Pain Relief

[malana3]

My wife has had a serious spinal condition for some years, the pain from which is controlled by Fentanyl Durogesic patches (75mcg/hr). Arthritis is now beginning to be a problem and I am wondering why the arthritic pain is not also suppressed by the Fentanyl. Any explanation would be appreciated.

[Sqad]

Your post is a bit short on information.
What spinal condition and is the pain from this, bony or nerve pain?
What do you mean that "arthritis is becoming a problem?
Do you mean by that the spinal pain has changed in character and you have attributed this to "arthritis?"

[malana3]

Thank you Squad for your swift response. The basic problem is osteoporosis causing collapsed vertebrae at the lower spine to trap both the sciatic nerves and thus confining her to a wheelchair. She is now experiencing a lot of pain in her left shoulder and her GP suggests that arthritis is the cause. Prednisolone has been prescribed but the pain continues.

[Sqad]

Right so the back pain is due to root pain and the new pain is almost certainly arthritic as you have described.
Your wife is on a small dose of Fentanyl so this could be increased if her main pain is from her sciatica.
You do not say what dose of Prednisolone she is taking.
Which pain is not being controlled, the back and leg pain (sciatica) or the shoulder pain.

I am off to my Club now but will review you question with interest on my return.

[Sqad]

P.S In answer to your question, it is my opinion that we are now dealing with two separate conditions which require two separate pain programmes......one for nerve pain and the other for musculo-skeletal pain (anti-inflammatory)

[malana3]

The back pain is well controlled by the Fentanyl, the dosage was increased from 50mcg/hr to the current 75mcg/hr about three years ago. It's the shoulder pain that is causing her distress at this time. The dosage of Prednisolone is 2x5mg plus 1x2.5 mg per day, (i.e. 12.5 mg per day). Thank you for your interest.

[bednobs]

Arthritic pain is often best addresses by a combination of simpler pain killers such as ibuprofen and paracetamol

[Sqad]

Yes I must say that I was thinking on the lines of bednob's post in that anti-inflammatory drugs for your shoulder pain than steroids.
However, that is the path that your GP has gone down and he must have had his reasons which should be respected.

I would return to your GP on the basis that the pain relief is inadequate.

[Peter Pedant]

I would ask the GP for a pain consult at the local chronic pain clinic

[bednobs]

It doesn't sound like a chronic pain though. If the ops wife hasn't even tried simple pain killers u yet it seems a bit like sledgehammer to crack a nut

[Sqad]

bednobs..........spot on ;-)