OA and a bit mystified with gp

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  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    i just spotted this, so i'm not sure if i been to this site before:

    Trying to "walk through the pain" can cause a mild case to become long-term and debilitating. In my case, being gentle on my feet for several months until there was no pain and then very slowly and carefully increasing activity was the key. Since rest is the highest rated treatment, I believe many others have had a similar experience. Unfortunately many have jobs that require a lot of time on their feet which may prevent time to heal. The condition is well-known to be "cyclic" in nature. Just when you think you are getting over it, the pain often comes back in full force.

    The most common complaints about doctors is that they do not seem to understand how terrible the condition can be, or that doctors make the patient feel as if they are unusual or otherwise at fault for showing up in their office with heel pain. Several have reported orthopedic surgeons find heel pain boring, difficult to treat, and unrewarding. Since heel pain is a mainstay of podiatric practices, podiatrists probably feel differently.
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    i don't quite get the reason for precribing something for one thing and being used for something else totally, even if by accident.
    the whole purpose from what i see is adding onto something unecessarily. or in some cases, cyclic.

    an injury would make someone depressed, then they learn to try and cope or learn to live with it, but often are depressed because they cannot function, which is understandable.

    it could be a case of hurrah the sciatica has gone but i am now more depressed than i was in the first place. so, because they become depressed by the tablets, they once again cannot function and have to go through the whole process of being treated for something they may not have had in the first place... aaargh

    if sciatica is caused by something in the back, just what on earth is the relationship by that and something in the brain... or am i missing something. i know stress causes bad backs. then again, the legs can go when someone has a cold or swollen glands.

    i've always argued in my case it could be a case of overdoing something. walking and standing was common place in work, over use of muscles etc over the years. just like what was said in the site, many have jobs that require a lot of time on their feet which may prevent time to heal.

    and maybe a cange of scenery could create a condition. maybe someone who was used to manufacturing etc, finished that work and either the body cannot cope because they become unemployed, or a change of work type which involves sitting down, office, computers etc, so the extreme opposite occurs
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    my arguement was that that i told them that as soon as my foot touches the floor, that's it. i feel the concrete... maybe it has something to do with walking in hard concrete floors for years...

    i kept on telling them that i feel a line going across the foot at times rather than down the plantar.. and the source seemed to be any pressure on the ball of the foot sets it off. but it wasn't quite in the centre of the ball, it was a tiny fraction just before it, underneath it, around where the plantar ends and joins the ball.

    anyway in 2009, a specialist put his thumb&finger there and pinched it, i reacted in a small jolt....and he said 'i don't know what's causing that'.

    specialist??? if he doesn't know, find out.. that's what they get paid for
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    Plantar Fasciitis and Heel Spurs

    http://heelspurs.com/_intro.html

    But, probably the number one cause of plantar fasciitis is lack of flexibility in the calf muscles.

    over exertion could tense the calves. or even under use.

    Sciatic nerve problems (sciatica) usually cause pain in the buttocks and back of the upper thighs, but the pain may also appear very low in the back where the pinching of the nerve begins and in the heel area where the nerve ends.

    so, why has the gp prescribed me amitrip again???

    was the osteoarthritis present and dormant before 2006?
  • Boomer13
    Boomer13 Member Posts: 1,931
    edited 30. Nov -1, 00:00
    so, why has the gp prescribed me amitrip again???

    Because the pinched nerve in your back is producing chemicals that are designed to excite the neural messaging system through your spinal cord to your brain. Amitriptyline slows down the signaling by blocking some of these chemicals before they travel to your brain to tell you your "X" is hurting.

    The doses prescribed for pain are much less than those prescribed for anti-depressant effect. Your GP likely wants you to keep on them because they work over time to slow down the entire pain-feeling system. So, not really for the anti-depressant effect at all. There are many drugs like, anti-rheumatics, anti-seizure medications, anti-depressants that have other medicinal effects that have been found to be useful for other medical problems, other than the one they were developed for.

    I'm not sure about your oa being present before 2006, but it seems likely to my mind. It was likely a process at work for awhile before enough damage had been done that you began to feel symptoms.

