Doctor won't prescribe stronger painkillers

[verystressedmum]

I've got really really bad back pain and even worse sciatica, I'm on diclofenac and co codamol at the moment but it's not really touching the pain and I can hardly walk or stand because of the pain.
Called the doctor to see about different pain killers and he said I'm on a really strong combination and he can't prescribe anything else I'll have to go to A&E.
Is that right? He said I must feel woozy because the painkillers are so strong, I said no I feel fine but they don't really help the pain.
I can't help thinking it's such a waste of everyone's time to go to A&E for painkillers.
I've read the threads I know there's other painkillers out there so how did you get them?
I'm in really bad pain so I may have to go to A&E but really....

I am exactly the same as you fairbalance. Cocadomol 30/500 makes me whoozy and dizzy and a bit high actually. Tramadol (which is theoretically stronger) has much less impact (and gets rid of the pain). My gp says that although both are opioids they are different drugs and everyone reacts differently and that even though tramadol is stronger is causes less side effects for quite a few people

Start with the lower dose for a few days and see how you go. You may find it just knocks you out overnight, and some people feel a bit woozy the next morning so best to just see how you get on with it at a lower dose first. As I said, it can take a few weeks to see any real change in pain sometimes so try to persevere. If you really don't get on with it, then push to try gabapentin/pregabalin - different people find different things effective. Would also second asking for a pain clinic referral.

Hope some of those suggestions help. Nerve pain is absolutely rotten

Forgot to say, a pharmacist should be able to advise you on combining it with other meds. I think you can, but definitely best to check for sure, and what dosages.

I hope you were a bit more comfortable last night. I found that the triptyline took time to work as I had to increase the dose gradually, but one of the best side effects for me has been the drowsiness! I have suffered from chronic insomnia all my life (and the pain didn't help!) but sometimes now j get 5 or 6 hours in a stretch which is amazing for me. I take it about 5pm or feel zonked the next morning, btw.

I hope it helps and I really hope the gp helps sort out a proper diagnosis and plan of action, at the very least they should help you get your pain under control.

And of course I'm sure you know this but just to say if you have trouble going to the toilet or numbness in that area, that is an A and E job!

Thank you Orange and Purple

I'm not sure the one tablet did too much except knock me out at 10 o'clock , the pain was still there this morning but I know it will take time to work. I've only got 14 tablets from the out of hours doctor so the doctor at my surgery had better prescribe me some more!!

I took 2 cocodamol and some ibuprofen, so I can stand and walk about. I find the ibuprofen works a lot better than diclofenac.

I'm getting what feels like shocks in my pelvis, it's like something twinges in my pelvis or hip and I jump like reflex. The reflex jump is in my pelvis area and leg. I can't describe it properly but I'm assuming it's something punching on the nerve?

This is all quite tiring tbh, all I do is think about and talk about my back and leg, I'm the most boring person in the world!

Hello verystressedmum. I'm going through the same as you, although my Gp has been very supportive. I have worked my way through many combinations and am currently taking tramadol, pregabalin (LYRICA), paracetamol and ibuprofen. I have had physio which didnt work as they said the nerve was too irritated. I had an Mri last week and see the specialist Monday to get my results. The pain is awful.. I have been signed off work for 4 weeks already and cant see me going back any time soon. Surgery has been mentioned which I will probably go for as my life is totaly on hold with this awful sciatica. I wish you some respite from this awful, awful symptom.

DH has the same thing,mit's been nearly a year now. He had a scan and a jab (but I can't remember what it was, probably cortizone?), after which he was great for a few weeks, but the pain came back.

He is waiting for the next thing, for which he will have another scan (waiting for the date) and then probably surgery. Initially he was prescribed Amytriptilene, however it's spelt, but he didn't like the side effects.

Did you know that anti-depressants in low doses are great for nerve pain? I am prescribed a-ds for ms pain (these days I take a lot more too, though).

