Help Medication to ease severe pain (neuropathic-like)

[Quarky00]

So I have chronic inflammation in my trigeminal nerve (jaw) , along with mildly receding gums , gingivitis , and a rotten tooth (nerve partially extract) . All together these multiply the pain , although nothing in its own amounts to a clinically "severe" condition , hence I assume the pain is neurological rather than purely nociceptive/injury/inflammation . I can't do all the proper procedures or go to a specialists , but I would appreciate a pain medication that I can order my GP to prescribe .

I'm currently on Paracetamol 5g/day , Metamizole 3g/day , both ease about 80% of the pain ; and if I take small amounts of Alprazolam+Clonazopam I reach a 90% reduction in pain at best . I've increased those dosages gradually over the last few months and I've reach maximum recommended dosage , that's why I'm looking for alternatives . My GI tract is fragile as it is and I don't want to harm it further . I've described the pain elsewhere , most of the time the entire left side of my face hurts (and occasionally numb) . It's hammering through my head . This is currently the main reason I cannot function / get out of bed . I'm also sensitive to sensory stimuli .

• I cannot use NSAID (COX) due to my GI issues , tried and tested several , and they help even less than my current "pseudo-NSAIDs" (which again implies inflammation is not the primary issue)
• I cannot use opioids due to rules at the place I'm at , and risk of constipation .
• I have previously tried medical cannabis , different strains etc , and it causes me to vomit/migraines (paradoxical effect) .
• I don't respond well to SNRI , SSRI , and TCAs ; serotonin ain't my thing

In addition , since I will not be seeing a specialist nor undergo any imaging/test (corona+tired) , I cannot offer my GP to prescribe some rare over-the-top painkiller , i.e. I need something that is relatively common , familiar , or known first-line treatment for severe pain . I will treat underlying conditions as soon as the pain eases further (vicious cycle ...) .

* I think there are quite a few members here with serious neuropathic pain , arthritis , fibromyalgia , etc -- I don't think I reach that level of severity but any insight would be helpful .

 

[Yomyom]

I didn't try them yet but I ordered couple of stuff that should relief pain (but I don't know if it's fit to strong pain)

Chuchuhuasi


Ho shou wu root powder


You can search more about it.
Feel well

 

[nitrogen]

@Quarky00
So glad to see you alive & kicking & being prolific on the forum again, posting graphs that nobody can understand, confusing medication names and numbers, well-organized bullet points, etc.

Love ya!!!

 

[Quarky00]

So glad to see you alive & kicking & being prolific on the forum again, posting graphs that nobody can understand, confusing medication names and numbers, well-organized bullet points, etc.
Love ya!!!

You're really harming your cold-blooded image there, shame . Thanks for the kitten , looks edible & delicious (compensating for you lol) .

Well , it's do or die .(literally)

 

[Busdriver]

Maybe Tramadol? Appears to be a strong pain killer. It seems to be a paracetamol/morphine-hybrid. So not pure opioid.

Your pain is so severe..and you are still alive. How strong!

 

[MartyByrde]

Gabapentin and pull that tooth if at all possible.

 

[Never Free]

So I have chronic inflammation in my trigeminal nerve (jaw) , along with mildly receding gums , gingivitis , and a rotten tooth (nerve partially extract) . All together these multiply the pain , although nothing in its own amounts to a clinically "severe" condition , hence I assume the pain is neurological rather than purely nociceptive/injury/inflammation . I can't do all the proper procedures or go to a specialists , but I would appreciate a pain medication that I can order my GP to prescribe .

I'm currently on Paracetamol 5g/day , Metamizole 3g/day , both ease about 80% of the pain ; and if I take small amounts of Alprazolam+Clonazopam I reach a 90% reduction in pain at best . I've increased those dosages gradually over the last few months and I've reach maximum recommended dosage , that's why I'm looking for alternatives . My GI tract is fragile as it is and I don't want to harm it further . I've described the pain elsewhere , most of the time the entire left side of my face hurts (and occasionally numb) . It's hammering through my head . This is currently the main reason I cannot function / get out of bed . I'm also sensitive to sensory stimuli .

