Pain in recovery

[kirsten117]

I am in recovery from drugs and alcohol...I recently was diagnosed with " opioid induced hyperalgesia" and was taken off all pain relievers. I have torn and frayed rotator cuffs...not bad enough for surgery yet. I also am in the 3 rd stage of degeneration in my 5,6,7th vertebra in my neck. The pain is debilitating .. I'm currently on neronton at 2400 mg per day and 50 mg if Elavil for insomnia. My sleep is still rotten, between the neronton and ibuprofen....I'm popping pills all day. Will i now become addicted to these " non narcotic" pills ?? I need advice... I'm at my end.!

[Hidden]

Nuerontin (Gabapentin), Ibuprofen and Elavil (amitriptaline) are not addictive. I am wondering why you are on Gabapentin and Ibuprofen as they are drugs from the same group. Are you self medicating? In any event I would ask your Dr about these because they can both cause stomach bleeds, especially when taken regularly in large doses. Gabapentin is the better pain killer of the two. Your Dr has taken you off opiates but you are still getting pain releivers for your other issues (neck, rotator cuffs) which must be painful. There are many, many alternatives to opiates and it might take a while for you and your doctor to find a combination that works for you. Elavil is known to improve sleep so my guess is your insomnia is part of your opiate withdrawal. I think you are underestimating quite how difficult this is: feeling rotten and being sleepless is normal for withdrawal but you will get better every day and it will all be worth it. Good luck!

[Harrison27 in reply to Hidden]

Hi. I don't think ibuprofen and gabapentin are from the same group of medicines. Ibuprofen is an anti immflamatory and gabapentin is a neuropathic drug. Please correct me if I'm wrong.

[earthwitch in reply to Harrison27]

agree. Ibuprofen is an NSAID and gabapentin is not. You can't take more than one NSAID at a time, but that doesn't stop you taking other types of meds for pain. In fact, NSAIDs are considered fairly mild painkillers, but they often have a far better effect on pain because of their extremely good antiinflammatory action.

[Hidden in reply to Harrison27]

Thanks Charles2703, you are right. Checked Medscape and Gabapentin is an anticonvulsant like pregabalin, valproate and topiramate (you can under Doctor's advice take more than one of this group at the same time) and Ibuprofen is an anti inflammatory (NSAID). I was informed by my consultant that the NSAIDs are more dangerous than people think: 1 in 1400 chance of fatal stomach bleed. With opiates 1 in 3000 chance of addiction if you are taking them for actual pain. There is a lot of mythology around these meds.

[kirsten117 in reply to Hidden]

Thank you Bowbells....I am not self medicating but working with a new gp....I have just moved to a new city and am still trying to organize drs to work with me and my limitations due to addiction. I am doing chiropractic and acupuncture as well as tens treatment. I have only rarely taken OTC meds.....I have always gotten a script. ..thank you for the advice. I will take it to the gp....it does make me annoyed that the first choice for chronic pain is an opiate and I can no longer safely take them....living in pain is hardly an existence at times.

[Hidden]

Hello

I am not a GP and below is only discussed for support and information.

Analgesics you purchase over the counter have several problems associated with them, you really need to watch Paracetamol, they can have really bad contraindications and cause problems with the liver,if you overdose the hospital can bring you back although the secondary contraindications can be so severe this dose is quite low and they will cause very severe problems after about three days after taking the medication, Also they can cause severe tummy troubles like all analgesics do. That is why these and over counter NSID are sold in small packets and they actually will only sell two boxes at a time. Although if the GP has told you that you cannot take pain medications because of your drink problem,you will need to look at other ways of pain control.

If you are allowed over counter medications for pain you could try paracodiene or something that has two different actions so they work in conjunction with each other. Ibuprofen is an NSID they contain the NSID with asprin as a base

Asprin and Paracetamol are good medications if you have colds as they can help with body temperature.

Neuro pain is treated with the antidepressant Amytrypalene they have a contraindication that reacts on neuro pain, like pins and needles etc, these are given at about half the recommended dose of what a depressed would take, there can be a period of time when you will need to reduce the dose to come of them. This medication is best taken at night as they can cause you to sleep. Remember these medications are not Analgesics

You will need to now discuss your pain medications with your GP as Opiate medications form a different group of medications to standard medications such as NSID and standard analgesic medications, you may be able to take pain medications that are not in that Opiate group. If taken safe Paracetamol is a very good medication for pain control.

One other way of reducing pain is a TENS machine, the GP will arrange lessons for you They work well for necks and shoulders You will be given a booklet that shows the locations for the pads, this system is non addictive. Pain Pens can also be purchased, Look on the web for suppliers, one is BODY CLOCK. If you are disabled you will not need to pay VAT ,

Remember all pain control will most probably cause addiction as a contraindication, Opiates can also cause problems

If you take these medications properly the only problem you will have is stopping taking them. I you do it slowly you will not have to many problems, I have been on Opiates and anelgesics of different groups now for thirty odd years and I am still standing

BOB

[kirsten117 in reply to Hidden]

Thank you....can you tell me the name brand for paracetamol ..and paracoidine......I'm not familiar with that name....I am using a tens unit and find some relief.

[Hidden in reply to kirsten117]

There is no real brand type get mine in LIDL,

If you go into BOOTS as for Paracetamol ask for Paracetamol BP that is the same only cheaper, same Paracodone BP, be careful with your dosing, if after a time discuss this with your GP as you will need to talk and confirm your medication dose.

BOB

[earthwitch]

you could always try other self help pain relieving things. I find ice and heat are really good at relieving that kind of pain. Use whichever one feels best, or alternate them. Even if that kind of thing only drops the pain one point on the scale, that can be enough for you to function better.

[kirsten117 in reply to earthwitch]

Thank you...I do find heat can reduce the pain spikes.

[Hidden]

Ice and heat can work well. I find Biofreeze gel from Amazon very effective for about six hours and you can use as much as you like. Forgive me Bob but para codeine is an opiate so Kirsten will not be able to take it. Don't worry Kirsten, there is a difference between physiologically addictive drugs which are opiates and other meds one has been on long term so the body is used to them. One has to come off these slowly as well because the body has adjusted to them but this is NOT addiction (and there are no cravings (eg. steroids). Paracetomol is a useful and safe pain control drug which according to the lead Pain Consultant at Imperial College Foundation Trust is under rated and safe if you do not exceed 4g per day (ie. 4 doses of 2x500mg tablets per day) and he suggests it be taken continuously as it is a prostaglandin inhibitor which will therefore reduce your pain. I have been taking it for 7 years with no ill effects.There are many other meds such as the anti convulsants (anti epileptics) which work well for pain, such as valproate, Oxcarbazepine and Topiramate amongst others. Remember you are just starting your journey in a new place and it sounds like your Doctor has made some good decisions. Yes, chronic pain is awful to live with, not just the daily struggle but all the losses to be mourned as well. Allow the grief in small doses over time so you get over it but keep up your hopes. After several years I improved considerably, to a place I couldn't imagine before. Hang in there, I really hope the same happens for you.

[Hidden]

Sorry I meant Paracodone is an opiate. Anything with "codone", "codeine" in the name is an opiate, I think these are most of the OTCS. prescription only there are lots of different names but they are unlikely to come up for you except maybe Tramadol , that's an opiate.