I have just started taking palexia sr (tapent... - Pain Concern

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I have just started taking palexia sr (tapentadol) 50mg twice a day. I am really suffering with nausea now. Will this go away in time?


I have severe sciatic nerve pain caused by a herniated disc which is compressing the S1 nerve root. I have been off work since the beginning of January with no sign of being able to return anytime soon. My pain began in November 2012 but responded...

21 Replies

I don't know what happened. I had typed a large story and when I went to submit most of it disappeared.



You will need give this medication time to work, all I can suggest is give it about two weeks or so to get into your system

Good Luck

mukeshgarg in reply to Hidden


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See a chiropractor. You need to start re-training your muscles in order to stop increasing the pressure on the nerve.

For muscle training you will need to see an Alexander teacher and investigate Mindfulness.

You cannot do anything about the herniated disc. Discs are not heavy and by themselves would not apply much pressure. The feedback into the muscles of the back is a different story. The muscles would alter the position of the disc and cause more pressure on the S1 nerve root unless you find ways of inhibiting the muscles from applying this pressure. This is where Alexander Technique training comes in. Buddhist Mindfulness training will teach you to be more aware of yourself and make it easier to enable you not to apply increased muscular pressure on the S1 nerve root.

The body obeys the laws of physics and engineering. Just taking pills will not modify the laws of physics and engineering.

Hope this helps

earthwitch in reply to johnsmith

I'd disagree about chiropractic if you have a herniated disc. thats not something you want to be risking manipulative treatments on - one wrong twist and it could leave you permanently disabled. Alexander treatment, or even pilates would probably be useful though.

johnsmith in reply to earthwitch

Chiropractic is not only about manipulating discs. I only know about my treatment from a McTimony Chiropractor. My Chiropractor works on the muscles in spasm as well. She would probably not twist a herniated disc. She would however work on the muscle spasms surrounding the area of the herniated disc.

For example I have problems with the muscles in my legs. They have a habit of getting too tight. This causes a pull on one of my lower discs which results in the strength in my legs going. Her treatment for this problem is not to manipulate the disc which is applying pressure on the leg nerve root. Her treatment is to manually stretch the muscles in legs.

When I go to the McTimony chiropractor sometimes with massive pain in my arm caused by my nerve root compression problem I have in my cervical spine. The McTimony chiropractor treatment is not to manipulate the disc. The treatment is to deal with the very small muscle spasm I have near my shoulder blades. The muscle spasm there pulls the spine out of alignment with resultant muscles elsewhere in the neck applying pressure on the discs as they try to compensate for the effects of the muscle spasm.

Hope you can see I was not thinking about manipulating discs when I suggested a chiropractor. I was thinking about muscle spasm problems which would make the problems associated with a herniated disc worse. A McTimony Chiropractor should be able to treat the muscle spasms without needing to manipulate the herniated disc.

It is worth looking at "mctimoneychiropractic.org".

When you do your web search on McTimony you may come across:


I know about this issue and the judicial review application against the "General Chiropractic Council". It was settled out of court after barristers for both sides made a lot of money. The settlement was that the college made a slight change to one of its courses. Nothing major.

I believe the legal bill for the McTimony was of the order of half to a million pounds.

I have been having McTimony treatment since 1994 on the NHS.

cren in reply to johnsmith

second time I have seen you mentioning mctimoney chiropractic :-) so glad you posted a link! I am gunna check it out right now. thank you, maybe we have one around here.... I agree that working on the muscles would be the most helpful, the muscles being tight are most definitely causing increased pressure, etc.

cren in reply to cren

dang, I can't open it :-( what's the end of it? mctimoneychiropractic.o.....? NEVER MIND! GOT IT mctimoneychriopractic. org :)

cren in reply to johnsmith

hmm... I am from usa...wonder if available here?? do you know? seems a more gentle way then getting CRACKED and thrown on a heating pad lol


I agree completely, as the shifting in the areas of the pain is proof of that, I've been fighting myself so long trying to be mindful of just where and what differing pressures are brought into play when moving and walking.

Relaxation is very important, but it is not the complete problem.

Learning how to use best your resources in the muscles as anyone with problems with back and neck knows that learning not to overdo ,and listen to your body as you move, but navigating the day to day can make it impossible as concentration and your word (Johnsmith) "Mindfulness" can just go in the blink of an eye.


