To think I can't take much more of this pain

[NiceScream]

Not really an AIBU as I'm pretty sure I'm not, just posting herefor traffic.

I've had a really painful headache (migraine?) since monday. It's only on my left side, strats just in front of my ear, near the jaw bone joint, then spreads out. It goes right up to my temple, behind and under my eye and also part way down the jaw bone itself. It begins as a dull ache near the ear then I get sharp shooting pain like needles ripping through my skin, spreading out across that side of my face.

BUT, this is the weird part, it's not all the time. It sounds ridiculus but all I can compare it with is a labour contraction. It starts of not too bad then ramps up and out until it is excrutiating, before dying away again. Lasts no more than a couple of minutes then nothing again, and I feel fine. Until the next wave of pain begins :(

I have experienced pains like this before, but they have never lasted for more than a day. Normally it just stops on its own eventually but this time its been 3 days. No painkillers make any difference, the pain just keeps on coming and I have no idea how I can get it to stop.

I tried to get a GP appointment today, but there were none available. I'll try them again in the morning and pray they can offer me something to stop it. I tried that NHS symptom checker thing for ideas, but it told me to ring an ambulance in case I was having a stroke! I really don't think I am, but I've really got to do something as I can't cope with this pain for much longer.

Yes the amitrytiline will help as pp have said it is an antidepressant but also commonly used with nerve pain hope it works well for you op.

I have trigeminal neuralgia and it's really pain beyond description when it kicks off. Mine tends to be triggered by head colds. I take carbamazepine x2 daily and amitriptyline (only at night as it turns me into a zombie) when I have attacks. You have all my sympathy, when mine starts off all I can do is pace the floor, whilst pouring tears, until the meds kick in. I get literally beside myself with pain.

WRT stopping taking the meds when the pain stops, I stop after 3 or 4 days, if it's gone I don't go back on the until it starts again but I ALWAYS have them with me, so as soon as I feel the ache in my cheek (that for me is the precursor to the excruciating shocks pain) I take one.

I've been managing mine successfully for well over 15 years now. Hope you start to improve soon

Did the GP not tell you what he thought it was OP? Pain can be so debilitating, I feel for you.

If it were migraine, the attack (headache) would last a maximum of 72 hours or it's actually something else.

Although imigran, which an earlier poster named, is prescribed for migraine and is available as Imigran Recovery over the counter, you would only get it from the pharmacy if you had previously been prescribed it and have filled out the questionnaire.

I'm medically trained and my first thought was Trigeminal Neuralgia.
You can get more info here, if it helps:

www.patient.co.uk/health/trigeminal-neuralgia-leaflet
www.patient.co.uk/doctor/trigeminal-neuralgia-pro

If the Amitryptiline doesn't sort it, go back and ask to trial Carbamazepine, I think that is the more common first line treatment these days.

Hope you get it sorted quickly x

You can't easily stop and start amyltriptiline but they do work on nerve pain. I use codeine based painkillers which seem to work better on the nerve pain than anti- inflammatories. Go back if it doesn't help, as the others say there is other stuff that may help.

Amitriptiline works for me but I need a fairly high dose. Good luck. Btw, stay away from sunlight as that can make it worse

Hoping the ami works for you, op. If it doesn't appear to be, go back and ask to try something else. The gp really should have put you on carbamazepine, as one way to confirm diagnosis is to take that. If it helps, and or helps QUICKLY then it helps decide that it is TN.
Amitriptyline used to be on the accepted list of medications for TN, but now the GPs are only supposed to prescribe carbamazepine. I can't link from here, but if you Google nice trigeminal-neuralgia then you will get the guidelines, they may be worth printing to take with you next time.

That said, there are lots of side effects for carbamazepine and I had to swap to gabapentin. but for me it's a miracle as I'm mostly pain free with minimal side effects.

We're you given a neurology referral? You should have been. Usually followed up with an mri scan to look for a cause.

OP I am a migraine sufferer and take Amitriptyline as a preventative. It is NOT a painkiller and will not help reduce the pain in the short term. What the GP SHOULD have done is tell you to take 3x 300mg dispersable Aspirin with 2 x Domperidone (Motillum) tablets. Both available from any pharmacy If you're having a migrainous attack, your stomach lining will be inflamed, meaning NOTHING will help unless you take an anti-emetic, which is what the Domperidone is. Only then can the painkiller get through the stomach to the bloodstream. Hope that helps!!

