take a paracetamol, not good enough advice for chronic pain.

[Sassyfrassy]

I went to see my gp yesterday as I have been in constant pain for about a month, on and off pain for much much longer. My hips, knees and feet hurt and as soon as I have been sitting down I can't walk but hobble for a couple of minutes. The hip pain is often bad enough now that I walk with a limp. So, his answer was, you have quite flat feet, take some paracetamol.

I know I have flat feet, I told him so, but this is not the normal flat feet achiness, something isn't right. There is no way I will be taking paracetamol, which wont help, every single day. So what do I do, would I be unreasonable to seek another opinion or will another gp at the surgery just look at my notes and send me home. I can't afford a private podiatrist.

It just doesnt seem right to be told that I will just have to live with the pain and he wont do anything =(

I also have chronic pain and my gp's always told me to take paracetamol.

I kept going back to the gp and it was either take paracetamol or other low pain relief.

I went to another GP and I was in so much pain that day she prescribed my some oramorph. It takes the edge off but it dont take the pain away completely.

I would keep going back to another gp and tell them how much pain you are in, it is also quite useful for you to keep a pain diary stating mark out of ten how bad the pain was and you took ect. You can also ask to be referred to a pain clinic, I am waiting for my referal to come through anytime soon for stronger pain relief

Sounds like a trapped nerve or something. YOu can take paracetomol and ibuprofen at the same time, they work well together.

You can see a chriropractor for 25.00 which should sort you out.

He should be ruling out forms of arthritis and rheumatism by ordering blood tests. Hospitals differ but there is usually a clinic that you can be refered to. You should insist on a referal to a pain management clinic, they can work wonders. The over use of paracetomol can lead to kidney and liver problems. There are much more effective drugs. Your quality of life is being really affected so you have every right to insist that he moves treatment up a knotch.

If you have sustained joint pain in several joints you should have been offered a blood test to try to diagnose the cause. Flat feet are not suddenly going to cause this as presumably you have always had flat feet yet you have never had this pain before?

Musculoskeletal clinic i was thinking of. You should not see a chriropractor yet, i doubt that they would treat you without your doctor having done bloods. You will then be advised by the clinic which way to go, you will be offered traetment the same as a chiropractor just not as quick as paying for it.

Sorry just seen your original question- you have received very shabby treatment. I doubt another doctor would not send you for tests. You can as a last resort if you are barely able to walk (during the quiet time) go to A + E. I carn't imagine why the doctor has ignored your problems. When you are on the road to recovery, complain. If your medical condition is impacting on your finances, once you have seen a doctor, think about applying for disability living allowance.

Paracetamol is a very effective painkiller if taken routinely, rather than just when the pain is unbearable.

You can take 8 tablets in 24 hours. Try doing this for a week and see if that makes a difference.

Have you been referred to a podiatrist? I have been told I now have flat feet (can you suddenly get flat feet??) which affects my knees and was told if I didn't get them sorted my hips would start to hurt too. So I saw a podiatrist and now have physio to correct my muscles.

I now have been fitted with specially moulded inside soles. Had really bad hip and back ache for a few weeks which I was told would happen as my bones realigned but now even my knees are feeling less achy

I think Nurofen/Ibuprofen is better for inflamed type pain because its a NSAID (non steroid anti inflammatory drug)

You can alternate them

But you need to work out the cause.

Go back, see a different doc, don't be fobbed off.

Paracetamol is what is recommended for chronic pain. I take 6 - 8 a day.

But I also have a diagnosis.

You should push for tests and referral to a pain clinic.

Thanks everyone,
I've know about the flat feet since I was little, I used to see a podiatrist and get insoles when little.
Neither paracetamol or ibuprofen does much for me unfortunately, and as my dad, after a car accident and constant pain, got addicted to painkillers, I am loathe to take them regularly.

I've had pain in my feet on and off all my life, but that would be in bad weather or after a lot of walking. Now it just never goes.
I'll get back to them again and persevere. My gut feeling is that it isn't something new but rather my joints effected by my awkward, flatfooted knockback knees gait. But I was hoping I could get some help correcting the problem or at least alleviating it.

I've just been told that my local university runs it's own podiatry clinic for it's podiatry students so I might see if I can selfrefer myself there.

I have leg pains which no one knows the cause of (have had it for years and isn't any of the usual things and the specialist was stumped) and I take parecetemol and it really works. Don't just dismiss it without even trying it.

Sassy, it may not be working for you because you are only taking 2 at a time. 2 does nothing for me. Take 3, or even 4, paracetamol at once. So long as you don't exceed 8 in 24 hours, you'll be fine.

Or try the new combo Paracetamol and Ibuprofen that just came out.

