Pain Medication Advice Please

[Charlock]

Hi, I've been suffering from some combination of tennis/golfer's elbow in both arms for a year, and more recently should impingement and I think cubital tunnel syndrome. I've tried various physio exercises via my practice physio, steroid injection (ineffective). I just went back to the doctor again because I don't have decent pain relief as both co-codamol 30/500 and ibuprofen give me a sore stomach and I find paracetamol alone pretty ineffective and I'm getting pretty worn down with it all as it's uncomfortable through the night and affects my sleep. I've also tried ketoprofen gel, not effective. She's referring me for xrays and doing bloods again to rule out inflammatory stuff (done in October, all normal). I was hoping she might prescribe me a different NSAID perhaps with a PPI to protect my stomach but she said that's a no-go because the ibuprofen gave me a sore stomach. So she prescribed me co-codamol 8/500 to see if I could tolerate the lower dose better. Well, I thought I was but on my 3rd dose and my stomach is doing what it did on the higher dose. She said I could try dihydrocodeine next as this can be better tolerated. And then it's tramadol.

I'm confused as to why it's only opiates I'm being offered, esp as you can only take them for short periods and this pain has been bad for a year and showing no signs of let up. Does anyone have any suggestions on what I could try? Can I do anything to help me tolerate these things? I'm 48yo F and on Sertraline 50mg and HRT. Thanks for any input!

I e been prescribed amyltriptelene before for nerve pain, it’s meant to be better than opiates. For me it didn’t help and I’m back (sporadically) on opiates.

You might find this podcast interesting https://www.hubermanlab.com/episode/dr-sean-mackey-tools-to-reduce-manage-pain

Pain is very complex and I get the feeling that science doesn't really fully understand it. They talk about acupuncture too.

I know my pain is worse when stressed. I am currently experiencing a big flare up which I think has been triggered by a virus.

I also prefer the long lasting ibuprofen although they aren't helping much at the moment.

Things that help me relax also help my pain but sometimes the pain doesn't allow me to do the things that relax me. Today I wanted (needed) to go swimming but I couldn't walk to the pool. So frustrating. I am trying to focus on relaxing alongside the pain pills. Not doing much today though.

@CaptainBeanThief Goodness, you've fairly been through it, really sorry, that must all be extremely challenging and difficult to navigate. I feel I should say I know my issues are not as bad as very many people, yourself included, have to deal with. I thought twice about posting because there is that sort of conditioned 'just put up and shut up, you're not that bad' mentality. How I feel about the pain does vary and I find at times I cope better when I stop trying to find treatment for it, maybe because then I feel more in control of the situation. I hate keeping on going back to the doctor/physio. If I could sleep through it at night it would help, and wake up without being in pain. I feel from this thread I've learned there are more options. I'll try using gel again as I have some and will try the modifications to physio that have been suggested, get the xrays and bloods and there see where I am. Appreciate the information, thank you.

That's really frustrating for you. I agree, how I feel about the pain varies and I think because I'm perimenopausal how I experience pain can change with my hormones. I can think I'm getting a bit better then for no clear reason (like physical activity) it can feel worse again. The longer it goes on, the more I wonder if I'll stay this way long term. I've had hip and back pain as part of peri which settles when the hormones do, and I've had ongoing back pain since I was a teenager. I think I'm quite good at accepting daily pain to a point. But it just feels like I've had to shrink to accommodate this pain as in no more yoga or spin or weights classes, no gardening, put off things like changing beds or putting shopping away as these things worsen it. Which doesn't sound like a huge deal but it can get you down sometimes.