What Next In Pain Relief?

[divegirl]

As some may know or remember, I suffer from chronic back pain. I am currently on 200mg of Pregabalin, 20mg amitriptyline [a day] and 10mcg of BuTrans [per week]. I also have arthritis in my ankles.
About a month ago I had a caudal epidural that did absolutely nothing!

I am in pain all day every day and can't really cope any more. I wake up with numbness in both hands and now my right arm/shoulder is causing me pain as well. I thought I'd found a lovely new GP but she has been off sick for weeks now so I have had to book an appointment with yet another new one for tomorrow morning.

My question is.... What next? I only got Pregabalin prescribed because I asked for it [I feel that it does nothing but am scared to stop taking it too] and am sick of being told to lose weight and get on with it. I feel like my mobility gets worse by the week.

Any ideas?

Lisa x

[divegirl]

I should add, I have been like this for over a year now.

[jackthehat]

Have you tried acupuncture?

Pregabalin is quite a nasty drug.....I had awful withdrawal effects when coming off it, and to be quite honest, couldn't readily identify how it had made me feel any better whilst taking it!

[divegirl]

I can't afford to have acupuncture and as far as I know it's not available on the NHS in my area. My kids bought me a course for Christmas a couple of years back to try to ease my plantar fasciitis and it didn't work for me so I don't know if it would work on my spine.
The pregabalin???? Who knows! My GP just kept upping the dose but nothing ever seemed to change. It seemed to be hailed as some sort of wonder drug but like you say.... doesn't seem to do much :0/

[jackthehat]

If you ring the Physio-department of your local hospital, you could ask if they offer acupuncture as a therapy.....or they might be able to point you in the right direction for some affordable practitioners.

Having any sort of chronic back-pain is grim and life-limiting and I wish you well. :o)

[divegirl]

Thanks Jack, I will ask at the doctors tomorrow. If I remember correctly you too have had surgery. I had a disectomy [sp] 22 years ago and it worked wonders, this time however the pain is due to a miniscule bone spur on the site of the original operation.... just one day pain free would do me right now lol
Thank you for your input.

Lisa x

[canasta]

What about a Pain Clinic (via the hospital)? They may be able to help with Acupuncture (try a different Accupunturist and make sure they're registered) or maybe a nerve block.

Hope you get some relief soon.

[divegirl]

Hi Canasta, I should have mentioned I am already being seen my a Pain clinic. It was there they decided to try the caudal epidural. I have a follow up appointment with them in the middle of October. I think right now I'm just feeling stressed at not finding any relief whatsoever. I attribute the majority of my other pain to my spinal problems.... I feel... out of line, literally.

Lisa x

[Eve]

Pregabalin has helped me a lot with pain from fibromyalgia, has toned down my OTT pain responses and made life much more comfortable. It also helped when I had it increased when I was getting horrible shooting pains as a side effect to my arthritis meds. I do sometimes wonder about cutting down on it but I'm worried that the withdrawal effects would be horrible and I'd realise how much it is helping and I'd gain even more weight with it by having to go back up again.

I had accupunture via physio at my hospital and it was good although it did provide relief but not a cure as the pain would come back, some relief for a while was lovely though. It seems my pain around my shoulderblades is caused by inflammation underneath them though due to rheumatoid arthritis so it figures the pain will just come back. I've now been told that I could have steroid injections there (already have my hips and shoulders done and general ones) to help and I've adjusted a lot of what I do so as not to aggravate it. Doesn't help I've got impingement in both shoulders too though.

The weightloss thing is hard if you are not very mobile and restricted in what you can do. I don't eat badly but had put so much weight on with the lack of mobility (used to be very active), pregabalin, mirtazapine (to help me sleep) and steroids. It makes me feel horrible but choice wise I choose not to be in so much pain.

Could you get a referral to a pain clinic, see if they have any new ideas to try? Do they know what is causing the back pain?

[woofgang]

If it was me I would be asking for the Pain Clinic to bring my appointment forward. Could you try that?

[Eve]

Sorry, too long typing away! :)

Have they considered surgery for the bone spur if that is appropriate? I've got one on both of my kneecaps as they don't track properly and are too tight and causing damage. I saw an orthopaedic surgeon the other week who said he hopes physio will help and doesn't think surgery will be needed for me so I imagine they can maybe stop them catching or something or get the kneecap better aligned. It makes more sense now where the pain comes from having seem them on the x-ray. Have you had a proper consultation about the bone spur and possible options?

[divegirl]

Hey Eve,
Surgery has been mentioned as a last resort. I did ask Sqad about it a while back [where is he anyway?] and transcribed to here the MRI results, he said in in his 'humble' lol opinion surgery was the way forward. My pain consultant did actually say my spine is on pretty good condition considering the original surgery.... just this bit of bone aggravating the thecal sac.
I think the main problem I have is the pain is at it's worst when standing or walking, neither of which I can do for more than a few minutes at a time before the pain becomes what I can only describe as a white hot numbness across the whole of the middle of my back and radiating down [now] both legs. My last GP was convinced pregabalin was the way forward but if this is the only choice of medication available then I would rather risk surgery... even though I know it may not work.
I just feel like I'm trapped in the body of a 90 year old and hate the thought this is how my life is going to be :0(

[Sqad]

divegirl....... bête noir of orthopaedic surgeons the pain of vertebral disc abnormalities.

There is little doubt that you have reaches the " end of the line" as far as drug therapy is concerned and surgical I fervent ion is staring you on the face.

Make an appointment to see your Orthopaedic surgeon.

[divegirl]

Ahhh there he is!

Good Afternoon Sqad,
Thank you for your input. I shall indeed press my pain consultant for an appointment with an orthopaedic surgeon as even after a year this has not been done. I think this is what is getting me down the most the thought of yet another waiting list. Time to get tough I think!

Lisa x

[Sqad]

"drug therapy is concerned and surgical I fervent ion is staring you in the face"

Sorry, typed this using my IPad at the Club and should have read:

" surgical intervention is staring you in the face"