He is taking
Naproxen, 500mg
Omeprazole, 20mg
Codeine Phosphate, 30mg
Co-dydramol, 500mg

He doesn't take all of them all the time, but varies it depending upon how bad the pain is. The Omeprazole is I think to do with side effects of the Naproxen. I think the main painkiller is the Naproxen; it was recommended to him by one of my ms friends.

I hope you get better pain relief soon. There's nothing quite like constance pain to sap the joy out of everything

... suck the joy out ...

to everyone suffering!

I remember when they first suggested surgery to me, I was all noooooooo. A few years later it's no longer an option anyway, but I'd bloody do it myself with a rusty knife if it made it better.

Thanks for the replies

The pain is so limiting, I can hardly walk and can't stand for very long either it's just awful. My house is a total tip as I can't do much.

I've taken some amiltriptyline but can't say it's done too much for the pain yet. Hopefully it will kick in soon.

I was on naproxem but it didn't do much. The cocodamol didn't do anything neither did the diclofenac. Nothing seems to take the pain away. I'm wondering what on earth is wrong with me no painkillers seem to work!

I'm tilted to the side as standing straight pulls on my calf and it hurts so much. I spend most of my day sitting down which isn't good as I should be keeping mobile but it's impossible at the moment.

My only hope is that the doctor tomorrow actually prescribes something for me or I'll be walking straight into another surgery to change!!

Do I ask the doctor about the injections? I'd like to try one (at this point I'm with Purple, I'd do anything just for a bit of relief!)
Sometimes I wonder how on earth this happened to me. I look at people just walking around normally and am so jealous, I used to be like them and totally took it for granted!!

Yes, ask, ask about everything, ask for a referral to pain clinic, to neurologist, back specialist, mri, anything you can think of! My dh has been in this state for such a long time, it seems we're back to the dark days when you had to wait 18m for a hospital appt. I remember that from my childhood.

Push and keep pushing. Being sedentary is not great, and can give rise to depression if it goes on; you really don't want that too.

A little update, I went to the GP today and the one that I saw was really good. He's prescribed gabapentin, and I start taking them tonight.
Each tablet or capsule is 300mg and I'll be working up to a daily dose of 1800mg, does this sound ok?

I'm not on any other painkillers. He said to stop the amitriptyline. And I suppose the other painkillers didn't work anyway so it doesn't matter.

Will the gabapentin take some pain away does anyone know? Has it worked for you?

I found gabapentin very helpful. It does take a while to build up a therapeutic dose in the bloodstream. It can also make you feel very tired and cognitively slow. This sort of improves.

I took 300mg three times a day for quite a while which was fine.mwhen the dose was upped to 600mg three times a day it took ages to build the dose up as it made me soooo sleepy. Eventually I got there, though.

I also take amitriptyine , cocodamol and naproxen. They all do different things. As I mentioned up thread you may not process codeine, quite a significant proportion of people don't. Tramadol would be worth trying instead. Good luck.

Thanks Matilda, I've read about the side effects and it's a bit worrying being really tired as I have to drive children around. But hopefully as you say it will better, and I can cope with tiredness better than excruciating pain!
I will be on 1800mg in 11 days according to the little plan the GP wrote out for me. If the side effects are too much I could speak to the GP about the dosage.

I read the article about cocodamol, it was very interesting, it just may not work for me because I was on 60mg codeine(with the paracetamol) every 4 hours with diclofenac or ibuprofen and it didn't even take the edge off the pain.

I'm sort of pinning all my hopes on the gabapentin, so knowing my luck it won't work at all!

The way I would describe the pain relief from gabapentin is that I have a 'numb pain' if that makes any kind of sense. Very much better than the non numb kind.

I will suggest that 11 days is very punchy. I would honestly recommend taking it slowly and steady. Maybe 11 days will be ok but it would have knocked me out cold. Ultimately I've switched to pregablin but that was for cognitive reasons rather than pain relief. I then found it worked better for pain in my case so am pleased. It's much more expensive so gabapentin is usually chosen first.

I would love 'numb pain' so here's hoping!