Really?! You can take more then 2 at a time?!?!?! Really?!?!? Not sure about that.

im the same.i know the cause for mine and ds3 suffers a more extreme form and im fighting for treatment now before he ends up with the chronic pain that I now have .I got told well take paracetmol and ibprufoen and Tee your wrong yes theres a maxium amount in a day but it has to be spaced out becuase otherwise your liver can not break it down .Do not overdose on paracetmol op .Just 2 or 4 to many can lead to all sorts of liver condtions .

And yes your right pain in your feet can lead to pain in your knees ,hips and back

No, you can't. 2g (4 tablets) can be used as a loading dose as a one off but should never be taken regularly.

4g in 24h, minimum of 4h between doses.

Really.

My pain consultant says so long as you spread it out through out the day, you don't have to take only 2 at a time.

I take 3 at breakfast and 3 just before bed and sometimes 2 at lunch, depending on how much pain I am in at that point.

You're not going to OD or ruin your liver. But you might just improve your quality of life.

I think it's quite common for the arches to drop when we reach a certain age. Bearing in mind you already have flat feet, could this possibly have aggravated things further? I know when it happened to me I could barely make it downstairs in the mornings, and I've heard of it happening to others as well.

Even so, debilitating pain like yours should be dealt with. I'm sur a lot could be done with physiotherapy.

Sassy, chronic pain patients end up taking regular paracetamol and anti inflammatory drugs day in day out and this is what would be suggested initially.

Contrary to popular belief, a blood test cannot diagnose everything although there are tests for inflammatory conditions (eg rheumatoid arthritis) and if you are concerned you may have this, it's worth asking your doctor to see if it's possible and to get the tests ordered.

If it's mainly your hip, an xray would be needed to show degenerative or arthritic changes and there is no reason you couldn't ask for one.

Arthritic patients often end up taking anti inflammatory painkillers long term as the initial treatment.

By all means see a podiatrist or get your gait checked. Could a physio help with stretching / gentle exercises?

Regular paracetamol taken properly is a very good painkiller, don't dismiss it out of hand.

Tee, I would never recommend exceeding 1g of paracetamol per dose aside from a loading dose of 2g as a one off.

Your pain specialist may recommend it for you - I have done several chronic and acute pain clinics and I would never recommend it for my patients. You seem to be taking advice meant for you and applying it to someone else who may be a completely different weight and build and for whom 2g paracetamol at a time may be a dangerous dose.

Unless you are medically qualified I would not give such advice out.

As i said in my earlier posts there are various clinics that you could be refered to and should be. You should not be living on painkillers until the root of the problem has been investigated. The doctor should have ordered bloods if you described to him your pain in bad weather. The pain management clinic is the best place to go for advice and they are under used by GP's (i say that as someone who works in pallitative care).

If you are on high doses of paracetomol then you need to have your kidneys and liver checked every so often as the long term use of paracetomol (even within guideline use) is the biggest cause of cirrhosis of the liver and some pescribed drugs, not alcohol as some believe. For long term pain relief you really need to vary what you take because everyday painkillers stop working after a while. You need specialist input, go back to your doctor and insist he takes it further.

Technokitten-arthritic patients also take meds such as Losec alongside to protect their stomach. Basic bloods should be done to rule out Athritis and Rheumatism. It is bad practice to send younger people home repeatedly with the advice to self medicate.

Dd (14) has chronic joint pain due to hypermobility (manifesting in flat feet inter al). She has been given a range of treatment, including physio, occupational therapy (being taught how to sit and stand) and exercise advice. It has helped but it hasn't taken the pain away. Her GP has prescribed regular dosing with paracetamol, but tbh dd doesn't take it, because years of experience has taught her that paracetamol doesn't actually touch this pain and she is worried about the longterm effect on her inner organs.

I would insist on referral to an orthopaedic expert.

I think you can usually take quite a bit more than 2 ibuprofen tablets without problems, but I really would be wary about exceeding the normal dose of paracetemol especially if it's on a regular basis. Obviously don't do either of those things without proper medical advice in real life.

I would probably go back to the GP and ask strongly for a referral to a specialist (maybe you could try the paracetemol for a week or something to demonstrate that it doesn't work), if they refuse then I think it's perfectly reasonable to see a different GP for a second opinion. It doesn't seem right at all for them to do nothing when this is obviously affecting your life seriously with the pain and reduced mobility.

Actually Techno, my mother, my brother and my father have all also had the same dosage recommended. And believe me, we are all different heights/weights and have different doctors.

Not that anecdote = data but I would also tell anyone who is in as much pain as the OP apparently is to at least try it. And as a HCP, so should you, as I would think your first goal would be to give them back some quality of life.

Apparently I am wrong on my last assumption, however.