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Thread: Ice pick-like pain following the rehabilitation

  1. #1

    Ice pick-like pain following the rehabilitation

    I am sending this mail from Japan on behalf of my best friend who fainted and fell down the stairs outside of his house in August 2010. It was very hot day. He was quickly transferred to a near hospital. After the surgery, he was told by the doctor that the third and forth cervical vertebrae were injured and he will not able to control any part of his body except his eyes and mouth for the rest of his life.
    In November 2010, he was transferred to a rehabilitation hospital where he was given massage every day to relieve stiffness in the muscles of his entire body. Gradually he was able to move his fingers. His specific level of spinal cord injury was C3/4, but it became C5 when he left the hospital in May 2011.
    Then he started home remedy. Two days a week, a nurse visits him and helps his rehabilitation training; standing up and keep standing for seconds with help of two persons, moving from bed to wheelchair with help.
    But the rehabilitation is associated with severe pain, ice pick-like pain.
    He is very much willing to do the rehabilitation for recovering but at the same time he has to accept the severe pain following it.
    He asked his doctors to reduce those ice pick-like pain but the prescription he is given doesn’t seem to provide any solution to his pain.
    I wonder how are those people having the same problem with my friend coping with the pain.

  2. #2
    Neuropathic pain following spinal cord injury is very common. What is the location of his pain? What medication was he prescribed, and how much?? Is he being followed by a physiatrist, neurologist, or pain specialist physician?? Is he getting physical therapy at a clinic in addition to the home nursing care?

    I am going to move this to our Pain forum.

    (KLD)

  3. #3
    Thank you very much for your responding.
    1. He has chronic pain from shoulder to fingers and the most severe pain comes to his fingers. On the other hand, finger is the first part of his body he could start moving. He can’t grab anything but almost touch his nose.
    2. His medication is still prescribed by the physiatrist of the rehabilitation hospital he was in for about 6 months. Now he is going to see the doctor once every two months. There is no neurologist nor pain specialist physician at the hospital. When he sees the doctor he just tells him what happed for the two months and gets medication but no physical therapy at the hospital.
    Prescription:
    Omeprazole 20mg 1 tablet/day
    Amezinium 10mg 1 tablet/day
    Selsyn 2mg 2 tablets/day
    Dantrium 25mg 2 tablets/day
    Lyrica 75mg 3 tablets/day
    Magnesium dioxide 2g/day

    In addition, he has a polyp in his nose and is on the following medication:
    Mucodyne 6 tablets/day
    Rulid 1 tablet/day
    Lebenin 2g/day
    Flunase nasal drops 0~2 drops/day
    Cravit eye drops 0~3 drops/day
    3. He has a physical therapist and an occupational therapist visit him two times a week and their rehabilitation program is made by the above mentioned physiatrist but they don’t belong to the hospital. They are sent by an agency specialized with medical staff.
    I think in Japan surgical procedures for SCI survivors are well taken care but those medical processes necessary for recovering their muscle and reducing pain are not. I also think that we don’t have a well-established system where medical specialists in different fields can cooperate and approach a problem from a different aspect.
    My friend used to be a runner and enjoyed full-length and ultra marathon (100km).
    I just wish I could do something to help.

  4. #4
    Senior Member NikkiMaya's Avatar
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    Quote Originally Posted by seiichihikaru View Post
    I just wish I could do something to help.
    It sounds like you are a really good friend, and you are helping. You found this American forum all the way from Japan, and you are writing to us on behalf of your friend. On top of that, I bet English is not your first language. I think you should be very proud of your efforts here!

    I am really sorry that your friend was injured and is going through this struggle. As a friend, it must be very difficult to watch. A lot of us here at Carecure have neuropathic pain, which sounds like the kind of pain your friend is experiencing. This pain is very hard to manage, even though there are some medications made specifically to deal with it, such as Lyrica. Unfortunately, many people do not get good results with these drugs or get bad side effects. Since your friend is dealing with pain, I hope they can see a pain management specialist for help with this problem. Such a doctor will be better equipped to help address this long-term and will have knowledge about the best medications to try.

