Neurapathic Pain

[Letmein76]

I had a hip operation in May which was successful. Since then My low back pain has got far worse although no pain in my hip. My back pain starts in my coccyx and goes right round.the lower part of my body. It is terrible at night although I do put a pad under my spine to stretch it. That does help a little but unless I walk all day the pain gets worse and worse. I don't know what to do. My doctor will just give me painkillers. I already take Gabapentin and 8 Tramadol a day. It takes the edge off my pain nothing more.

[healthfare]

Things which may help or be worth asking your doctor/consultant.

Osteoporotic? Take calcium

Vitamin D deficient? High dose VitD Loading dose then a maintenance dose

Fentanyl patches changed every 3 days better than Tramadol as mainstay for pain management and use tramadol for breakthrough pain.

Also not so many s/effects and constipation as tramadol.

Fentanyl 12,25,37.5,50,75,100 mg patches available - you may need 25mg then titration to 50mg

Amitryptiline which is also a muscle relaxant has lesser s/effects than gaba. Also helps you sleep. 10mg up to 3 times a day and up to 50 mg at night

Anti inflammatory painkillers eg Ibuprofen, naproxen or etoricoxib May help - with a stomach ulcer protection drug eg omeprazole

Sleep on hard mattress to stretch spine and wear a back support

Use hot water bottle and don’t sit down too long

Tell your doctor you have a friend with similar problem and they are using the above meds and would they be useful in your case

Double check bloods since back ache worsening due to ovarian cancer dismissed/ not differentially diagnosed as cancer for my sister and then only recognised at stage 4 and then 6 x 3 monthly routine rheumatologist / neurosurgeon appointments still did not suspect cancer when they should have and alas she passed away due to total apathy by NHS doctors/ delays and consultants

Ask for a second opinion at a different hospital as you seem worried.

All the best. Let me know the outcome.

[cyberbarn]

Do you have access to a physio? It could be that your gait had altered before you have the hip operation in order to protect yourself from pain, and that can cause a weakness in the muscles. Now you have a pain free hip joint you might be using the muscles differently and and that could be causing pain when they go into spasm.

If you haven't got a physio that you can see, either self refer if you can or ask for a referral because it could just be a simple case of unbalanced muscles.

[johnsmith]

See a sports therapist. Suspect muscle over tightening.

You say: " That does help a little but unless I walk all day the pain gets worse and worse" Not sure what you mean here. Gentle movement. This helps things move and as a result helps prevent over contracting.

Physios are one size fits all. The theory of muscle weakness and strengthening exercises is blatantly wrong. Muscles are strongest at their longest length. The more contracted they become the weaker they get.

There are nerves to contract muscles. There are no nerves to un-contract muscles. The movement of other muscles do the lengthening. Muscles that are prevented from moving contract. Un-contracting these can be a painful process taking weeks. Your operation was in May. It is now August. Seek advice about seeing a chiropractor. A chiropractor can stretch out over contracted muscle near the spine. However, do not know about issues of tissue still healing and thus not ready to be worked on.

Pain killers have the potential of you doing yourself very serious damage. Pain killers will prevent injured tissue from notifying you when you apply wrong stresses to it.