Pain

[LLOYD1964]

I am cuurently on 3600mg gabapentin 120mg zomorh 3000mg zapain after a spinal operation and still in pain I top it up with oromorph can anyone suggest anything else ?

[Madlegs1]

Fentanyl is the best post op pain relief- but only for a few weeks. Sounds like you're already on a lot of stuff.

How long are you out from the op?

Should you go back to the pain team if it's really bad?

Good luck.

[stokebones]

There is very little between any of the opioids in terms of efficacy, one simply isn't superior to others. It is very individual.

Were you on opioids prior to the procedure?

Is the morphine not helping ? If not, second like would probably be a swap to oxycodone and third fentanyl.

What type of pain are you suffering from - are there neuropathic components ? Obviously you don't list the other medications you take.

Generally TCA's or duloxetine are used for pain!

[Freelie_Wheelie_1983 in reply to stokebones]

Duloxetine is not really a pain killer , it is really a anti depressant, which work on levelling out the serioning in your brain, which is what they call the happy hermorno. I have been on every pain killer going, I taking so much I have got to the point my body doesn't really feel the affect of pain killers any more. So I am in total pain all the time, I just get on with it, it is now part of my life I have to live with !!!

[stokebones in reply to Freelie_Wheelie_1983]

Lots of medicines are used for pain but were not originally developed for pain, to name a few examples, amitriptyline, nortriptyline, imipramine, duloxetine, venlafaxine, pregabalin, gabapentin, carbamazepine, tegretol, diazepam, clonazepam etc.

Duloxetine is used a lot for pain, and has a considerable amount of evidence for it.

This may be of interest - fda.gov/downloads/AdvisoryC...

It has also been shown to reduce the opioid dose post surgery when 1-2 days worth of it have been taken. It is opioid sparing.

It is licensed for diabetic neuropathy in the UK, but has shown to be comparable if not better for some cases of chronic pain syndromes such as fibromyalgia.

In the US it has additional licenses for Fibromyalgia and Chronic Musculoskeletal pain.

"I have been on every pain killer going, I taking so much I have got to the point my body doesn't really feel the affect of pain killers any more."

Unfortunately that is the risk of taking high doses - this usually happens more with opioids then other classes of medicine. If so maybe your doctor is trying to reduce your tolerance with duloxetine.

[Hidden]

My doctor switched me from Gabapentin to Carbamazapine. It has given me more relief than Gabapentin. If you haven't tried it, maybe you could ask your doctor about it.

[Dexter1 in reply to Hidden]

Carbamazepine is for nerve pain just like Gabapentin so not sure switching would make a big difference.

[makemepainfree]

Lloyd iam not saying this right for you speak too your doc re these meds its what iam on after trying all sorts of combinations I had back surgery .morn pregabalin diazepam lodine OxyContin top up oxynorm citalopram also thyroid problem no 2 people have the same needs so always best too check with doc at night also on amitriptyline with diazepam oycontin and pregabalin