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Suggest Treatment For Severe Back Pain Post Surgery
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I am sorry about the chronic symptoms you are experiencing:
Chronic pain and abnormal sensations are common consequences of spinal issues even after surgery. The treatment you are under I must say is already an adequate treatment, Lyrica, an anticonvulsant, is a first line drug for such neuropathic pain.
The only other alternative would be the use of antidepressants which also act on neuropathic pain. Such antidepressants are tricyclics like amitriptyline or SNRIs like duloxetine. They can be tried alone or in some cases even in combination with anticonvulsants like Lyrica. One must have realistic expectations though, neither anticonvulsants nor antiepileptics (the first line drugs on this type of pain) are effective in all patients and combinations or dose incrementations make side effects more likely.
Other options would include over the counter antiinflammatory painkillers, but they aren't that effective for neuropathic symptoms (might help with the back pain) and regular long term use may be associated with vascular and gastrointestinal complications.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I am sorry about the chronic symptoms you are experiencing:
Chronic pain and abnormal sensations are common consequences of spinal issues even after surgery. The treatment you are under I must say is already an adequate treatment, Lyrica, an anticonvulsant, is a first line drug for such neuropathic pain.
The only other alternative would be the use of antidepressants which also act on neuropathic pain. Such antidepressants are tricyclics like amitriptyline or SNRIs like duloxetine. They can be tried alone or in some cases even in combination with anticonvulsants like Lyrica. One must have realistic expectations though, neither anticonvulsants nor antiepileptics (the first line drugs on this type of pain) are effective in all patients and combinations or dose incrementations make side effects more likely.
Other options would include over the counter antiinflammatory painkillers, but they aren't that effective for neuropathic symptoms (might help with the back pain) and regular long term use may be associated with vascular and gastrointestinal complications.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
since palexia is s morphine based drug how long would it take to withdraw from if I have been on it for 15 months and what would substitute to make the withdrawals easier or could I stay on it long term if it eases the pain.
Brief Answer:
Read below
Detailed Answer:
Tapentadol is an opioid analgesic as you say, having similar mechanism of action to morphine. However compared to morphine and other opioids its potential for abuse is much lower, it leads to much less dependence and tolerance especially at lower doses, so it can be used long term if it is deemed to be effective (not that the risk for dependency is not there, but lower).
If it is indeed decided to interrupt it, it should be done very slowly, it depends on the dosage you are taking now, if say you are taking 250mg a day, you could lower it by 50mg a week. It's an individual issue though, so should be monitored for symptoms, if necessary may slow down tapring even more or use medication like clonidine to alleviate withdrawal symptoms.
Read below
Detailed Answer:
Tapentadol is an opioid analgesic as you say, having similar mechanism of action to morphine. However compared to morphine and other opioids its potential for abuse is much lower, it leads to much less dependence and tolerance especially at lower doses, so it can be used long term if it is deemed to be effective (not that the risk for dependency is not there, but lower).
If it is indeed decided to interrupt it, it should be done very slowly, it depends on the dosage you are taking now, if say you are taking 250mg a day, you could lower it by 50mg a week. It's an individual issue though, so should be monitored for symptoms, if necessary may slow down tapring even more or use medication like clonidine to alleviate withdrawal symptoms.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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