    Just my humble opinion though. I'm just a regular person; no medical background other than what my disease has made me learn.
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    hi.. from what i see, all the amitrip is doing is covering it up. i know what you mean, personally i would prefer something that goes straight to the back/spine rather than messing about upstairs in the head, because soon as i saw that you may feel like throwing yourself under a train bit, that causes worry and wonder what is going on.. you're not supposed to get extra depression on top.

    what i noticed today, because i was on 30/500mg co-codamol and even though it was causing some some small changes like tightness in arm, a thick head, i can feel everything else underneath the sensations the co-cod does. now i am on 5/500mg, my body is starting to feel a craving for the 30 and feels like something is missing, and the amitrip or maybe just the reduced co-cod is waking me up earlier than usual. before, if i got up say 5am, i go back to sleep. now, if the same happens, it feels like the tabs won't let me go back to sleep and it catches up later.

    in the afternoons especially with the 30mg, i would feel tiredness in the face and eyes then starting to fall into deep sleep. i haven't felt that with the 5mg yet, but saying that i feel light sleep coming on. maybe it's because it's a warm day and the heat is irritating. In a way, it's confusing cos i don't know if it's the sun or the tabs doing it.

    i'm not really the type for tabs that mess about with nature or the brain that alters the mind, and tricks the body into thinking things are ok when they are not. if that is the case, everyone would be on magic pills but they are not that magic as they are messing about by chemicals.

    what could happen is, that because it's blocking out the pain signals, it has an affect on something else, like being unresponsive to other situations. i would rather be the real me happy/sad by nature and endure pain than a false me and feeling less pain but feeling false emotions created by the tablet, or even blocked emotions.

    end of the day, if the back if fecked, it is fecked. if the leg has sciatica, it has sciatica. if the foot is fecked, it is fecked and that's all that there is to it. there is a reason why the foot is not good and if there was a way to make it as comfortable as possible, do it. same with the sciatica and spine. all the tablet will do is mask the pain, but reality is it's still there floating about underneath :(

    if i wanted to go to the shop pre-tabs, as my routine was limited to wednesday and saturday, and i wanted something on tuesday, i would go without and wait until tomorrow as i would know that walking to town two days in a row is bad for the conditions. if i was completely out of milk or bread, maybe i would do it. other things could wait a day.
    and most times i do not feel like going out anyway even if it my shopping day. but as i know the shopping time is socialising time and getting out for a breather. most times i would go to the shop even if the pain was more than usual, just an endurance and feel like krap when i get back.

    what i do not want is some chemical interfering with my nature and changing it (if that makes any sense). i do not want any mind altering drug making me feel i do not want to go out when previously i would have gone or even in the case i do not want to go out. that was my nature, my brain telling me not to go out. and if this amitrip starts playing up with thoughts and interferes with nature, that's not going to do any good at all and create confusion of it comes to it. and maybe the amitrip wi;ll end up telling me to go out when i have no need to go out.

    confused? ... if amitrip is something that replicates normal behaviour and convinces the body everything is hunky dory when it's not, i would say that's a false perception. next thing it'll be telling me that there is no osteoA, you're spine is fine, go and do things a fit and normal person does, ie, the things experienced pre-conditions.

    a leopard does not change it's spots. a tiger has it's stripes (unless it's a white tiger). i'd rather get my happy emotions from reading a book, or chatting to someone, or watch a film, or simply by going to the shop. and get sad by the endurance of the conditions.
    i don't want to be artificially happy by some tablet creating chemicals in the brain and sending false signals :(
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    lets look at it in another way, why the amitrip at all if the co-cod was sufficient? why not have the amitrip on it's own.

    i like to know the ins and outs of something before i start taking something. going back to the gp, isn't it their job to explain was the tabs are for first before dishing them out like skittles?

    half the time pre-tabs, i would like to go and do this and go and do that, but i can't.. not won't, can't..... and when you get people saying there is not such word as can't, i avoid that now as i think they don't know what they're banging on about... like the old saying is, i know my capabilties are and i do not want any tom, dick or harry telling what i can do.
    if i can't go for a 4 mile treck up the mountain, i can't...simples

    wish i could go up the rec, put on a pair of football boots and kick a ball for small excercise, i know i can't cos it'll mess up the leg as a precaution.

    then again, if something needs doing in the house, such as the kitchen floor needs cleaning, i do avoid it because i do know that bending down, crouching down will aggravate things, and i will get annoyed with myself for being a failure. so, i try bit by bit, even if it takes a week to do it.

    i really like to know what i am letting myself in for before taking any tablet, especially one i don't know anything at all about such as amitrip :(
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    I've never gone down the amitrip route (and never will) for the following reason: the stronger the pain relief the more you are removed from the pain, not vice versa. The pain will not disappear, it will not go away never to return because pain is the moss, dandelions, Japanese knotweed and ground elder of our lives. Once it's there it's there.

    I have been in pain for over seventeen years, once it was just the one joint, now it's from head-to-toe. So what? I have two forms of arthritis and this is what it does. I can't be fixed but I can be helped, that is what my rheumatologist and GP are doing to the best of their abilities. They don't have much in the way of answers because those don't exist; arthritis is a stubborn and mysterious beast of a disease and its ubiquity doesn't help.

