Having Severe Chronic Lower Back Pain. Using Tramacet. Suggest
Posted on Fri, 20 Dec 2013
83866
Question: I have severe chronic lower back pain originating from a car accident and am allergic to codeine, torodol, talwin. I am presently using tramacet, 6 per 24 hours and it barely relieves the pain. What do you suggest for I am desperate at this point.
I am a psychotherapist and must have a clear mind for my work. I think a pain management control physician would be best to advise.
Brief Answer:
Combination drug and Tricyclic antidepressants
Detailed Answer:
Namaste
Welcome to Healthcare-Magic
Greetings of the day
Combination of NSAID and opioid will be more beneficial and will act synergistically.
I would recommend combination of Diclofenac Sodium and Tramadol . Both have different mechanism of action and will act synergistically . Addition of Tricyclic antidepressant Like Amitriptyline is also helpful in management of chronic back ache.
I hope you have thoroughly evaluated the cause of backache and surgically correctable cause of backache like disc prolapse are ruled.
Apart from Pharmacotherapy I would also suggest you following
1. Proper posture while sitting
2. Using right sleeping mattress
3. Trascutaneous electric nerve stimulation(TENS) may also benefit.
I hope it helped
Do get back to me if you have any other query.
Take care
Regards
Dr Deepak XXXXXXX
MBBS MS MCH
Consultant Surgeon
Follow up: Dr. Deepak Kishore Kaltari (4 hours later)
I have been advised strongly by a physician at CAMH not to take antidepressants of any kind. I believe he feels the tendency of mine to overreact in a highly emotional manner could be exacerbated.
Many years ago I was given marcaine injections for reflex sympathetic dystrophy. Unfortunately I was allergic to it although my pain management specialist said nobody is ever allergic to marcaine.
I am truly hindered in many ways by pain. Would you recommend a pump should it contain the correct ingredients?
Any alternate to tramadol that will not cause my mind to cloud would be so appreciated.
Regards,
XXXXX
Brief Answer:
Taking pump is not advisable
Detailed Answer:
Namaste
Greetings
Taking pump for chronic pain is not advisable.
Alternatively you can take Ketorolac or apomorphine in place of tramadol.
Also remember,too much stress or anxiety will provoke more pain in chronic pain.
Wishing you healthy life ahead.
Take care
Best Regards
Dr Deepak XXXXXXX
Consultant Surgeon
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
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Having Severe Chronic Lower Back Pain. Using Tramacet. Suggest
Brief Answer:
Combination drug and Tricyclic antidepressants
Detailed Answer:
Namaste
Welcome to Healthcare-Magic
Greetings of the day
Combination of NSAID and opioid will be more beneficial and will act synergistically.
I would recommend combination of Diclofenac Sodium and Tramadol . Both have different mechanism of action and will act synergistically . Addition of Tricyclic antidepressant Like Amitriptyline is also helpful in management of chronic back ache.
I hope you have thoroughly evaluated the cause of backache and surgically correctable cause of backache like disc prolapse are ruled.
Apart from Pharmacotherapy I would also suggest you following
1. Proper posture while sitting
2. Using right sleeping mattress
3. Trascutaneous electric nerve stimulation(TENS) may also benefit.
I hope it helped
Do get back to me if you have any other query.
Take care
Regards
Dr Deepak XXXXXXX
MBBS MS MCH
Consultant Surgeon