Managing neuropathic pain - no drugs, please!
Discussion
Morning.
After much digging around with my doctor, we've concluded that my chronic loin pain is brought about post-surgically from kidney issues I had ~15 years ago.
If it is becoming too much on a daily basis he has suggested going onto painkillers, specifically starting with amitriptyline. This is also used to treat depression and, quite frankly, I don't like the look of the side-effects. I also know people who have been on this and other prescription painkillers, and everybody has told me to avoid them if I can.
So far I have managed my pain, which ebbs and flows through the day, with "micro-meditations" when it flares, and an acknowledgement acceptance of it the rest of the time. Its flare-up timings are such that I can rule out psychosomatic causes with reasonable confidence.
So, after a bit of meandering my question is: does anybody else struggle with chronic pain, and if not on painkillers, how do you manage it please?
My current thoughts are to try deeper meditation methods (I am aware I've only scratched the surface of mindfulness in this regard), but they're not always possible if flare-ups are poorly timed.
Any experiences/thoughts/advice gratefully received!
After much digging around with my doctor, we've concluded that my chronic loin pain is brought about post-surgically from kidney issues I had ~15 years ago.
If it is becoming too much on a daily basis he has suggested going onto painkillers, specifically starting with amitriptyline. This is also used to treat depression and, quite frankly, I don't like the look of the side-effects. I also know people who have been on this and other prescription painkillers, and everybody has told me to avoid them if I can.
So far I have managed my pain, which ebbs and flows through the day, with "micro-meditations" when it flares, and an acknowledgement acceptance of it the rest of the time. Its flare-up timings are such that I can rule out psychosomatic causes with reasonable confidence.
So, after a bit of meandering my question is: does anybody else struggle with chronic pain, and if not on painkillers, how do you manage it please?
My current thoughts are to try deeper meditation methods (I am aware I've only scratched the surface of mindfulness in this regard), but they're not always possible if flare-ups are poorly timed.
Any experiences/thoughts/advice gratefully received!
Still Mulling said:
Morning.
After much digging around with my doctor, we've concluded that my chronic loin pain is brought about post-surgically from kidney issues I had ~15 years ago.
If it is becoming too much on a daily basis he has suggested going onto painkillers, specifically starting with amitriptyline. This is also used to treat depression and, quite frankly, I don't like the look of the side-effects. I also know people who have been on this and other prescription painkillers, and everybody has told me to avoid them if I can.
So far I have managed my pain, which ebbs and flows through the day, with "micro-meditations" when it flares, and an acknowledgement acceptance of it the rest of the time. Its flare-up timings are such that I can rule out psychosomatic causes with reasonable confidence.
So, after a bit of meandering my question is: does anybody else struggle with chronic pain, and if not on painkillers, how do you manage it please?
My current thoughts are to try deeper meditation methods (I am aware I've only scratched the surface of mindfulness in this regard), but they're not always possible if flare-ups are poorly timed.
Any experiences/thoughts/advice gratefully received!
I tried amitriptyline for back pain. The dosage is very low. I noticed no effects I experienced when on SSRIs for a few months. No boost to moods, none of the concerning side effects. It worked a bit I think. I've stopped taking it. Consider trying it.After much digging around with my doctor, we've concluded that my chronic loin pain is brought about post-surgically from kidney issues I had ~15 years ago.
If it is becoming too much on a daily basis he has suggested going onto painkillers, specifically starting with amitriptyline. This is also used to treat depression and, quite frankly, I don't like the look of the side-effects. I also know people who have been on this and other prescription painkillers, and everybody has told me to avoid them if I can.
So far I have managed my pain, which ebbs and flows through the day, with "micro-meditations" when it flares, and an acknowledgement acceptance of it the rest of the time. Its flare-up timings are such that I can rule out psychosomatic causes with reasonable confidence.
So, after a bit of meandering my question is: does anybody else struggle with chronic pain, and if not on painkillers, how do you manage it please?
My current thoughts are to try deeper meditation methods (I am aware I've only scratched the surface of mindfulness in this regard), but they're not always possible if flare-ups are poorly timed.
Any experiences/thoughts/advice gratefully received!
Every now and again I experience sciatica. I find it difficult to cope with and have resorted to taking half a 500mg paracetamol. Works for me, and quite quickly. Only lasts three hours or so, but the dosage is 1000, so strict adherence to timings doesn't apply.
I have a little pain management system that works for me, but it is defeated by toothache and sciatica.
TGCOTF-dewey said:
How much core strength and flexibility training do you do?
It's amazing how much it can make a difference for all sorts of internal weird aches and pains... Especially if the pains are post surgical.
