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Suggest Treatment For Radiating Pain In The Neck

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Posted on Wed, 26 Oct 2016
Question: I must know....there are many things in my life that cause pain. I have a pinched nerve in my neck that sends nasty pain down my right arm. I have toothaches all the time and have spent a fortune at the dentist office. I have a tooth ache right now, being estimated to fix for app. $1500.00 (root canal and crown), which I can't afford. My Dr. won't give me a pain med with an oppiot. Here is my problem. Because of Bariatric surgery two years ago, I am told I can't have, Motrin, Advil aleve asprin, etc...all the anti inflammatories. Why? What bad will happen. And what can I have?
doctor
Answered by Dr. Sameer Kumar (6 hours later)
Brief Answer:
you may choose selective COX-2 inhibitors like ETORICOXIB

Detailed Answer:
Hello,
I feel if you already have cervical spondylosis with pinched nerve in the next then apart from pain killers, a neck collar with some physiotherapy would indeed do wonders for you. You have been told to avoid normal NSAIDS like motrin, advil and aspirin because all of them has gastrointestinal side effect of gastritis, ulcers and haemorrhage apart from anti-inflammatory properties. Considering opioid at your age should be actually the last resort for chance of dependence, though it is effective but its more of a prophylactic and supportive management.
The reason post bariatric surgery with possible gastrectomy NSAIDS which can cause gastritis and haemorrhage should be avoided. So the next best thing for you considering this side effect is to use selective COX-2 INHIBITORS like CELECOXIB or ETORICOXIB.
for info:-
NSAIDs are associated with potentially harmful side effects. Cyclooxygenase exists in two isoenzymatic forms, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Cyclooxygenase-1 appears to be constitutively expressed in many tissues and produces prostaglandins, which regulate normal cellular functions. However, COX-2 activity is induced by proinflammatory cytokines and produces prostaglandins that mediate the inflammatory response and pain signaling transmission. Traditional nonspecific NSAIDs inhibit both COX-1 and COX-2, and in doing so, not only decrease inflammation and pain, but also promote gastrointestinal tract damage and bleeding.The potential clinical benefit of COX-2 inhibitors is significant due to the number of patients chronically treated with NSAIDs and the three- to ten-fold higher risk of gastrointestinal injury and death associated with traditional NSAIDs.

Hence, you may discuss the option of these selective cox-2 inhibitors with your physician over opioids and am sure you should be benefitted of your pain.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar (1 hour later)
a little confusing due to the technical terms. Cox 1 and Cox 2 ....are they then less dangerous that NSAIDS? Can a person buy them over the counter? Can they be crushed? How effective are they. I have gabipenton ....But in liquid form it is unpalatable...seriously...in pill form I am always uncertain if it is absorbed....and it
doesn't work very we.. Oh...I am curious. When I was in my 20's, a doctor gave me Darvon for menstrual cramps. Is that still around. Would that be dangerous for the weight loss patient? I know I couldn't get that by myself.
doctor
Answered by Dr. Sameer Kumar (23 minutes later)
Brief Answer:
answered

Detailed Answer:
These are available in tablets form and can be crushed if need be for intake. They are definitely better than other NSAIDS,and with no bleeding side effects. These are not available as an OTC.
DARVON tab, I am not sure , BUT THERE ARE OTHER better meds available now for menstrual cramps with drotaverine.
You should try cox 2 inhibitors and am sure you would be benefitted.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar (1 hour later)
thank you for your amazing quick response. I looked up the Cox 2....and it said that it had an increase in Heart related problems and stroke....and connection to some cancers. I do realize that 'life' itself is related to heart problems, strokes and cancers. It wears me out. This pain slows me down so much. I am 70, and am a retired school teacher and have an antique business....besides creative activity is good for me. Provigil gives me energy, acts as a pain killer, helps with sleep problems, and temporarily relieves anxiety and depression...and my doctor has prescribed it, but my insurance won't put it through and it costs $800.00 a month. They used to okay it, but they won't now.
doctor
Answered by Dr. Sameer Kumar (1 hour later)
Brief Answer:
Answered

Detailed Answer:
The risk for stroke and heart problems is the same as with any NSAIDS like motrin, aleve. So they have to be used occasionally and not regularly when required. It is not advised in a daily dosage and for long. prodigal is modafinil and is not a pain killer but is a wakefulness-promoting agent (or eugeroic) used for treatment of disorders such as narcolepsy, shift work sleep disorder, and excessive daytime sleepiness associated with obstructive sleep apnea.
I am sorry if your insurance doesn't cover it. In that case cox 2 inhibitors shall be helpful and they can be combined with oxycodone as well on alternate days disallowing any tolerance issue.
Regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sameer Kumar

OB and GYN Specialist

Practicing since :2002

Answered : 1782 Questions

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Suggest Treatment For Radiating Pain In The Neck

Brief Answer: you may choose selective COX-2 inhibitors like ETORICOXIB Detailed Answer: Hello, I feel if you already have cervical spondylosis with pinched nerve in the next then apart from pain killers, a neck collar with some physiotherapy would indeed do wonders for you. You have been told to avoid normal NSAIDS like motrin, advil and aspirin because all of them has gastrointestinal side effect of gastritis, ulcers and haemorrhage apart from anti-inflammatory properties. Considering opioid at your age should be actually the last resort for chance of dependence, though it is effective but its more of a prophylactic and supportive management. The reason post bariatric surgery with possible gastrectomy NSAIDS which can cause gastritis and haemorrhage should be avoided. So the next best thing for you considering this side effect is to use selective COX-2 INHIBITORS like CELECOXIB or ETORICOXIB. for info:- NSAIDs are associated with potentially harmful side effects. Cyclooxygenase exists in two isoenzymatic forms, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Cyclooxygenase-1 appears to be constitutively expressed in many tissues and produces prostaglandins, which regulate normal cellular functions. However, COX-2 activity is induced by proinflammatory cytokines and produces prostaglandins that mediate the inflammatory response and pain signaling transmission. Traditional nonspecific NSAIDs inhibit both COX-1 and COX-2, and in doing so, not only decrease inflammation and pain, but also promote gastrointestinal tract damage and bleeding.The potential clinical benefit of COX-2 inhibitors is significant due to the number of patients chronically treated with NSAIDs and the three- to ten-fold higher risk of gastrointestinal injury and death associated with traditional NSAIDs. Hence, you may discuss the option of these selective cox-2 inhibitors with your physician over opioids and am sure you should be benefitted of your pain. Regards