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Suggest Treatment For Severe Nerve Pain In Leg

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Posted on Mon, 31 Aug 2015
Question: I have had bad nerve pain down my leg for the last 7 days, which is similar to what I had 5 yrs ago before my
Laminectomy surgery. I haven't seen a dr yet but it is getting worse. A physical therapist & chiropractor recommend that I take a muscle relaxant like Flexiril, 600 mg of Ibuprofen & prednisone. Would appreciate your expertise on these & if you would recommend the patch?
doctor
Answered by Dr. Olsi Taka (2 hours later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern.

Given your history of spinal problems and radicular pain nerve root compression is well possible.

Of the drugs recommended to you, I do not agree with prednisone, not much benefit and high potential of side effects.
Ibuprofen can be used, but you should be aware of possible side effects on stomach ulcer or high blood pressure, at your age should try to keep daily dosage at 800 mg at most.
Flexeril can be used but not for long periods of time 1-2 weeks.

I am not sure what you mean by patch, there are several types available containing medication of the Ibuprofen group or anesthetics like lidocaine. Their effect is only mild though, you can try them, few side effects, but if pain is severe do not expect much.

Other options are pain killers like Tramadol or opioids (preferable to be avoided). Also neuropathic pain medication can be prescribed, two major groups, anticonvulsants like gabapentin, pregabalin or antidepressants like duloxetin.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (39 minutes later)
Thank you! Sorry I should have specified that I was asking about the Flector patch. The pain has been extending down my leg over the past wk & is now down to my ankle. Obviously, I am very concerned about nerve damage also. Wouldn't Prednisone be good to reduce swelling & just using it short term? I forgot to mention that I have tried Gabapentin @ 200 mg twice daily but didn't get pain relief. It makes me feel groggy & out-of-it which I don't like.
doctor
Answered by Dr. Olsi Taka (8 minutes later)
Brief Answer:
Read below.

Detailed Answer:
Thank you for your feedback.

Flector is Diclofenac, a drug belonging to the same group as Ibuprofen, as I said before can try but wouldn't expect any miracles.

Prednisone or any other steroid is not effective for that purpose at least not taken by mouth, it's not in any guideline. If oral medication doesn't work then injection of local epidural steroids under imaging guidance can be discussed, that is an accepted treatment, but not prednisone by mouth. And its side effects added to Ibuprofen would be really dangerous.

If Gabapentin was of no help and felt side effects, then no need to retry I agree. As I mentioned before Tramadol is the one pain killer left to try.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Severe Nerve Pain In Leg

Brief Answer: Read below. Detailed Answer: I read your question carefully and I understand your concern. Given your history of spinal problems and radicular pain nerve root compression is well possible. Of the drugs recommended to you, I do not agree with prednisone, not much benefit and high potential of side effects. Ibuprofen can be used, but you should be aware of possible side effects on stomach ulcer or high blood pressure, at your age should try to keep daily dosage at 800 mg at most. Flexeril can be used but not for long periods of time 1-2 weeks. I am not sure what you mean by patch, there are several types available containing medication of the Ibuprofen group or anesthetics like lidocaine. Their effect is only mild though, you can try them, few side effects, but if pain is severe do not expect much. Other options are pain killers like Tramadol or opioids (preferable to be avoided). Also neuropathic pain medication can be prescribed, two major groups, anticonvulsants like gabapentin, pregabalin or antidepressants like duloxetin. I remain at your disposal for other questions.