Maybe the pain will go away on a lower dose so I won't need to go higher. I'd love it to go totally but I know it may not but if it's tolerable that will be good enough.

Thanks for all the advice.

Gabapentin did help me, for quite a long time, but as ms isn't curable, and you will only get worse with it, there came a time when it wasn't enough.

These days I'm mainly on pregabalin - as you can tell they're both something to do with gaba receptors. I was told by my pharmacist that they work better if you take them with paracetamol. It may be worth asking your pharmacist if that's the same with gabapentin.

I do hope they do the trick for you.

Have you looked at Actipatch ? I bought the trial one and it made a huge difference to my DH back/hip pain, he just keeps moving it round his body and you can use it with painkillers.

I really hope it helps!

They are £££ but if you can get GP to prescribe lidocaine patches they helped me. If you have small areas with concentrated pain it helps to sort of numb them, I also found it helped with that awful "jumping electric shock" pain consequently.

Can you afford to get your MRI done privately? It really sounds like a slipped disc which an MRI will confirm. After 8 months it's not going to get better by itself.

I had the same for a similiar length of time. Once I had an MRI I was referred to an orthopaedic surgeon. We tried a steroid injection first which had limited benefit so then went for surgery (microdiscectomy). The relief when I came round from the anaesthetic was instant and pure bliss.

I would push really hard for your MRI or just take matters into your own hands if you can and go private. This isn't going to get any better until you do (IME).

It all started with a slipped disc as I felt my back 'go' and then after a few weeks the back pain settled and it went to my leg specifically my calf none in my thigh. It was getting better but a few months ago my back started hurting again and the sciatica came back really badly. Then it was easing and I had no back pain and a few weeks ago my back started aching again and the pain is now horrendous in my back, hip, buttock,a bit in my thigh and in the calf.

I got a quick look at a few lines of the x ray report on the screen when I was at the GP yesterday it said marked degeneration at discs L5/S1 and significant narrowing of disc canal..there was another few lines but I this is all I remember. So because of those things the sciatic nerve is being compressed.

I'm seeing a consultant soon so I'll ask how long it will take for the MRI and what it would cost to go private.

I started the gabapentin last night, it didn't have an immediate miraculous effect on the pain and I was up in the night in really bad pain (which I never have before) and the pain was very bad this morning. I just called out of hours doctor and I'm collecting a prescription for diazepam in about half an hour, hopefully it will give some relief when it's bad until I've worked up the gabapentin.

I haven't tried the patches, I'd never heard of them but I'll definitely look into it. I'm going to look into tens machine as well as recommended on here.

This back/leg business is all consuming! It's all I think or talk about it seems.
Thank you for the replies it's so nice to have support from people who understand

OP I sympathise. I had a trapped sciatic nerve due to two prolapsed discs for 17 years. When I finally got the surgery I had been begging for, it was just magic. Instant relief and the pain has never come back (the surgery was 25 years ago).

Unfortunately, because the surgery was so delayed I spent many years slumping on to one hip to relieve the nerve pain and the result was that I needed a total knee replacement because of the distortion the slumping onto my hip had left on my gait. Luckily that was very successful. But I am always baffled at the way that doctors fanny about with pain killers, various other drugs, physio etc. without any real success before they get round to surgery, often leaving the patient with knock-on side effects that take further surgery to remedy. It seems so counter productive.

Exactly grimbletart. I am always amazed at how long GPs are satisfied to leave back pain rumbling along. Chronic pain is miserable and can lead to real distress and even depression. Surgery was literally instant relief for me. Luckily my consultant understood the severity of my case early on. That's why I'm so keen for the OP to get her MRI so a consultant can see what the route cause is rather than just (ineffectively) treating the symptoms.

Best of luck OP. My herniated disc was at L4/L5 so maybe your treatment plan would be different. However I reallywant to stress the importance of getting your MRI ASAP so you can get a long term solution to your back pain rather than just pain mmanagement.

OP, come and join us on the Back Pain thread for more support. Lots of us who understand on there.