Does anyone else find that NO medications work? - Pain Concern

Pain Concern

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Does anyone else find that NO medications work?


My mother used to say that she had no relief from any analgesia. At the time I didn't really believe her, but now I certainly do! It's very likely that she - and I - were poor metabolisers of drugs metabolised by the CYP4 pathways, which would also account for excessive reactions to drugs which are metabolised more slowly than normal. This problem would mean that drugs needing to be broken down in this way, such as codeine, have less or no effect. However, I would have expected buprenorphine or Oramorph to work - which they don't. I also have little relief from most antidepressants - doing better on the older tricyclic medications.

I really find TENS to be the only effective pain relief - apart from the radiofrequency ablation for my low back pain. However, nothing is working for what is presumed to be polymyalgia rheumatica pain/ and I think my steroids will have to go up quite a lot again.

5 Replies

Hello BOB here

Pain medications do not cure pain or prevent it. They suppress it depending on the patients metabolic rate, so you will always feel the pain at differing someone else. In fact two people with the same medical problem will both feel that pain at differing levels. Sadly this is more a problem with chronic pain sufferers.

You can use different techniques to control pain, that you may learn from a Pain Clinic or similar, that is as far as it goes. We who suffer chronic pain are always looking for that magic bullet.

If you take excessive doses, or doses of the same medication over an extended period, your system becomes used to that medication and will become less effective in pain control, we should always try and learn how to control the doses of the medications we take

More information regarding this can be obtained from the GP. Some know or have pain control expertise.

All the best


I take very little, as it is ineffective and I know the risk of loss of effect or addiction.

Hidden in reply to missrat

Hello Ann

BOB here

Try and take a little more of your medications, we all have the problem too set limits.

Chronic pain sufferers have problems coming of pain medications although it is not really an addiction,

it is caused by the use of the medication, you can learn how to prevent the side effects. T his can take an extended period of time

What are we supposed to do to get relief, we have problems enough when we suffer chronic pain

Good luck



Not a total surprise to me..... morphine codeine and buprenorphine are at least in part metabolised by CYP3A4 so hardly a surprise if you do not get results from one that you have similar problems with the other.

SSRIs are also mainly dependent on CYP3A4 but i am surprised that you get much benefit from tricyclics as most of them are too!

I have read somewhere that sometimes how drugs work isn't all that well understood. Many drugs trials are carried out on healthy males - for good reasons - but that might mean that a proportion of the population won't necessarily metabolise the same drugs in the same way, or have the same responses to them.

I think it's worth trying whatever medication is prescribed because you never know if it might work or not. It just seems relentless sometimes. A few years ago I was given an appointment to see a pharmacist at my pain clinic, which was very helpful as he explained that some drugs won't work for some of us and it's not your fault (I think it's easy to think that it is sometimes), and that if a drug's side-effects outweigh any benefits then it's sensible to stop taking it - following guidelines from a doctor or pharmacist, of course.

There is nothing wrong with using things like TENS machines. Use whatever you need to in order to ease the pain. I find that heat packs can often be the only thing that helps me.

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