    Oddly enough, none of us on here like the situations we are in, that doesn't only apply to you, but you do seem to be taking this very personally. Arthritis does not respect us or what we think our rights about life should be. End of. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Boomer13
    Boomer13 Member Posts: 1,931
    edited 30. Nov -1, 00:00
    John, I understand what you are saying. I went for several years without taking anything for pain because I value my clear-headedness more than just about anything. I think it comes down to a person decision about what you can tolerate. For myself, I just became so irritable and anti-social, just lying around all the time, that I have to take pain meds even though I hate the mental effects. Being able to move a bit and sleep now is preferable. I don't like it, but what else does one do?

    I haven't taken amitriptyline so I don't know how it affects one mentally, but I do take gabapentin, and various others. Over time I seem to have become used to the effect and as long as I don't have to take too many in a day, I can be pretty functional. I've reduced meds on a few occasions and seem to have more ill effects on brain and emotions from my illness, not the meds.
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    hi guys, i haven't been on since the last post. at the end of the first two weeks of the amitrips, i hold my hand up and say, what the heck is going on? i don't know if it's the amitrip that is causing the problem or the co-co's. i feel more agressive now than i was before taking them.
    the first co-cos were 30mg now own to 10. feels like a type of headache you get after a few lagers or something.

    whichever one it is, the only thing i can describe is like if the 'system' has tightened inside, and getting acutely irritable rather than a normal irritation. and a further increase in pain level when going to town but not so bad indoors. Maybe the leg is feeling more tired because the tabs are making me more tired and can't take the strain.

    what i haven't noticed since is the heavy nodding off for no reason in the afternoon. and the amitrips is making me not sleep enough. instead of a gradual waking up, and if i was a bit tired, i'd go back to sleep for another 5 or 10 mins. now with the amitrips, as soon as i wake up, i'm up and i can't get back to sleep for 5 or 10 however hard i try. they won't let me

    what else? the strain in the arms is still there so im saying the co-cos is doing that, but somehow the feeling of 'depression' is not as deep as before. and that could be down to the amitrip. if i feel i need to be annoyed, the amitrip won't let me. bit of a swell in the glands, but i used to get that when stressed in the past and when, or when working at pace.

    it may sound strange, but if amitip is trying to produce normal endorphins and trick the body into thinking there is nothing wrong, i'm pretty well sure that the part of the brain already knows that something is wrong in the first place with the foot etc, and there maybe a conflict going on.

    if part of the brain is telling you to slow down and relax cos it knows something is wrong, and yet at the same time the amitrip is trying to tell the brain nothing is wrong and get up and go.

    slight digestive problems, a sense of need to become normal. and repressing or supressing annoyance, or 'angry'
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    diasy, i think you are right there. you know what i am remembering from hospital visits? when i was going to the podiatry, i was remeber the reumatology direction sign. and it always go my thinking why hasn't anyone referred me to them for a chat.

    my gp isn't interested in what's happened in the past, now is important. what got me thinking the other day, not only could it have manifested through wear and tear over the years at work, but all those cold and damp winters shivering in work. somehow the body kind of adapts to conditions but there are limits. when spring and summer came, things went back to normal.

    i agree with you, pain is always going to be around floating about underneath it all. maybe there is a twist in my leg.

    what else i noticed is that the paon on the spine seems to be number or duller than usual which is a bit more tolerable than before the co-cos
  • stickywicket
    stickywicket Member Posts: 27,697
    edited 30. Nov -1, 00:00
    I'm sorry I can't help, John. I've never taken amitryptiline or higher dose cocodamol, only the very lowest so I've no idea whether or not not what you are experiencing is related to them. I hope you feel better soon.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    boomer, gabapentin is meant for seizures as in epilepy, but is used for neuropathic pain, similar for nerve pain as amitrip does.
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    tbh, i have to agree with the pychological side of pharmaceuticals. it's quite hard to explain how i feel with amitrips, the closest i can think of is they are trying to make me feel normal, and in an odd way, it reminds me of how i felt at the end of a working day when you get home, tired and sleepy. i don't know if it's also used as a relaxant, and if it is, it's making me feel not to do anything at all by making me feel tired.

    this week i'm meant to be upping the dosage to 3.. stared off on 1 before sleep, week two 2 before sleep.. and ending up with 5 in week 5... yikes
  • johnsouthwales
    johnsouthwales Member Posts: 58
    edited 30. Nov -1, 00:00
    what i feel the gp doesn't understand at all is if amitrip produces endorphines, the other pressure from the dwp is counter productive,. i know i have to take it in my stride and wait for the tribunal, which could be another 3 months, so the additional stress from dwp etc is present as well.

    in a way, amitrip is suppressing the emotional problems. after getting over the intitial suprise of being passed fit for work and losing £36 a week which is causing a lot of problems, i don't feel annoyed or angry because of the amitrip. otherwise i would have been tamping.

    i really don't know where i am going with these. i can read the internet about the consequences but i do not know exactly what is going to happen until i take them. maybe i carry on this week and if it gets worse, i'll leave a note for the gp for advice