Sciatical oddity

[Palioly]

For some months now, while awaiting a Spinal De-compression, I have been using Zomorph, slow-release morphine, plus Amytriptyline - but the pain relief effect has been diminishing. Where once I got relief almost from when I get up in the morning, I now have a most painful morning, with relief coming in slowly from mid-day onwards, until by early evening I'm really happy and real OK pain-wise.

Anyone got a clue if this is "normal" ?

I sought help from my G.P. who says that since my pain is nerve based the Zomorph is perhaps not a great solution and has removed my Amytriptyline and substituted Pregabalin, to be started slowly (I think 2 x 25mg/24hrs.), and to be built up to a higher dose eventually.

Any comments about this substitution ?

Dan.

[PFKAAde]

Hi dan

Couple of thoughts, could the relief you feel later in the day be as a result of being active? Are you able to 'keep busy' during the day? I find that when I wake up my back is usually quite sore from sleeping in the same position for (however long it is since my back woke me up!) some time. But as I 'get going' it gets easier.

In fact now I have got into a routine of going to the gym 3 times a week, which at first caused more pain / sciatica, but now I notice that the opposite is true. If I go early on (which nearly kills me) then by the time I leave I am feeling much, much better and in less pain. My Personal Trainer informs me that we are 'designed to be active', and when we aren't we seize up to varying degrees.

There is a balance though and if I've had a particularly busy day then I tend to get a return of sciatica by the time I go to bed . I'm not suggesting that the gym is the answer for you at this stage by the way. Idk.

Also you don't say what dose of SR morphine or zomorph you are on, but as you probably know we develop tolerance to opiates and they can become less effective over time. I was on a very high dose (long story) of morphine but have reduced it hugely and now find I get more benefit from it again.

Also was there a reason your GP stopped the Amitriptyline? It can be given alongside Pregabalin. It was for me anyway.

A word of warning about Pregabalin, for some (myself included) it causes major problems if I forget to take a dose. I feel dreadful and have what I can only describe as flu-like symptoms. I have been slowly reducing from 300mg twice a day for over a year now and will be glad to get off it. YMMV.

All the best.

Ade

[Sorebones]

I'd rather have the amitriptylene! But both are used for nerve pain. Some get on with one while others hate it and vice versa.

In all honesty you won't know until you try. 🐸

[Palioly in reply to Sorebones]

I had taken the Amytriptyline for about 2 weeks, with no noticeable effect or diminuition of my leg pain - so now to try t'other, the Pregabalin. Does anyone know what the effect should be and how quick I should notice a result ?

And there is the other part of my question so far unsolved - the fact that my leg pain is severe upon awakening, while using the Zomorph, and only gets less severe until well into afternoon.

[Sorebones in reply to Palioly]

If I sit down, my leg pain eases after a couple of minutes. But I can't stand long enough to fry an egg!!

Am on 100mg amitriptylene and my Dr has just added 600mg Gabapebtin x3 a day! I'm not hopeful that it will help with the pain, but my fingers are crossed just in case 🐸

[GillyGangGong]

Pregablin are really good for nerve pain. They help you sleep better undisturbed REM sleep that helps restore connective tissue while sleeping indoing so helps Alleviate aching muscles. Just be aware sometimes when first starting it, it can make you feel pretty down. This usually wears off after a few weeks. It may not be a problem for you as your starting on quite a low dose,

I was given 75mg 4 times a day and discharged from rheumatology which could have contributed to my mood changes. 🌷

[Palioly in reply to GillyGangGong]

I'm "pretty down" as it is after around 12 months of intermittent strong leg pain. The only good time has been the 3 months after my nerve-block injection; since then I've had a radio-frequency de-nervation after a 4 months painful wait but which has given me hardly any pain relief. Next planned is a Spinal de-compression for which I am definitely not looking forward.

[GillyGangGong in reply to Palioly]

I bet your not I wouldn't be either hopfully you will get some relief. 🎈 I'm worried about any operations I may need on my spine. I'm awaiting results from my mri of full spine . I'm sure I gave spondylitis I know I have scoliosis with fused T3/T4.

I hope you start to manage your pain 🎈

[ellesbells]

I didn't get on with pregabalin. Had no effect on me at all other than made me a bit light headed first couple days for about twenty minutes but everyone is different and I know it works really well for some people so good luck...

[Palioly in reply to ellesbells]

For some reason my 40mg twice/day of Zomorph seems to now be barely working, and so even some hours after taking this dose I'm still painful so much as to make walking or sitting difficult to bear.

Therefore today I had to abandon my Zomorph and instead tried a Tramadol 50mg tablet, (a left over from a previous prescription of 4/day), plus taking my first of 2/day Pregabalin 25mg tablets. Hours later, to my surprise, a great reduction in pain level. I'm amazed !

My GP keeps trying things but I feel that I need two or three major pain killers, so as to be able to use a different one from time to time as my body gets used to the current one.