    I am sure SCI-Nurse can elaborate more as can other members. I am glad you found us and hope you will post again if you need more information or support. On a separate note, I visited Japan--Osaka and Aomori--in 1996 and it was lovely .
    In our world constituted of differences of all kinds, it is not the disabled, but society at large that needs special education...to become a genuine society for all. -Frederic Major, Former UNESCO Director General

  5. #5
    It sounds like he may be having some "at level of injury" type neuropathic pain. Lyrica is a drug used for this, and the dosage can be adjust slow up to a maximum of 600 mg. daily. Was he tried on gabapentin (Neurontin) before Lyrica?? That can be dosed up to 4500 mg. daily, but generally started at 300 mg. daily. With these drugs, while they may help the pain, it is unlikely that they will result in total absence of neuropathic pain.

    Other drugs that are sometimes used include tricyclic antidepressants, and Tegretol. Some people take opioids, but research indicates that they may not really help that much.

    With segmental pain such as he displays, the use of TENS may be helpful. Also acupuncture should be considered if he can access this on a regular basis. Relaxation therapies such as medication, Matram repetition, and self-hypnosis have also been used. Medical marijuana is also frequently used in areas where it is legal.

    Can you get your friend on-line and have him join our community?? There are many others dealing with similar issues here who can help him learn more about these issues, and also provide him with support and a listening ear. You are a good friend to seek out resources for him.

    (KLD)

  6. #6
    It is exciting to have reply against my post.
    I thank you, NikkiMaya and SCI-nurse. The information I got through this forum shall be delivered to my friend and his wife immediately.
    This forum is very useful to know the facts of life those SCI survivors are facing. Before I came to visit this forum I thought that you (in U.S.) have a good solution for the severe pain so that you can concentrate on even the hard rehabilitation and get good results which we can’t expect in Japan. I got this idea through a special TV program came on the air some years ago, which was about a certified facility of Project Walk introduced as the first institution of spinal cord injury recovery in San Diego (in the world?). The program also introduced many clients from Japan who made wonderful results those survivors became able to walk. The work-out program looked very hard, so they must have a good solution for the pain, I thought.
    NikkiMaya, I visited your blog and was shocked to find out about your story of implanting neurostimulator because that is exactly the next step the physiatrist is recommending him to use. I am sorry that it doesn’t work as you expected. But I learned a lot from you and this forum that he still has a lot to do trial and error especially with the combination of his medication before the medical device implantation.
    My friend can talk and eat and move his arm and fingers a little. He can’t grave anything nor a pen. His wife bought him an i-pad so that he can operate it by voice. But it doesn’t work by some reasons: the siri system doesn’t wait till he complete his commands, someone must push the button to start and so on.
    Some day, I hope he can be here to communicate with you by himself.

  7. #7
    Senior Member NikkiMaya's Avatar
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    Seiichihikaru,

    I am glad you have been able to get so much good information here. Yes, my spinal cord stimulator failed, but for some people they work really well. If your friend's doctor is recommending that he try it, I would suggest that he can learn a lot from the trial implantation. This is when the device is partially implanted in the body to allow the patient to get a sense of whether it will work well for them. With the spinal cord stimulator, only the wires are temporarily implanted in the spinal canal for typically about three days, and the rest of the device is left outside the body. I am not sure if there is a trial procedure for the deep brain stimulation system, as I am not familiar with that modality.

    In my case, I did the temporary trial and I did not have good results. Knowing this, I should not have gone forward with the final implant surgery. However, my surgeon insisted that I was still a very good candidate and that he had every confidence that it would work for me. It was hard to resist his assurances. This was a big lesson for me and I learned that sometimes you have to override what a doctor is telling you, and really listen to your own body.

    There is a lot more information here on carecure about neurostimulation devices, from people who had both good and bad experiences. Please don't let my bad experience scare you off. Just understand that like any other medical treatment, it does not work for everyone and is not a decision to be undertaken lightly. Do lots of research and trust the results you get from the trial.

    Please continue to post anytime, feel free to send me a message if you have any questions I can answer, and we do hope to hear from your friend in the future when he is able to post. Please give him our best regards!
    In our world constituted of differences of all kinds, it is not the disabled, but society at large that needs special education...to become a genuine society for all. -Frederic Major, Former UNESCO Director General

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