Be very careful about Motilium - it has recently been linked with heart related deaths, and is in the process of being restricted / banned in some countries (sorry Missdread, this is really recent info, historically I have used it without problem)

I have migraines like that. Painkillers alone wont shift them as you need a migraine tablet to actually get rid of it.

Miss, OP hasn't been prescribed ami for migraine type pain. TN is very different. Not even morphine works for TN, apart from making you care less about the horrible pain you are in.

Amitriptyline is a recognised treatment for neuralgia. No normal painkillers work as it's nerve pain. Effective treatments are anti-seizure (eplilepsy) medicines like carbamazepine, gabapentin, lyrica etc as they deaden the reaction of the nerve to the cause of the pain. In my case, an artery in my brain that presses/rubs on the nerve.

Other treatments are tricyclic antidepressants, of which amitryptilene is one.

Here's the link for the NICE guidelines (which used to list all those treatments until about 3 weeks ago, when they changed)

cks.nice.org.uk/trigeminal-neuralgia#!scenariorecommendation

Sounds strange to give you amitriptyline as its a preventive measure and im assuming a low dose to even do anything.They also take a good few weeks to kick in and really fuck with your sleeping pattern when you come off them.

It did fuck all for my nerve pain!

Actually, Miss, I've read back and realise that the OP hasn't confirmed what the GP thinks it is. If they have any idea.

Sorry, but you are wrong, kali.
Amitrip is often given for TG - because it works. And it does not take "a good few weeks" to kick in for TG. It might not have worked for your nerve pain, but it doesn't sound like you had TG, so please don't try to frighten the OP.
there are many different sorts of nerve pain and therefore different treatments. As many here have testified, TG is mind-blowingly painful. I've had ketamine after a major accident (think possible amputation) - but the pain of TG beats that into a cocked hat. And amitrip works for me. Often you will be started on a low dose and told to increase it each day until you are painfree. Like others here, I keep a packet handy just in case I get another attack.
OP - hope you get a decent night's sleep tonight. Amitrip does tend to knock you out, hence taking it at night. I was normally sound asleep about 30 minutes after taking my dose.

Not sure why I typed TG instead of TN!

It may work for some yes , it didn't for me. Im not trying to scare her at all. She is asking for opinions and this is mine.
Im only saying what doctor said to me that it takes for weeks to start working and few for your sleeping patterns to go back to normal, that i definetley remember well!

I was actually opposite and took it in the morning as it didn't make me drowzy at all.

Most meds you get put on are started on a low dose. Trying to find the lowest dose you find useful as it's a long term thing. It took 6 weeks on the gabapentin to find a good level for me, raising the dose every week, but I did have some relief almost immediately.

I'm on a TN group on fb with lots of members. The thing I've learnt is that we are all different and what works for one may not work for another.

2kids I'm asking my neurologist to be tried on that. Have you had any side effects on it if you don't mind me asking as the one I'm on at the mo has caused me no end of trouble!

Compared to carbamazepine, no. On that I had drowsiness, couldn't stay awake, dizzy, couldn't walk in a straight line and had a severe twitch. I couldn't type and was having memory issues and problems finding my words.

It's much better on the gabapentin.

I'm noticing that my memory still isn't quite what it was, pre medication, but it's not getting in the way much. And I have a tiny twitch in my arms/legs from time to time. Other than that I am side effect free.

I doubt there's much that we can take that won't cause side effects. After all, we are messing with the way our central nervous system works in order to get the nerve to calm down.

As an aside to the OP, for those with TN - have any of you been offered botox injections? A good friend of mine has botox injections for TN, every few months I think, into the nerve? or the area, not sure of the details and she swears by the effectiveness of it pain wise, and additional to not having to take meds that affect her whole body (she has that for another condition as it is) as the botox is direct to the area of pain, she also has amazing looking skin seriously though, if no-one has looked at this as an option, and is not managing well on their current meds, look into it.

Thankyou 2kids helpful to speak to someone who is actually taking it. Did it cause you any anxiety ?

Not that I've noticed.

I hope you are feeling a bit better. I have taken amitriptyline in the past, it didn't fix my depression but it didn't have too many side effects either.

How are you getting on, op?