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Suggest Treatment For Chronic Pain Caused By Fibromyalgia

Posted on Tue, 17 Mar 2015

Question: Hello
I believe I'm experiencing a very bad fibromyalgia flare up as I'm in pain all over my body including my legs and right hip which is so very painful walking hurts even sitting getting up hurts I'm crying walking I'm bk on crutches I'm struggling and feeling very weak and being physical sick more than normal for me! Is it more to it I've included my medications
Pregabalin 150mg one tablet twice a day
Pregabalin 50 mg one tablet twice a day
Paracetamol 500mg two tablets up to four times a day
Citirizine 10 mg one a day
Cyclizine 50 mg one tablet three times a day when needed
Codiene 30 mg two tablets four times a day
Fultium d3 800 one tablet twice daily
Fluoextine 20mg one at night
Phenergan 25 mg one to two at night when needed
Tovaiz 4mg one daily
Fostair Evo inhaler
Salamol inhaler when needed
Tramacet 37.5mg/325mg two tablets ever six hrs
Naproxen 500mg one tablet morning and night

My allergies
Penicillin, Trimethoprim, Ethromycin (Tablet Form), Lymecycline
My medical conditions are
Urine leaking small amount
Chronic pain syndrome
Chronic pelvic pain
Fibromyalgia
Asthma
Depression
Anxiety
Social phobia

Answered by Dr. Tushar Kanti Biswas (1 hour later)

Brief Answer:
Fibromyalgia-flare up

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
You are on multiple medications but poor relief of pain.
What you need for fibromyalgia related pain is physical conditioning and to begin low levels of aerobic exercise with slow but consistent advancement.

Treatments that incorporate improved physical function with relaxation, such as yoga and Tai Chi, may be helpful.

Exercise programs are helpful for reductions in pain & tenderness and for enhanced self-efficacy.

Opioid analgesics are to be avoided . These agents have no demonstrated efficacy in FM and are associated with opioid-induced hyperalgesia that can worsen both symptoms and function.Hence you need to stop codeine.

Since you have got depression and anxiety , drugs that have both analgesic and antidepressant/anxiolytic effects, such as duloxetine or milnacipran, should be the be the best first choice. Hence instead of fluoexetine,duloxetine would be better.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Tushar Kanti Biswas (18 hours later)

Thank you
Im on Tramacet four times a day but dont feel its doing much but at night it is as its helping me to sleep
I am struggling emotionally and mentally i also keep vomitting i do vomit up to 6 times a aday anyway they arent so sure why
But today ive vomited a lot more im also running a temp what should i do im becoming very scared ?

Answered by Dr. Tushar Kanti Biswas (5 hours later)

Brief Answer:
Amitryptiline or Duloxetinea

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Since opioid analgesic tramacet is not working,you need to switch over to Amitryptiline or Duloxetinea and paracetamol orally .
For vomiting you need to take Domperidone orally.
Consult your primary physician.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Tushar Kanti Biswas (42 hours later)

Ok thank you i have previously been on these and they mDe me very ill
Would a fentyl patach work ? Was suggested by a pharmacist

Answered by Dr. Tushar Kanti Biswas (6 hours later)

Brief Answer:
Follow-up query

Detailed Answer:
Hi,

Fentanyl patch is a transdermal system containing fentanyl.
Fentanyl is a potent, short-acting, rapid-onset opiate agonist that relieves pain by stimulating opiate receptors in CNS.
You need to avoid any opiod based medication.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D