pain management issues

nearlybionic

Hi
I haven`t posted for a long time as I have not felt the need to ask for support. I was born with bilateral hip dysplasia and developed osteoarthritis in both hips, which have been replaced. I also have degenerative disc disease in my lumbar spine, and had an anterior interbody lumbar fusion 3 years ago. Since then I have lost 5 and a half stones, tried to walk more to increase my fitness and general y do all the things the docs usually say to do. Regardless of this I am in excruciating pain in my spine and legs , and am probably looking at having further spinal surgery . I already take a lot of pain killers including Tramadol, Naproxen, Pregablin, and paracetamol. my GP can only suggest Morphine as my next step, but as I have tried this in the past and went through awful withdrawal , I am not keen to do this. Can you suggest any other options for neuropathic/nerve pain?
Sorry for long post
Thanks
NB

helpline_team

Hi nearlybionic, thanks for your message on our forum and I’m so sorry to hear your pain is so bad in your spine and legs, and that your current pain medication isn’t helping to ease the pain enough.

It’s understandable if you don’t want to return to the morphine, as like you said, it can be addictive and withdrawal from it can be tough. Opioid painkillers might be more agreeable when administered through a patch on the skin rather than tablets. These patches can be more successful for some people, so if you haven’t tried them you might want to talk to your GP about them. I’ve added some more information on them below for you.

As you mentioned you have nerve/neuropathic pain, often medications such as pregabalin which you’re currently taking are good at reducing this type of pain. Pregabalin is part of a family of medications called tricyclic antidepressants, which given at lower doses can help ease nerve pain. You could ask your GP if you could try a different kind of tricyclic anti-depressant to see if it might help some more. We have some more information on this type of painkiller and other families of painkillers in our guide, which I’ve added below for you to look at.

You could also try talking to the GP about getting a referral to a pain clinic if you’ve not been to one before. These are places where people can be referred to if they have long-term pain which might need expert support.

For nerve issues and long-term pain in the back/spine, some people may want to opt for certain injectable treatments such as steroid injections, nerve blocks, or something called radiofrequency denervation. Our page on managing OA in the spine has some more information on these types of treatments which you can read through below.

Our guide to painkillers: https://www.versusarthritis.org/about-arthritis/treatments/drugs/painkillers-and-nsaids/

Our guide to opioid painkilling patches: https://www.versusarthritis.org/about-arthritis/treatments/drugs/opioid-painkilling-patches/

Our guide on treatments for OA in the back and spine: https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-oa-of-the-spine/

I hope this information is useful and remember you can always talk it through in some more detail with an advisor on our helpline.

Wishing you all the best, Jack – Helpline Advisor

nearlybionic

Hi Jack
Thank you for your very informative reply.
I have previously been seen in the pain clinic, and have had injections into my facet joints and epidural , which had very limited effect.
I may look into the patches- thanks for that information.
I will have a look at the links you have given me to read.
Thanks
NB