chronic nerve pain - how much gabapentin

[cansu]

I have a compressed nerve causing severe pain in my arm and hand. I have just started gabapentin which is helping but am on starting dose of 300mg a day. How much do I need to be on to get completely on top of it?

I think I went up to 900 but I put on about half a stone, so changed to pregablin which helped.

I’m prescribed 400 to take 3 x a day but I try to stick to 300 just a couple of times a day. I take it as little as I possibly can tbh as, before starting it, I googled it and the horror stories about side effects and withdrawal symptoms frightened me to death. I’d rather put up with some pain than end up like some of those poor people.
Pregablin didn’t touch my pain at all though.
I hope things ease for you soon

Wow goodness I take 1800mg a day. 2x 300mg three times a day. I haven't had weight gain or any adverse effects. First few days really tired but that passed.

Have you tried doubling up with other pain killers? When i had it for sciatica i was reluctant to move up to a higher dose. GP told me to try doubling up with paracetamol and ibuprofen( and codine if i needed it). I found once i added the other tablets in the pain relief was much better.

I'm currently on 1800mg, which I take as 2*300mg three times a day. I haven't had any bad side effects. It doesn't fully control my pain but I also have Naproxen twice daily and Co-codamol when I need it.

With nerve pain though there isn’t anything that can take it away, I have read that it can be as low as 20% reduction. Apparently the amount that would take the pain away would suppress the nerves so much you wouldn’t be able to do anything.

It is so depressing. It is there all the time but seems to ease when the pain killers kick in now with a bit of gabapentin. I can't work out whether I should:

a NHS Approach: Take more gabapentin and just chuck as much pain relief as possible at it. Do physio exercises. Then wait for the 9 weeks mark when the NHS might think about an MRI and seeing what is exactly wrong with me. I have been trying to reduce cocodemol and oromorph. I now only have a couple of cocodemol, 2 naproxen, the 300mg a day gabapentin and the occasional bit of oramorph at night as that seems the worst time.

b Do above and also continue with osteopathy which was v painful and I worry in case it makes me worse.

c. Take all the drugs and pay for an MRI now to see if that gives me more info about exactly what is wrong with me. I am three weeks into this hell.

I have been told I have either a slipped disc (by physio 1) or a compressed nerve c7 (by osteo) caused by muscle tension in my neck and chest

When I talked about private MRI with GP, she suggested I book a private consultant appointment but I am pretty sure that all that will mean is that I pay two hundred for the consult plus the MRI plus the follow up conversation which will cost me even more.

Any other advice welcome.

Do you have decent general strength /fitness? If yes I would assume physio alone won't make any difference without a proper diagnosis.

I personally haven't found osteopath helpful and the prices adds up. It sounds like more going on than can be manipulated by them.

As far as I'm aware... You would need to meet a consultant before a private MRI as they need to give a detailed brief to the team who do it (can't remember their names) to understand what to scan and what to look for. For reference my private MRI took 75 minutes and was hundreds of images.

I suppose it depends how long you can wait and if you can afford it... Private can happen very quickly in a few days whereas my nhs one took ages to get results etc.

thanks doadeer
I am generally well and whilst I wouldn't describe myself as fit, I have no issue with the exercises which seem to consist of moving my head side to side, up and down and doing the angry cat move which I have done in yoga many times before. I am inclined to agree about the osteopath but they seem so confident about what they are doing.
Did you have many parts of your spine scanned? My GP tells me you have to pay for each part and thinks the consultant will know which parts to do.

I don't think I paid for each part as such... I had my whole pelvis and lumbar spine. It was Harley street and around £900 I think but I have insurance.

You should be able to get that info of the process and estimate costs without having to pay for a Consultation.

The NHS MRI didn't pick up any of my issues and they were straight away on private and I've been having a big course of treatment. I suppose if this is the case for you, you need to consider if you can afford more treatment or what you will do.

It's so tough I really feel for you 😢

I take 600mg 3x a day.

It varies person to person. I am on 800mg x 3 and have some break through nerve pain but I don't want to keep edging up, if I can avoid it.

How did you get on OP?

I went up to 900 which is the 'top' dose; then I was put on pregabalin which is much better and has kept me going for years, the dose gets increased from time to time. I'm now on top dose, so I imagine they'll be switching me to something else sooner or later but no idea what yet.

However I've also been taking low dose dosulepin too. I've been on that for years now, and we're doing thegradual phasing out of it and phasing in of duloxetine(?) right now.

It might ge worth asking about that sort of medication along side your gabapentin.