Options for Nerve Pain / Neuropathic Pain

[jbridges9]

Hi,

I've posted here before but thought I would try again. I am taking 3600mg of Gabapenting (900mg QID), Cymbalta 120mg, Amitriptyline 50mg, and Lithium Carbonate 600mg (300mg BID) for nerve pain but none of this seems to help, or if it is helping then my pain is REALLY bad.

I get a burning sensation throughout my trunk, my back, my butt, thighs, down into my legs and feet, Some days it's worse than others. If I feel that the pain is coming from my right leg, and I move my right leg (manually) then that pain sensation changes, it happens this way everywhere.

They say my lithium levels are normal. What are my other options medication wise? I don't want to have surgery or have anything surgical implanted.

Can any of these meds be increased? If so, how long to take effect?

[t8burst]

I manage my neuropathic pain with methadone. I was on Gabaprentin but stopped taking it as it didn't seem to work.

[jbridges9]

Originally Posted by t8burst

I manage my neuropathic pain with methadone. I was on Gabaprentin but stopped taking it as it didn't seem to work.

Does that have any side effects?

[t8burst]

Originally Posted by jbridges9

Does that have any side effects?

Standard side effects of any opiate, constipation, lack of mental sharpness, risk of abuse. All are manageable. For the latter it is important to dial back your dosage occasionally so you don't get into the trap of ever increasing amounts. I prefer methadone because of the opiates I have tried it has a negligible effect on my mental acuity (as far as I can tell). Most doctors will just read literature and say opiates are not effective for neuropathic pain. The problem with that is there is no one size fits all solution to pain management, everyone is different. I take between 20 and 40 mgs a day and have for over three years, nothing makes the pain go away it is all about management. Finding what allows you to function, not so much you are a drooling idiot and not so little all you think about is the pain.

[darlagee22]

Lyrica is a newer drug related to gabapentin, but for some it works better. I switched to it on advice of a pain specialist physiatrist and I think it is more effective. I also take nortriptyline and occasionally oxycodone and ibuprofin when I think its related to real body pain below my line of injury.
I would ask for a recommendation to a dr with specialty in pain management that also understands sci nerve pain so you can find the best options for you and also because you are combining several things and you have to be careful how they combine and how you stop and start new drugs.

[fromnwmont]

I am trying a topical cream brewed up by my pharmacy it contains Ketoprophen, Ketomine, gabapentin and DMSO so far it has been helping but if i am more active it seems to make the legs on fire come back worse as cream wears off, I know logic says just add more cream but i need to get the timing right.... But that said it has given me as much as 40% relief at times and i dont have to tell you ANY relief is awesome....

[jbridges9]

Originally Posted by darlagee22

Lyrica is a newer drug related to gabapentin, but for some it works better. I switched to it on advice of a pain specialist physiatrist and I think it is more effective. I also take nortriptyline and occasionally oxycodone and ibuprofin when I think its related to real body pain below my line of injury.
I would ask for a recommendation to a dr with specialty in pain management that also understands sci nerve pain so you can find the best options for you and also because you are combining several things and you have to be careful how they combine and how you stop and start new drugs.

Hi
I've been on Lyrica before - 400mg/day with no relief. I was told (from a pain mgmt doctor who has an SCI specialty) that if I got no relief at 400 then I wouldn't get relief at 600 (the "max")

I'm so desperate.. I'm too young to be in chronic pain!

[fromnwmont]

Should have mentioned I also take lyrica, gabapenton,methadone & hydrocodone NONE take the pain away but do help cope most days. Sorry you are suffering & wish I had a solution for you.

[ECUrach85]

My pain sounds a lot like yours. My trunk is the worse. And it is weird that movement changes the sensation. I am complete injury with zero feeling but pushing my wheelchair aggravates my core pain and I can't sleep on my left side because its baaaad on that side. Pain dictates my life. So annoying.