this is my first post so i hope I have done this correctly.
Husband is in a lot of pain and has been taking paracetamol every 4 hours. He is also type 2 diabetic. on daily insulin. can anyone suggest a safe stronger painkiller please. As long as he is on his back in bed or sat upright in a chair the pain is bearable. thank you
Think we need to know what pain is from…. guessing he still has PMR? If it’s from that - then painkillers won’t help… he needs to increase Pred.
But a bit more info would help…
Yes he still has PMR and is on 5mg of Pred. It cam e on about a week ago for no reason we could think. so you are suggesting increase it to 6. any need to contact his GP? thanks for your help
Where is the pain? ..and does it feel like PMR to him? Or has he done anything (no matter how minor or insignificant) that could account for it… doesn’t take much with PMR. Did the paracetamol help at all?
Has he recently reduced his dose? Say a couple of weeks ago if so it might be a flare… see this for usual recommendation if it is that -but as I said you really need to know what’s causing pain-
If the pain is from the PMR pred is the only thing that will help. If the pain is from something else why don't you have a word with the pharmacist and you can buy something over the counter or alternatively ask his GP.
Co-Codamol is OK to take but not everyone gets on with it, it can/does cause constipation and the 30/500 dose is only available on prescription. As already said, it won't help with your husband's PMR pain and if its for something else you really need see your doctor to discuss causes/treatment/options etc.
That sounds like either myofascial pain syndrome or low back pain due to arthritis in various joints - he has my sympathy because I have exactly the same problem - I too have no pain when sitting upright or lying in the right position! Paracetamol alone does almost nothing for me, I found a mix of paracetamol and ibuprofen worked brilliantly - but the Pain Clinic doctor told me I mustn't use ibuprofen constantly because of longterm kidney and cardiac adverse effects.
The sudden onset sounds like muscle spasm and really you need medical advice. My short term solution is an 800mg flooding dose of ibuprofen and sitting upright with a hot water bottle over the place that hurts. Unfortunately, that isn't allowed for more than a few days! The 800mg is important as that is the flooding dose which occupies all the receptors and achieves good pain relief - and then you top it up with a lower dose at intervals.
For non-PMR back pain I find Solpadeine Max soluble tablets to be the painkiller of choice. It's 12.8mg of codeine to 500mg of paracetomol, and is the strongest you can get in the UK without prescription. I find that one of those in water will knock the pain down after around 10 - 15 minutes.
If you can't get the soluble ones there is also a capsule shaped version that you take with a drink. It's just as strong, but takes longer to work than the soluble version.
As someone else on here has pointed out, taking codeine will give you constipation, but as long as you know that in advance you can compensate with a mild laxative.
I do find heat works wonders with pain if it is localised. Before my PMR diagnosis I was getting up to reheat hot water bottles (last summer) a few times in the night, and/or showering at midnight! Heat was the only thing to work even a little bit.
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