Pain Control problem

Pain Control problem

Alas I have Sciatica - real bad, on my right-hand side - for several weeks now. I have gone thru using Paracetamol, P.+Codeine 8mg, P.+Codeine 30 mg, and am still in awful pain mostly in my right hip area and right calf muscle. The pain peaks momentarily every time I stand up, with less when standing or walking.

Where do I go from here - physiotherapy ? As a runner I have been unable to run since this started.

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  • I can thoroughly recommend osteopathy. I suffer with headaches but at one point, I spent 8 months with almost constant neck / back and shoulder pain. I wasn't sure at first, it seemed to have no effect (and was very expensive!), but after a few weeks, it was gone and I haven't had the same pain since. I guess it depends on the quality of osteopath, but mine was very good and I still use tips he gave me to keep the back pain at bay. Might be worth investigating?

  • Hello

    You do not say if you have been to your GP ?

    Generally you will need several medications too treat sciatica, an NSID, and a pain medication and possibly Amytryptalene for the nerve pain. Although your GP will know the medications you will need so bow down to him

    You could try the use of a TENS or EMS depending on what suits. Try nerve blocks down the side of hip and thigh

    Good Luck

    BOB

  • Have you asked your doctor whether the problem could be at least partly inflammatory, and whether its worth trying an anti-inflammatory (NSAID)? I know that a lot of my pain is inflammatory, and no amount of codeine deals with that, but regular doses of NSAIDS (which are much milder painkillers, but much more effective anti-inflammatories) make a huge difference. You can actually take both NSAIDs and opiates at the same time too.

    Also, physio probably is a really good idea. There are specific exercises you can be shown that help stop that nerve being pinched, so they can give huge relief. Also to get taught techniques for moving that mean you won't keep reinjuring yourself. I would avoid any kind of manipulation (chiropractic, etc) because the potential to do serious damage to your spinal cord is fairly high, especially if they don't have the advantage of being able to see up to date xrays or MRIs of the area.

  • Have indeed seen GP - his view is that Sciatica is the probable cause, although a running coach suggested my IT Band as another possible cause.

    Am not able to take any NSAIDs due to previous heart problem - Papworth Hospital 4 years ago said to rely on Paracetamol only for my future pain control and never to use NSAIDs.

    Anyway the best NSAID would be Diclofenac, which especially is a no-go in view of my cardiac history. (ref: cks.nice.org.uk/nsaids-pres...

    I will be asking at my local physiotherapist on Friday if they can help.

  • Is using an NSAID topical gel an option if you can't take them orally? Very little of the gel actually ends up in your bloodstream (compared to the oral NSAIDs). My GP was happy for me to use the gel when oral NSAIDs are contraindicated.

  • Have you ever had any back pain? I only ask as I have chronic Sciatica resulting from two severe herniated discs. An MRI scan proved this as I had no results from physio or osteopathy. I think you should try physio. It could be like pp said a muscular problem say for instance the piriformis muscle (in your buttock /hip area) pinching the nerve .

    I no longer take codeine as it is not effective in relieving my pain. Although my situation started as a bit of sciatica over the years, (I was an aerobics I instructor ) there is always an underlying reason for sciatica.

    I'd suggest seeing your GP, a referral for Physio. Could you try tramadol for the pain if you can't take nsaids. Also ice and heat periodically. The leg pain is often the worst pain I find. I take Gabapentin to control the nerve pain and it does take the edge off but I'd try and steer clear of drugs if I was able to! Sorry to hear you're in pain it's awful and I'm sure you're missing your running! Let us know how you get on and what you decide to do. I found simple stretching every few hours helped, foam roller and lacrosse balls to ease tension. Worth a try!! Does it keep you awake?

  • Back pain ? - no, very little over the last 40 years.

    I already have a G.P.'s referral for physio., and will also privately check out a recommended local physio. and ask if my problem is something they would be able to investigate.

