Drug suggestions for neuralgic pain (human!)

Re: Drug suggestions for neuralgic pain (human!)

Martin Atkinson — Mon, 11 May 2015 10:17:34 GMT

For longer term Omega 3 supplementation works well for me (I think)! I have taken glucosamine and chondroitin for ages plus an EFA. I stopped taking EFAs several months ago as it ran out and I was concerned about reports linking it to heart problems (well there's always those even though its promoted for heart disease). I went through a period of recurrent back and knee pain. I've been taking it again for about 2 months now and been much better apart from the odd little niggle. Coincidental or placebo or does it really work?

Re: Drug suggestions for neuralgic pain (human!)

Wren — Mon, 11 May 2015 08:48:53 GMT

The ortho chap I saw said that studies showed paracetamol did work, but you had to take it q4hrs, regardless of whether or not you had [pain at that time. I prefer to take drugs according to how I feel (eg. had some codeine/ibuprofen at 5am today to help me get up, but might not need anything until after work now), rather than by the clock. I didn't ask for the reference!

Re: Drug suggestions for neuralgic pain (human!)

Niall Taylor — Sun, 10 May 2015 15:57:16 GMT

[quote user="Lucy Fleming"]Wasn't there a study recently that said paracetamol was crap for back pain? Therefore paracetamol = placebo, perhaps? Therefore acupuncture is no better than placebo....[/quote]

Indeed - the full paper is available here, with a press release here.

The paper didn't use quite that term though ! In fact it was quite cautious. According to the press release there were some weaknesses to the study (although I've not looked at the paper in detail) but NHS guidelines are under review.

I should have mentioned in my earlier post that "real" acupuncture is no different in trials from sham acupuncture. So when the Cochrane report said "acupuncture" helped lower back pain that should be read as "randomly sticking needles in people" helped lower back pain.

Disturbance in my Qi not withstanding, I think I'll stick with paracetamol!

Cheers,

Niall

PS - found the original reference - http://www.cochrane.org... low-back-pain

Re: Drug suggestions for neuralgic pain (human!)

Anthony Todd — Sat, 09 May 2015 17:59:40 GMT

[quote user="Arlo Guthrie"]Sorry to hijack the thread, but whilst on the subject of human pain relief,[/quote]

Arlo, this from a mate, ex Squadron Leader, used to fly Hawker Hunters, just think of doing that for a job!!!

I have been prescribed two drugs for the gout. One is for its relief, Colchicine and the other, whose name I have forgotten because I don’t take it, is for its prevention. The colchicine works really well for me. The instructions are to take it every four hours until the gout stops or you get diarrhoea!!!!!!! I find one or two tablets in 24 hours is enough for me and so far I have kept clear of gout most of the time. As for the second drug, whose name I will supply when we go back home, I saw no point in starting yet another drug when the colchicine seems to keep me clear most of the time.

I'll send you the name of the "other one" when he gets home!

Re: Drug suggestions for neuralgic pain (human!)

Arlo Guthrie — Thu, 07 May 2015 17:50:51 GMT

[quote user="Hannah Wynne Richards"]Gout's probably an improvement on starvation.[/quote]

I dunno, it's a pretty close run thing.

Re: Drug suggestions for neuralgic pain (human!)

Lucy Fleming — Thu, 07 May 2015 17:28:45 GMT

[quote user="Martin Atkinson"]

[quote user="Niall Taylor"] A recent Cochrane review (sorry, can't find the reference) suggested acupuncture was no more effective than paracetamol at treating lower back pain[/quote]Surely the placebo effect is greater!

[/quote]

Wasn't there a study recently that said paracetamol was crap for back pain? Therefore paracetamol = placebo, perhaps? Therefore acupuncture is no better than placebo....

Re: Drug suggestions for neuralgic pain (human!)

Hannah Wynne Richards — Thu, 07 May 2015 17:14:44 GMT

Gout's probably an improvement on starvation.

Wynne

Re: Drug suggestions for neuralgic pain (human!)

Martin Atkinson — Thu, 07 May 2015 16:49:30 GMT

[quote user="Arlo Guthrie"]Ha. I don't really drink the stuff, but from what I read seafood, red meat, cauliflower, asparagus, oily fish, chicken and turkey are the bigger culprits. [/quote]Cut the red meat from that menu and it is largely what we are told to eat for a healthy diet. Great, we may live longer but we're gong to be crippled. Can't win really.

Re: Drug suggestions for neuralgic pain (human!)

Arlo Guthrie — Thu, 07 May 2015 15:50:12 GMT

[quote user="Hannah Wynne Richards"] Arlo Try less port![/quote]

Ha. I don't really drink the stuff, but from what I read seafood, red meat, cauliflower, asparagus, oily fish, chicken and turkey are the bigger culprits.

Re: Drug suggestions for neuralgic pain (human!)

Martin Atkinson — Thu, 07 May 2015 15:45:46 GMT

[quote user="Hannah Wynne Richards"] Arlo Try less port![/quote]You'd have got the buzzer from Stephen Fry on QI for that answer - I nearly fell for it but it was too obvious!