Johnsmith, mindfulness

Calceolaria in reply to Hidden

What did you mean Alexander, when you said you agreed because the areas of pain had shifted? I'm aware the post was a while ago!

dazid61 in reply to Hidden

Hidden, I was in your position in 1983 and carried on with grumbling discs interspersed with acute attacks. I was recommended to have spinal fusion by the surgeon, Mr Webb. I was very skeptical. While pondering his recommendation I had quite a large herniation which left me with a limp. I went on to have a discectomy, this failed and left me with worse pain and so similar to having drawn 13 in blackjack, I felt compelled to take another card, which was the spinal fusion. This surgeon had a good reputation, even Prince Charles had travelled to Nottingham to see him about his back problem. Now in 2017 and five surgeries later I rue the day I ever sought out this man's opinion. I found out that at the time he did the most spinal operations in Britain. The reputation as Mr Fixit transposed into him getting many private referrals, which is very lucrative - he was only slowed by a very high profile suicide attributed to the pain of his surgery. The man then went on to lie at the inquest. Only when I went to rehab units in Nottingham did I come across other failed back patients, who were worse off for having surgery. All this was before the easy access to information that the internet gives us. My message is, be very wary of surgery and do your home work. In retrospect the best time I had pre -op was when I was doing regular yoga. Seek out a pain management course. Walton hospital in Liverpool have a good one that runs over a month - you stay in a hotel for 4 days per week. Think very hard before surgerI

I know what you're going through. Only by telling my own story can I warn you of the pit falls of someone in your position.

Best wishes to you.

did you start straight into the two twice a day dose? I've found that with any new strong pain killer, I have to slowly work my way up to the effective dose or I can get quite nauseous, dizzy and generally feel awful.

Hi. I have started on the lowest dose of 1 tablet twice a day. My GP said that I can increase the dose by one tablet every few days. At the moment I feel that the dose isn't high enough as about 5 hours after taking my tablet I am climbing the walls in pain but have another 7 hours till I can take my next one. I'm seeing my GP tomorrow and will ask whether I can take something else in between. My problem is I do not react well to medication and have had to stop taking naproxen, dihydrocodeine, amitriptyline, gabapentin and pregabalin due to the side effects or ineffectiveness of the medication. I feel that I am quickly running out of options.

Hidden in reply to Ihavenolife

I am also really bad with a lot of medications, my pain clinic consultant put me on Dosolupine, even though it is the same family of anti-depressants as Amitriptyline, it has been wonderful for me I get excellent results from it and have had no side effects that were not mild and transient,the Palexia too, I hope you get some much needed relief,it's so awful to be in constant pain, and people just don't understand,I feel that most people think that if you take painkillers that it equals no pain! Instead of painkillers = takes the edge off it so you have some degree of functionality.

Thanks everyone. I wouldn't feel comfortable letting a chiropractor loose on my back at the moment. I will definitely look at the Alexander Technique once my back is better. I have already been looking at one to one Pilates with a physio. Prior to the return of my back pain I was attending 3 Pilates classes a week and swimming twice a week. I now feel that I would have been better having one to one sessions focusing on my problem areas. Currently I am unable to sit and can only be on my feet for a few minutes at a time. I spend about 23 hours a day lying on my side at the moment and physio has not helped. I am due to have a second epidural steroid injection tomorrow so hope that this will give some relief. My first injection in January made no difference at all. I also have an appointment with a neurosurgeon at the beginning of April so hope that I will be a candidate for surgery. Initially I was resistant to the idea but after living for nearly 3 months in agony with limited mobility I would jump at the chance if the surgeon felt he could help.


I have been on Palexia for 5 weeks now, I find that despite what it says on the drug lingo,as long as I take it on a full stomach it has been excellent. I only had a bit of nausea at the start of the treatment and now do very well on it, and am about to increase dose to 100mgs twice a day.My pain consultant said that Palexia is like Marmite, love it or hate it, I have found it much better than any other pain killer I have tried, stick at it a bit longe,r why don't you ask your G.P for an anti-sickness drug if you are not already taking one, or a different one if you are, I wish you all the very best in your quest for pain relief.

Ihavenolife, please give this time as I am prescribed this the exact same 50ml and it is a godsend and I don't know what I would do without it, and the best thing it does is to take a little pressure of the nerves when you don't tense up too much (which the pain causes) and allows you to move better, and it has side effect's like people start to not believe you more, as you move better, because good pain meds is just another tool to aid you through the day and give you some help to bear the pain as it will not take all the pain away, depending on how much you move, so give it time best in the New Year.

Hi I've been on palexia for about one month. It is helping a lot. Nausea is one of the side affects so don't know if it will go away in your case. Individuals react differently to all drugs.

Talk to your doctor.

Hi I've been on palexia for about one month. It is helping a lot. Nausea is one of the side affects so don't know if it will go away in your case. Individuals react differently to all drugs.

Talk to your doctor.

I've just recently been put on this drug too I had been using endone tablets 8xday but the Dr is now weaning me off the endone and trying to find a drug that works for me.... he started me on tramadol and panadol osteo and dropped me to 6 endone which didn't work so is now trying me on 6 endone and this medication.... it's not giving me the relief I hoped for but now I've got daily headaches sore back and I feel weak all the time almost like flu symptoms I'm hoping he can quickly find something that works for me :(

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