    Keep me awake ? - not a great deal, but I do have some disturbed nights since this started.

    Tramadol ? - I'm feeling it might be a little soon to start on the opiates ?

    Dan.

  • Alas the experiment with me using tablets combining 500mg Paracetamol+30mg Codeine look like having to be ended as constipation has set in, a known side effect of Codeine.

    I will have to go back to less effective straight Paracetamol. In addition when I wake up in the morning it is up to 12 hours since that last pain-killers were taken - so immediately I am in considerable pain until the first of the next days tablets takes effect.

    Not a happy bunny !

  • Ah the wonderful side effects of Codeine!

    May I recommend Prune Juice or Psyllium Husk (available from Amazon) which is mixed with water. Both are natural products and worked for me.

    Best regards,

    Dave

  • I find Traditional Chinese Acupucture works for me. Can be difficult to find an experienced and well qualified practitioner. Please don't confuse this type of Acupuncture with the Symptomatic type. Trad Chinese type treats the body as a whole person.

  • I would suggest a McTimony chiropractor. If you have a muscle spasm in the spine you could be applying pressure on nerve tissue. The pressure on nerve tissue will give referred pain known as Sciatica.

    You need it checked out. Pressure from a tumour mass can also give Sciatica. Prescribing pain killers for pain without doing appropriate checking should not be acceptable practice by a GP.

    Hope this helps.

  • Talk to your GP about any worries you may have regards Sciatica, and its treatment. You can try creams on this complaint, although a proportion may enter your blood through the skin given time however small.

    Look on the problem in a simplistic way initially and if you are having problems with NSID medications look into Cox 2 medications as well you may be able to take those over a shortened period.

    There are other medications they could try, although with them the contraindications can be very severe so I would imagine that course of medications may be closed to you.

  • I think for me that "Coxibs" are as contra-indicated as NSAIDS.

    Local Hospital has recommended Amytriptylene to be added to my medication.

  • It may be if you take above during the day you will feel sleepy, personally I would take them at night just before bed, say something like 45 mins. You will get your cover during the day and will sleep well at night.

    I have been on then now for years and i find the way above is the best way. You could also split the dose in two cuts this can also help if the former is not recommended

    BOB

  • Local Hospital recommended Amytriptylene and GP has given me 10mg tabs to start with; to be added to my existing Paracetamol/Codeine tabs.

    Comments please, anyone ?

  • So far the Amytriptylene does not appear to make any difference to my high level of pain when standing. I am fine and almost painless when sitting.

    After two further painful days local Doc. recommends using Diazepam - (presumably added to existing pills) - any comments anyone, please ?

  • Agreed about no NSAIDS - yes I am unable after heart trouble 4 years back - I was told then to never again use NSAIDS medication.

    Last sciatica was 4 years back and then Diclofenac worked wonderfully, so it truly is a problem for me not to be able to take it this time.

  • G.P.has now asked me to try Tramadol, and have got 30 x 50mg. tablets.

    Now I have 2 questions ---

    I'm unsure if the Tramadol is a replacement for the Paracetamol/Codeine tablet I'm currently using or in addition to it.

    Second question: In relation to the Tramadol - is 2 tablets 3 x/day the same as 1 tablet 6 x/day ?

  • The present position is that my GP's Practice Nurse has suggested I interlink the Tramadol with the Paracetamol - something like Tramadol, then 3 hours later Paracetamol, then another 3 hours take Tramadol, and so on.

    This helps but does not kill the pain anything like completely, which can be real bad when standing or walking, and especially when getting up in the morning.

    Any suggestions as to what to do next ?

  • I now have been taking Tramadol alas without a huge decrease in my sciatica pain level for very long after taking the prescribed dose.

    Now I believe I may have an allergy to it as I have acquired some tiny red spots on arm and legs. Or could it be the Paracetamol ?

    Any comments ? Anyone, please !

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