A fair amount, and I'm increasing it at the moment. I swim and run along with S&C work, so I have a good level of fitness. I was also going to include more yoga into my routine, as anything that aids flexibility may help stop the scar tissue pulling, if that's a cause.It's amazing how much it can make a difference for all sorts of internal weird aches and pains... Especially if the pains are post surgical.
Derek Smith said:
I tried amitriptyline for back pain. The dosage is very low. I noticed no effects I experienced when on SSRIs for a few months. No boost to moods, none of the concerning side effects. It worked a bit I think. I've stopped taking it. Consider trying it.
Thanks Derek, nice to have a counterpoint to the doom-mongering of SSRIs et al. I'll keep it in mind. How long did you take it for, and can you remeber the dose? I have read about using a low-level to "retrain" the body/nervous system before coming off it.Still Mulling said:
Derek Smith said:
I tried amitriptyline for back pain. The dosage is very low. I noticed no effects I experienced when on SSRIs for a few months. No boost to moods, none of the concerning side effects. It worked a bit I think. I've stopped taking it. Consider trying it.
Thanks Derek, nice to have a counterpoint to the doom-mongering of SSRIs et al. I'll keep it in mind. How long did you take it for, and can you remeber the dose? I have read about using a low-level to "retrain" the body/nervous system before coming off it.I was told it might be the placebo effect which makes it useful. If so, it still worked for me.
A lot of people, the majority I think, have a low reaction to paracetamol. For me, though, it's great. The 250mg is no placebo. It works. I just wish it had a greater effect on sciatica.
I got to the stage with my back where I was taking paracetamol all the time. I mentioned it to my Dr and he said to try amitriptyline. I'd try anything by then. Paracetamol has bad side effects if taken long term. Liver, I think.
Best of luck. Pain hurts.
Sorry, this is a bit of a long saga...
I've had chronic pain caused by a C5 neck injury 20-odd years ago in a car crash. I also now have had an arthritic condition (Spondylosis) build up in that area. They won't operate as that's where the heart & lungs nerves come out of the spinal cord.
Up until last year I had two major bouts of pain and immobility. Both were solved with physiotherapy. I tried Acupunture in the physio but it just made me feel sick. I had to give up most aerobic activity (basically anything where my feet leave the ground). About 5 years ago I discovered Pilates which is very much like physio but with an aerobic content. It's really good for core and lower back strength where many problems emanate from. I also started regular massages. My GP prescribed a pain killer (Naproxen) which was mildly successful.
Last Autumn I started to suffer tremendous pain in the left hand side of my body. It was as though someone had put an electric cattle prod in my armpit. My whole left arm was an electrical firestorm. I also had pain in my hip and left leg/foot. My masseur suggested an Osteopath and I had a few treatments with him which helped on mobility but not pain. He again tried Acupuncture but I nearly jumped through his roof in pain. Both suggested the current problem was neural rather than soft tissue. My masseur could even identify the point in my neck where to press to modulate the pain. TENS machine was only relief not solution. At this point I had to give up all aerobic activity including swimming. The Osteopath also asked if I'd been put in a collar after the accident (I had) and noted that it is now known that this actually makes things worse (when was the last time you saw someone in one ? - I hadn't noticed they aren't used any more for whiplash)
I went to see my GP and he confirmed the suspicion of it being neural and switched me to Amytriptiline whilst I waited for a Neurosurgery referral. That meant another bout of physio. This time the physio made me feel worse not better (strong feeling of nausea). The case was referred but they again came back with nothing further they could do (no new surgery techniques).
For about two and half months the Amitryptiline didn't seem to be having any effect. Then almost without me realising one week my pain significantly subsided (it was my wife that noticed I was doing much less arm stretching - by this time I was sort of hypnotised to the pain). That was March and I have to say that now in May I'm at a pain level I can live with and have done a few gym & Pilates sessions in the last month.
I have had no side effects with Amitryptiline and haven't noticed any mood changes (positive or negative). The doc did say it would take a few weeks (not months) to take effect. In an ideal world I'd rather not be taking more drugs but with no other options I will carry on. It was very interesting seeing the article on the BBC news this week saying that these type of drugs don't work but crucially they only ran the trial for 2 months so I'd say it was dubious research. There must be a reason why drugs initially used for one reason start to have evidence of positive effects in somewhat unrelated conditions (although mental health had been linked to Neurology for centuries - remember the "nervous breakdown" ?) Crucially you are started at very low dose levels compared to an MH condition patient.
