors your titrating the dose. Common sense says if co-co's at highest strength aren't dealing with your pain then an alternative should be sought, not remain on it.

The starting dose in these patches is 5micro grams per hour . X

I have taken tramadol for a few years. Needless to say, it appears to be helping very little after all this time and following a visit to gp last week, they out me back in dehydrocodeine daily and I have oxycodone when pain is worse .

I hope you find something that helps you.


Hi Helzbells,

Due to the complications caused by your allergies, I would have thought it would be appropriate for your GP to refer you to your local pain clinic. Have you requested such a referel?

As it now appears to be NHS policy to get as many people with chronic pain off opiate based pain killers as possible, this is going to be problematic for many.

When I came off Tramadol I experienced terrible withdrawal symptoms, unlike anything I had previously experienced.

Hope you get the pain relief you need sorted out soon.



Given your allergies and complex issues, I would agree that you need a pain clinic referral. If you're lucky and have a good pain clinic, they'll be able to offer you support apart from medication.

I found gabapentin to be a very good drug. I cannot take amitriptyline or anything in that family.

in reply to Hidden

i started gabapentin yesterday 1x300 tablet morning. In 15 minutes i felt like a zombie, i was spaced out and sleepy all morning, can u tell me how you manage thanks..

On a completely different note....I've been seeing a cranial osteopath and have found it very helpful at relieving systemic pain. Not the cheapest option and my Rheumatologist poo poos it, but it's helped me reduce my cocodamol intake significantly.

Obviously tricky due to your allergies but firstly have you thought of weaning off the cocodamol to see how you feel without them, they are known to be addictive and perhaps after 5 years it would be good to get off them if you can. There has also been some research to show that bizarrely they can actually heighten your response to pain! Having a period of time off them may then mean if you need extra relief you could reintroduce them for short periods of time, perhaps try just taking paracetamol? I know it's not the best pain killer and it will be hard but I really don't see any point you taking the codeine if you've built a tolerance to it. Meanwhile I'd be talking to the consultant about options as obviously the meds you are on are not doing the job.

Hello The so called doctors put me on tramadol,seeing they wouldn't refer me to a hip specialist ,To have my badly eroded left hip joint replaced.i took 1 capsule it did not kill the pain so i took another one.I started becoming high as a kite.They did nothing for the pain,but i felt better about it lol.I saw the chief doctor about 2 weeks previously.I asked him to prescribe some stronger pain killers.because i was in total agony with my hip especially at night.I was taking over the counter 5/500 co-cocodamol which was no good. he flatly refused to prescribe anything i had to put up with it.this doctor has now retired.Not before time in my opinion.A week later i was hobbling past our hospital in pain.so i called A&E. to get it xrayed.seeing another doctor at the same malpractice.said to me i shall not send you for a xray ,i want to keep you away from the surgeons.what a load of BS.The A&E doctor sent them a message to ask them to prescribe strong pain killers.Which they gave me 30/500 Co-codamol.These worked ok at first then they stopped working.I have found co-codamol and aspirin deaden the pain a bit A brand new sparkling hip joint would render me pain free. No more drugs. my problem is,i am over 65.Before i was 65 i got excellent treatment on the NHS. Since retiring these so called doctors are not interested.Yes sure the nurse will check my blood pressure,but nothing much else.Well i am now 72 year old,soon be dead lol.

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