Med does not stop pain,what's a better drug?

[Downinthefrontrow]

I have had noropothy which leaves me in pain 24/7. I take 3600 mg. of neurontin and 3x20mg. OxyContin and Dr. Won't increase doseage,anyone take something other than that and get releaf? I have constant burning in my toes and bottom of my feet feel like I am walking on big rocks and bruised for 3yr.s..

[Mollyrae]

I use Cymbalta for my pain and believe it or not, it really works. Actually I am killing two birds with one stone so to speak... it also helps the depression.

Just a thought.

[Downinthefrontrow]

Well I have used those patches and I got a few cigarette burns in my carpeting but I felt no pain anywhere..lol..that is the most powerful drug I have ever had and I have tried a lot!  Wow..good luck kicking it..

[Downinthefrontrow]

Thank you all for all this great info.and taking the time too help me..saw doctor and I got lidocaine patches that I put on the bottom of my feet and it does seem to be helping so far along with the other meds..now I am going to start winning off the tramadol if possible..thanks

[Jinx_777]

no matter what you do........................ REFUSE fentanyl if offered.  seems doctors like to get patients on it and have no clue what to do when it comes time to get off of it.  i would have to agree with everyone that say's opiates are not good pain relief for nerve pain anyway.  i am just going to start detoxing off the 50 mcg patch and i am scared to death.  i would never even advise fentanyl for end of life pain.  

[ThePaz]

Yes, I'm taking neurontin & baclofen along with a long list of other meds. The baclofen is for the cramping/spasmatic feelings & the neurontin, an anti-convulsants medication, for the burning/bee-stinging neuropathic pain. Also take anti-depressant medication that goes hand-in-hand with chronic pain.

[trixy71]

You also have to be careful of "serotonin syndrome" if you take tramadol with anti-depressants. Oxy isn't really a good pain reliever in that eventually dose increases tend to become necessary after time, more so than others. But there are other medications that you can try also that might help with the nerve pain and your regular neck and back pain as well. A lot of people say opiate's aren't good for nerve pain and for the most part, they aren't BUT one thing to remember is everyone is completely different and its something that might be effective for you. Its something to discuss with your doctor. Maybe try a different long acting medication that might help. I've been hearing good things about Opana. I would talk to your doctor and ask about changing things around completely before giving up. You never know what might help. I also know someone who has RSD pretty bad to the point where it hurts just to shower and the flector patch works great for her, but does nothing for me. Also, maybe adding a muscle relaxer might help as well.

Let us know how things work out for you. Good luck and god bless.

[ThePaz]

It's the tryciclic anti-depressants that have help with neurophatic pain. But depression is associated with many people with chronic pain.

[ThePaz]

Thanks for the warning & advice.

[DayDreamer41]

I would be very careful with tramadol and the medications being taken    concurrently with it. I took it approximately a little over two and a half years and then out of the blue was hospitalized with severe grand-mal seizures not once but twice.  
My physician later told me that seizures are quite common with tramadol therapy and that risk increases with increased time of use. Especially if you are taking a medication that can already lower the seizure thresh-hold
Be well,
DayDreamer

[philnoir]

Opiods are chemicals that affect specific biochemical structures, called opiate receptors, that occur in the human nervous system. Activation of these opiate receptors reduce pain (analgesia), and have helped reduce discomfort in humans for over 500 years, but can also create other undesired side effects.

There are three opiate receptors recognized by medical science, and they are known as the mu, delta, and kappa receptors. The mu opiate receptor appears to be the primary neuroreceptor in opiod analgesia, while the delta and kappa receptors may have other minor roles in reducing certain kinds of pain. All three opiate receptors may have a role in causing the unwanted side effects -- these complex chemical interactions are not yet well understood.

Tramadol is an opiod, and therefore activates the mu opiate receptor, so it can be effective against pain. However, morphine is 600 times more effective than Tramadol. This means that tramadol is a weak agent for the treatment of pain, which is why it is indicated for mild to moderate pain.

Unlike other opiods like oxycodone and morphine, Tramadol also activates the delta and kappa opiate receptors and these receptors may be involved in some of the unwanted side effects of opiate medication. Tramadol also spares serotonin similarly but not as effectively as SSRI antidepressants, and I've heard more than one pain doctor express the opinion that this serotonin sparing property of Tramadol may be its main mechanism for analgesia.

In the 1990s, when Tramadol was first released as a pain medication in the US, the pain community had great hopes for this medication to provide safe analgesia for mild-moderate pain without opiate tolerance and addiction. Unfortunately, experience with Tramadol has shown this to be a false hope.

