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Old 01-30-2010, 01:57 PM   #1
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What Meds Work The Best

Two years ago I had a cervical laminectomy. Now I am having all the same problems again. Pain in right shoulder down my arm and into my hand. Also weakness and tingling. I go for my MRI on Tuesday, but already know what it will say. I wont be able to have another surgery until the Summer. So my question is what meds work the best for the pain. I already took a prednisone (sp) pack which did little to help. I am currently taking Cymbalta for my fibromyalgia pain, but that also does not help this kind of problem. Any suggestions would be greatly appreciated.

 
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Old 01-31-2010, 03:42 PM   #2
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Re: What Meds Work The Best

Elle,
I'm sure you know that what works is a complicated mixture of chemical, physiological, and metabolical factors. But in general, nerve pain (burning, tingling, etc) is often treated with a group of anti-seizure meds like neurontin and lyrica. This type of pain usually also responds to stronger narcotic pain meds. I can say this is true for me. Any pain due to inflammation ought to respond to either NSAIDS or steroidal meds = ibuprophen and prednisone, respectively. Then there is ultram or tramadol - a non-narcotic pain med. I use this and find it helps for low-level pain and I take it with narcotic pain meds to add coverage. And then narcotic meds - vicodan and many others. I don't know enough about how cymbalts acts on pain to comment.
What works best? Hmmm.... for me, I've used all of these (except cymbalts) at various times and with very varied outcome. No more NSAIDS for me - ulcers. And that stinks cuz they really helped. I am dependent on neurontin due to permanent nerve damage post-op lumbar fusions. Some narcs make me very ill and I'm allergic to some, too. So, I have tried to get by using non-narcotic ultram and having epidurals and nerve blocks to avoid the narcotic meds. worked well until recently.
Are you in pain management? I'm just started with a new group and I hope they will be able to help me review the best options as I have another skeletal problem that is very painful and sure as heck needs managing. For me, my cervical pain was also mostly right arm pain (burning, tingling, some numbness and weakness). Even on 1800 mg neurontin, I was needing the max dose of ultram and vicodan to handle the pain. I wish you luck. SQ

 
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Old 01-31-2010, 05:49 PM   #3
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Re: What Meds Work The Best

Suzy-Q

Thanks for the reply. I have been taking tramodol but it does nothing for the pain. I also have lidoderm patches which are a joke. I took lyrica in the past but had bad side effects. I am going to call my NS on Monday and ask for something stronger. I am waiting to see what my MRI results are before I go back to pain management. I do have gabapentin 100mg (neurontin) but it makes me so drowsy. How many mgm's do you take and how often? Thanks again for your help.

Last edited by elle45; 01-31-2010 at 06:23 PM.

 
Old 02-01-2010, 11:38 AM   #4
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Re: What Meds Work The Best

Ellie,
Yes, calling and letting providers know that things are not working well enough is what i learned I had to do or I'd be left white-knuckling pain and then chastised on top by the providers at apt time for not calling. So good for you for being pro-active. I am taking a whopping 2400 mg a day of gabapentin (neurontin). I got there incrementally by increasing the dose over a few weeks (about 3.5 years ago). Now I can up or down my own dose by +/- 600 mg a day over a few days with little ill effects. I've done well on this med though I do feel a generalized fuzzy mental affect. It never has made me afraid that I'd doze off at the wheel, however. Never. In fact, it isn't even enough of a sedative effect to help me nap if I lie down. I realize other people have drastically different responses. And I am always surprised my my reaction to this med considering the extreme intolerance I've shown to so many others. My doc calls my system "the global and hair-trigger reaction system". I've been on as much as 3700 mg a day.
Though patches have been discussed at times across the now 7 years of my spinal/skeletal journey, I've never tried a single one. So too bad they aren't helping you and hard to know how much is due to it being the wrong med versus the wrong dose. I have found it very hard to get a provider to stay focused long enough to figure that out for me. They either seem to be victims of inertia and can hardly be talked into doing anything or they flit from method to method so radically that nothing can be deduced from my symptoms. Well, there was a rant for free. Sorry bout that. This was suppose to be about you. Oh, I take my neurontin in 600 mg tabs (4 xs a day). Back to you. SQ

 
Old 02-02-2010, 05:12 PM   #5
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Re: What Meds Work The Best

Suzy

I got a stronger dose of the Gabapentin today. Thanks for all your helpful info. I also had my MRI today. I can't wait to find out the results. Of course my Dr. is going on vacation tomorrow so I have to wait til he gets back. WOW! My arm and shoulder are killing me today. It was raining, maybe that has something to do with it. I hope this new dose works. I hope you are feeling well.

Elle

 
Old 02-03-2010, 08:14 PM   #6
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Re: What Meds Work The Best

I'm doing OK, Elle, thanks for asking. I had an MRI today, too. My MRI was interesting and long. Its my first pelvic/hip MRI and, please, my last. I asked for 2 CDs of the MRI and I always get a copy of the report. You can do the same. I'd even go so far as to say you ought to. I hate to "should' but it is really good advice. Even if only for your records, it's a very good idea. And I have found it useful to be able to directly ask my docs to clarify report language. Believe me, it has woken some of my docs up to the fact that I am paying attention and not going to allow them to filter a 3 paragraph report down to 4 words without forcing them to go on record that the rest of the report is not important. Plus you may be able to get some general help with the vocab right here. And, probably best of all, it is something you can be doing instead of waiting cuz your report is yours and likely available to you in a few days so there is no need to wait out a weeks long doc's vacation. Course, you do just as suits you. Was this your first MRI? How'd it go?

 
Old 02-04-2010, 05:47 PM   #7
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Re: What Meds Work The Best

I called the radiology office today and they said I could pick it up on Tuesday. than the Doctors nurse called me and said the Dr. will be back on Monday and wants to see me first thing in the morning. That can't be good. My appointment wasn't until the end of the month after his second wee k of vacation (he will be in the office for two days next week). I asked the nurse what the report said but she didn't have it, only the films. She said those showed that I am in A LOT OF PAIN. I already told them that.
This was my fourth MRI so I'm a pro. I get in there and take a nap LOL. My Dr. is very down to earth and will explain everything to me. He's cute too.

 
Old 02-04-2010, 07:04 PM   #8
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Re: What Meds Work The Best

Well, I guess it is good not to have to wait for long but it does sound like the doc has an opinion about the findings! A nap in the MRi? Yep, you're an old pro. Hope you can rest a bit over the weekend. SQ

 
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