So my two recommendations are Pilates and Amitryptiline (if you do go for the latter give it plenty of time).
I've had chronic pain caused by a C5 neck injury 20-odd years ago in a car crash. I also now have had an arthritic condition (Spondylosis) build up in that area. They won't operate as that's where the heart & lungs nerves come out of the spinal cord.
Up until last year I had two major bouts of pain and immobility. Both were solved with physiotherapy. I tried Acupunture in the physio but it just made me feel sick. I had to give up most aerobic activity (basically anything where my feet leave the ground). About 5 years ago I discovered Pilates which is very much like physio but with an aerobic content. It's really good for core and lower back strength where many problems emanate from. I also started regular massages. My GP prescribed a pain killer (Naproxen) which was mildly successful.
Last Autumn I started to suffer tremendous pain in the left hand side of my body. It was as though someone had put an electric cattle prod in my armpit. My whole left arm was an electrical firestorm. I also had pain in my hip and left leg/foot. My masseur suggested an Osteopath and I had a few treatments with him which helped on mobility but not pain. He again tried Acupuncture but I nearly jumped through his roof in pain. Both suggested the current problem was neural rather than soft tissue. My masseur could even identify the point in my neck where to press to modulate the pain. TENS machine was only relief not solution. At this point I had to give up all aerobic activity including swimming. The Osteopath also asked if I'd been put in a collar after the accident (I had) and noted that it is now known that this actually makes things worse (when was the last time you saw someone in one ? - I hadn't noticed they aren't used any more for whiplash)
I went to see my GP and he confirmed the suspicion of it being neural and switched me to Amytriptiline whilst I waited for a Neurosurgery referral. That meant another bout of physio. This time the physio made me feel worse not better (strong feeling of nausea). The case was referred but they again came back with nothing further they could do (no new surgery techniques).
For about two and half months the Amitryptiline didn't seem to be having any effect. Then almost without me realising one week my pain significantly subsided (it was my wife that noticed I was doing much less arm stretching - by this time I was sort of hypnotised to the pain). That was March and I have to say that now in May I'm at a pain level I can live with and have done a few gym & Pilates sessions in the last month.
I have had no side effects with Amitryptiline and haven't noticed any mood changes (positive or negative). The doc did say it would take a few weeks (not months) to take effect. In an ideal world I'd rather not be taking more drugs but with no other options I will carry on. It was very interesting seeing the article on the BBC news this week saying that these type of drugs don't work but crucially they only ran the trial for 2 months so I'd say it was dubious research. There must be a reason why drugs initially used for one reason start to have evidence of positive effects in somewhat unrelated conditions (although mental health had been linked to Neurology for centuries - remember the "nervous breakdown" ?) Crucially you are started at very low dose levels compared to an MH condition patient.
So my two recommendations are Pilates and Amitryptiline (if you do go for the latter give it plenty of time).
Edited by Speed 3 on Friday 12th May 13:03
Thanks Folks.
Speed3: thank you for taking the time to describe your journey; I hope it was cathartic, not a burden! I used to do pilates when managing a dodgy back while playing hockey, and I'll probably seek to get back into it. Adding yoga and upping core work is essentially combined with pilates, so makes more sense from a time-management perspective! Interesting to read your experience of amitriptyline, thank you.
Speed3: thank you for taking the time to describe your journey; I hope it was cathartic, not a burden! I used to do pilates when managing a dodgy back while playing hockey, and I'll probably seek to get back into it. Adding yoga and upping core work is essentially combined with pilates, so makes more sense from a time-management perspective! Interesting to read your experience of amitriptyline, thank you.
I have had a few patients find this useful for chronic non-nociceptive pain https://www.tamethebeast.org/
Lots on youtube by the same chap.
Lots on youtube by the same chap.
knk said:
I have had a few patients find this useful for chronic non-nociceptive pain https://www.tamethebeast.org/
Lots on youtube by the same chap.
Thank you, knk. I'll take a longer look this evening.Lots on youtube by the same chap.
knk said:
I have had a few patients find this useful for chronic non-nociceptive pain https://www.tamethebeast.org/
Lots on youtube by the same chap.
I would highly recommend this too.Lots on youtube by the same chap.
mclwanB said:
Yoga and core strength exercises. And acupuncture if not enough
Thanks. I'm integrating more yoga and core into my weekly routines. I hadn't considered acupuncture for neuropathic pain; it helped my a lot with back pain during my competitive sport years, but the link to muscular aid was direct and clear. How would it work for neuro, as the needle would have to be bloomin' long to reach the pain "site" (acknowledging that much of it is in the mind, not the actual site itself). 
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