Re: Drug suggestions for neuralgic pain (human!)

Hannah Wynne Richards — Thu, 07 May 2015 15:39:48 GMT

Arlo Try less port!

Wynne

Re: Drug suggestions for neuralgic pain (human!)

Martin Atkinson — Thu, 07 May 2015 15:37:47 GMT

Re: Drug suggestions for neuralgic pain (human!)

Niall Taylor — Thu, 07 May 2015 13:14:49 GMT

[quote user="Wren"]Either way (and despite my protestations that the pellet is likely to be lead, and not magnetic), they are not currently willing to risk MRI.[/quote]

A lot of shot is steel these days:

In the United States, UK, Canada, and many western European countries (France as of 2006), all shot used for hunting migratory waterfowl must now be non-toxic, and therefore may not contain any lead.

The last thing you want is a tiny steel ball scything through your abdominal viscera as it makes its way to your exterior at speed!

A recent Cochrane review (sorry, can't find the reference) suggested acupuncture was no more effective than paracetamol at treating lower back pain and carrried a higher level of risk.

Niall

Re: Drug suggestions for neuralgic pain (human!)

Arlo Guthrie — Thu, 07 May 2015 07:04:02 GMT

Sorry to hijack the thread, but whilst on the subject of human pain relief, anyone got any suggestions for gout? I tried naproxen first, because I don't really want a voltarol heart attack. Then changed my mind and decided a heart attack would be preferable. But voltarol didn't do anything either. Colchicine next, and that doesn't seem to be working. All mixed with codeine, and despite taking more than the prescribed dose, hasn't really touched the sides.

Wondering whether there is something a step up from codeine without turning me into a zombie. Dr Google suggests a steroid injection into the joint might do something, but that sounds pretty awful!

Re: Drug suggestions for neuralgic pain (human!)

Kate Richardson — Wed, 06 May 2015 21:26:19 GMT

K laser therapy? We have just got one and it apparently fixes everything!

Re: Drug suggestions for neuralgic pain (human!)

Anthony Todd — Wed, 06 May 2015 18:10:25 GMT

[quote user="Bob Russell"]Not sure it helped the pain but I don't remember caring so much![/quote]

A certain well-known VS, about to start a big evening with a splitting headache reached into the bathroom cupboard and took two tablets from a foiled strip.

Ovarid! Did nothing for the headache but he couldn't have cared less..... or so he told me.....

Re: Drug suggestions for neuralgic pain (human!)

Anthony Todd — Wed, 06 May 2015 18:05:11 GMT

[quote user="bob lehner"]More recently have a very painful shoulder - diagnosed as rotator cuff/shoulder impingement. [/quote]

Make sure you declare it before you tell Floyd Mayweather he's a poof.....

Re: Drug suggestions for neuralgic pain (human!)

Anthony Todd — Wed, 06 May 2015 18:02:50 GMT

I'd only add that, with chronic pain, drugs usually just put off the day when something has to be done if possible.

My experience with sacral dislocation [Friesian front foot trimming...] was that manipulation turned me from a bent-double cripple to normal with one manipulation; so I walked out skipping. Same result every time and he did it about 10 times!!

So if "manipulation" doesn't work on day 1 forget it. Same with physio, I think.

And, when it recurred,two experts could fix it in one, others sort of stroked my sacrum which was nice, but made no difference.

[I know a good guy in London and one in Yandina, QLD; the rest were a waste of time and money.]

Re: Drug suggestions for neuralgic pain (human!)

tess — Wed, 06 May 2015 17:52:06 GMT

I found physio had little or no effect on my shoulder. Mainly I think because our local physio at the GP surgery deals mostly with geriatric old ladies.

I resorted to acupuncture, but my problem was so bad the therapist ended up using electro-acupuncture on it, combined with a deep massage. It worked really well.

Re: Drug suggestions for neuralgic pain (human!)

Martin Atkinson — Wed, 06 May 2015 16:22:40 GMT

[quote user="bob lehner"]More recently have a very painful shoulder - diagnosed as rotator cuff/shoulder impingement. Diclofenac seems much better than anything else I've tried - tho' it's not prescribed so much now due to cardiac concerns I believe.[/quote] Same here - third time. First one took a year to resolve despite every exercise and physiotherapy and medication I threw at it. So the second one I didn't bother at all and it spontaneously improved after 6 months. This time its over 2 years since I injured my shoulder in a snowboarding accident so maybe its time I saw someone about it but us cyclists don't believe in pain we just get on with it.

As for diclofenac I'm wary of taking it long term but I figure that as I have about 3% body fat, am fit as a butchers dog, my LDL cholesterol hardly registers while my HDL is high I reckon I'm not at too much risk of coronary artery disease.

Re: Drug suggestions for neuralgic pain (human!)