In the 15-20 years we've been using Tramadol, we have learned that Tramadol does cause opiate addiction, and for reasons yet unknown, people have a very hard time stopping this medication.

Tramadol withdrawal has been compared to withdrawal from the strongest
opiates, like Fentanyl and methadone. Search for stories here at MedHelp of people trying to get off Tramadol after so many years and you'll see what I mean.

The decision to use one medication or another is up to you and your doctor. This is why all chronic pain patients need to understand the risks and benefits of all treatment options, completely.

I am not a medical doctor and do not advocate any position on medication for chronic pain, but I have been a pain patient for over 30 years and have learned quite a bit about pain and pain treatments during this time. Here I try to share the information I have accumulated over those years to help pain patients make choices in their treatment. I believe in empowering pain patients through knowledge.

This is why I share that many who have used Tramadol believe that the
analgesic benefits of Tramadol do not outweigh the problems associated with this drug, and therefore chose not to take Tramadol.

[Downinthefrontrow]

I have been on tramadol for about 2yr.s but with all the other meds I take really can't tell how much it is helping.So it is also a drug that causes dependency?most nights I take excedrin,if I don't I wake up about 4am due to joint and hip pain so I think to myself "how is it I take all these controlled substances and it's the excedrin that helps most stopping pain"..and thank you for the prayers..

[marycarmel]

Be very careful with tramadol.  It is just as likelynto cause dependence and you have to be careful coming off.

[ThePaz]

I'll pray for you. You can do it, just have faith in yourself!

[Downinthefrontrow]

Really scared too do it but I guess I am going too tell my Dr. I want off oxy..Its really don't stop the pain..is 60mg. A day really a high dose that is going to be hard to "kick"? So the only other thing that I am hearing is antidepressants and I hear so many bad thing about those..getting old is not as fun as it looked when I was working toward it..thank all of you for your help..

[ThePaz]

With neuropathic pain I'd be very concerned with taking OxyContin, as it's a very dangerous drug, in my humble opinion. Please check for other options, speaking from 20+ years of "RSD" burning-stinging neuropathic pain and the consequences of utilizing non-effective opiates.

[ThePaz]

There is literature out there that indicates that tryciclic (spelling?) anti-depressants work well with pain. And yes people with chronic pain most often are clinically depressed also. So this should be addressed too!

[ThePaz]

I concur with your advice. As an individual suffering from RSD and the neuropathic pain associated with it,  I've found that neurontin works best for me. I got off the fentanyl patch 100 mcg/hr and vicoden two 10-325 tabs every six hours after many, many years. I believe the change in behavior, angry outburst, effecting loved-ones is opiate related. Also I agree with you that neuropathic pain really doesn't respond to opiates! I'm opiate free now, still in pain but out of the "fog" of opiates. I feel alive again, it can be done if you taper-off gradually. I'm proof of that!

[philnoir]

The antidepressants can help with pain. They're not given to treat depression, however, most of us with chronic pain are depressed.

There are two kinds -- SSRI and SNRI. Ask your pain doc about both.

Best wishes.

[Downinthefrontrow]

Thank you for your reply,I have tried lyrica with and it did not help.the oxy really does not stop all the pain but w/o it I end up in the emergency room..the pain is so overwhelmingly intense.I have had my neck fused and so many spinal blocks and other things over the years I can't count but since this foot pain I don't even know I have a back..I was hoping treating my back would stop my foot pain but I did not so this is for life I guess.i really don't want to go on antidepressants,will that stop or mitigate this pain in any way?if so I sure would give it a try.creams do nothing.thanks again for your reply,it help just talking to someone that's been where I am..pk

[philnoir]

A polyneuropathy of three years is considered chronic and unlikely to improve. I too have an idiopathic polyneuropathy in both feet, with sensations of heat and cold, and for me it feels like walking on small pebbles -- but no matter, I understand.

You are taking the maximum dose of gabapentin (Neurontin). Have you tried the newer medication, Lyrica? It may be more effective in that it requires a lower dose.

Treatment with opiates is not generally effective. They do nothing for my foot symptoms, but do help relieve my spine pain, which is probably the cause of my neuropathy -- pressure on the spinal cord.

Other treatments include antidepressants and sometimes a topical capsaicin cream works for some (not for me.) Many people get relief from antidepressant treatment -- have you tried?

What helps me with the heat/cold sensation is keeping the callus on my feet down to a minimum (I have old feet.)

Best wishes.