Bob Russell — Wed, 06 May 2015 15:54:53 GMT

I had problems after pushing a caravan. Voltarol and diazepam. Not sure it helped the pain but I don't remember caring so much! I suspect some of my conversations were a little more 'interesting' than they normally are but the others in the practice kept a check on me!

Changed the mattress to a supportive but not overly firm memory foam one and bought one of those stupid looking orthopaedic chairs that bu++er up your knees. Back much better but I hobble for a few steps when I get up from the seat!

Pretty sure the seat helped most after a breaking in period!

No lower back problems for years but did have neck problems. Tried about 10 different pillows (my wife thought I was extremely odd) but eventually found an £8 memory foam pillow from Poundstretcher did the trick! Stopped selling them now so have a very expensive Tempur pillow that does the same job for more than 10 times the price.

Re: Drug suggestions for neuralgic pain (human!)

bob lehner — Wed, 06 May 2015 14:46:52 GMT

I used to suffer horrible sciatic pain years ago - so bad that I couldn't stand upright for any length of time. I felt it was my slouched position whilst driving for much of the day that had a lot to do with it - and bought a special back cushion/support thingy to change my driving position

I found hanging upside down on a set of stairs (with a good reliable person holding my feet so as to avoid an undignified head-first descent) was very useful - stretches the spine and relieves disc pressure (n.b. back down, not tummy down!).

I didn't have any other treatment - and the problem eventually disappeared (as so many things do).

More recently have a very painful shoulder - diagnosed as rotator cuff/shoulder impingement. Diclofenac seems much better than anything else I've tried - tho' it's not prescribed so much now due to cardiac concerns I believe.

Re: Drug suggestions for neuralgic pain (human!)

Ian Battersby — Wed, 06 May 2015 14:27:07 GMT

I just had L/S microdiscectomy for r sided sciatica that wouldn't go away ( over a year duration) about 10 weeks ago.

I had most things including nerve root steroid/bupivicaine injections before eventually ending up at surgery. Only thing I didn't have was gabapentin, spine specialist never seemed keen on it. It takes a while to build up levels and can make some feel awful apparently. I didn't particularly enjoy the amitryptliine , I slept well on it but felt odd during the day. ( although I stopped spraying around the house . it seems to help settle things initially.

Out of all the things I did pilates ( stretches and core stability ) improved things the most. I got to a point were I could walk pain free but It just wouldn't settle and would be set off by swimiming ( 1 length) or sitting or even kicking a ball in the park ( once!)

Not surprisingly read everything I could about it. The challenge is even if you have an MRI, most people have a L/S disc bulge and not everyone has problems, so when is an L/S disc significant. Some symptom free people discs have massive prolapses. A lot of people improve just with time as the disc settles ( they talk about physical compression as one aspect but also release of inflammatory agents from the damaged disc that diffuse into the nerve and hypersensitize.). That is before you start the whole world of central chronic pain pathway establishment and the influence of stress/positivity etc

So I didn't have an MRI until 6 months or so. I chatted to the physio and specialists and we agreed at that time as I wasn't an emergency surgical case ( I could manage pain and didn't have paralysis/incontinence etc) and most likely disc. It started a few weeks after an acute back incident when I bent down . So treatment initially would be physio etc regardless of how big a blunge I had. Only had MRI when we start going down nerve root injections.

I personally found diclofenic more tolerable than Naxpron ( but there a new EMA review found a slightly higher risk of coronary artery thrombosis on patients using it, so use has been pulled back) . But after a while I didn't take any NSAID as didn't help with leg pain.

Hardest thing is remaining positive; even when your arse, thigh and calf feels like someone is jabbing you all the time. There are loads of help sites out there full of people with chronic sciatic problems, and I made the mistake of reading to many of them initially and then I learned that most of the people who post are not as positive about the situation as others ( which doesn't help) and are the few rather than the majority. Most sciatica resolves within 12 weeks, but of those that go to specialists only a small number eventually need surgery, I think I read a stat somewhere of 2 or 3/100 so stats are in your favour, I suspect most settle with time as was never convinced the spinal injection really did anything.

Hope that helps . But I am sure and hope things will settle over next few months

Re: Drug suggestions for neuralgic pain (human!)

Martin Atkinson — Wed, 06 May 2015 14:17:42 GMT

I probably suffer no more back pain than any other nearly 65 year old does albeit everything is slowly wearing out and it lets me know if I'm a bit careless about lifting something, jolt my back or sit awkwardly for too long. I do very few back specific exercises apart from a few planks and arches, and I sit on a Swiss ball for an office chair. However as many are aware, I cycle many thousands of miles a year and although after couple of hours that makes my back ache, paradoxically I suspect the cycling is probably one reason why I have a strong core and suffer from relatively few back problems.

Re: Drug suggestions for neuralgic pain (human!)

Mark Hedberg — Wed, 06 May 2015 14:04:49 GMT

[quote user="Wren"]

I really, really want to avoid surgery. Far too busy and really can't take any time off!

[/quote]

What would you tell one of your clients if you heard that one?