• I cannot use NSAID (COX) due to my GI issues , tried and tested several , and they help even less than my current "pseudo-NSAIDs" (which again implies inflammation is not the primary issue)
• I cannot use opioids due to rules at the place I'm at , and risk of constipation .
• I have previously tried medical cannabis , different strains etc , and it causes me to vomit/migraines (paradoxical effect) .
• I don't respond well to SNRI , SSRI , and TCAs ; serotonin ain't my thing

In addition , since I will not be seeing a specialist nor undergo any imaging/test (corona+tired) , I cannot offer my GP to prescribe some rare over-the-top painkiller , i.e. I need something that is relatively common , familiar , or known first-line treatment for severe pain . I will treat underlying conditions as soon as the pain eases further (vicious cycle ...) .

* I think there are quite a few members here with serious neuropathic pain , arthritis , fibromyalgia , etc -- I don't think I reach that level of severity but any insight would be helpful .

Pretty gross, but didn't go to the dentist in like 10 years. My teeth are really bad. It started in middle school. I had really nice teeth. Never cavities, but then having to go to school with retainer, and losing it, or not putting in after lunch since I wasn't allowed to bring my toothbrush. Figured I'd end up suiciding very soon back then. Now my teeth are awful and I plan to stay round for a while. Scared to go in. The pain, and judgment, and if I needed a lot pulled. Though have used clove oil that was meant for aroma therapy and it's worked really well.

 

[Deleted member 1465]

Maybe Tramadol? Appears to be a strong pain killer. It seems to be a paracetamol/morphine-hybrid. So not pure opioid.

Your pain is so severe..and you are still alive. How strong!

I'd thought of tramadol, but...constipation

The pain, and judgment, and if I needed a lot pulled. Though have used clove oil that was meant for aroma therapy and it's worked really well.

Sorry that's scary stuff. I had an extraction before Christmas whilst under extreme anxiety. LOL and it still hurt, I thought they got the wrong tooth! Clove oil has helped me in the past too, but it tastes awful.

 

[Never Free]

Sorry that's scary stuff. I had an extraction before Christmas whilst under extreme anxiety. LOL and it still hurt, I thought they got the wrong tooth! Clove oil has helped me in the past too, but it tastes awful.
[/QUOTE]thanks, haha I kind of like the taste. I have clove flavored tea, and had clove flavored cigars. Kind of burns at first and numbs my tongue after, but I don't mind. It's quick, and the pain isn't unbearable. Plus it's very effective wonder if those over the counter stuff like Orajel will help. Think many have clove, but the taste isn't as strong. Hydroperoxide has worked ok for me, but only a little. Heard applying an alcohol soaked cotton ball can help.

 

[Quarky00]

Figured I'd end up suiciding very soon back then. Now my teeth are awful

@Never Free , I'm so sorry to hear about that . I was in a similar state a decade ago , so I've been through the same. My teeth were all decaying and black and I though I'd end things soon so why waste the money (I did not have anyway).

I then went into relationship and decided to treat it, well 14 crowns, pretty much all my molars. Cost a fortune and lasted for years (6 years every other week terrible pain). Which added to my anxiety, depression, and stress. I had to work too much and couldn't eat. To make matters worse I was so afraid of breaking up with my abusive ex (shared a flat).... I stayed in abusive relationship several years only waiting to finish the dental treatment Fuck life!!!!


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Gabapentin and pull that tooth if at all possible.

Thanx! I was researching that a bit. GPs can't prescribe it here, need neurologist. So that's pretty much a dead end for me (takes months for appointment, scans, etc). Just to keep that as an option in case I won't kill myself, I'm detailing what I've found. I have found that pregabalin may be better (we can't know obviously), and is given specifically to help "trigeminal neuralgia" (which I don't happear to have clinically but share symptoms closely).

A 2010 European clinical guideline recommended gabapentin as a first-line treatment for diabetic neuropathy, postherpetic neuralgia, or central pain.

Not much info otherwise. The dosage is non-linear , i.e. less can be ineffective while more can cross a threshold and be effective. That's not the case with pregabalin which is linear so effects/tinkering is easier.

The European Federation of Neurological Societies recommends pregabalin as a first line agent for the treatment of pain associated with diabetic neuropathy, post-herpetic neuralgia, and central neuropathic pain. A minority obtain substantial benefit, and a larger number obtain moderate benefit. It is given equal weight as gabapentin and tricyclic antidepressants as a first line agent.

More interestingly:

Pregabalin is moderately effective and is safe for treatment of generalized anxiety disorder. The World Federation of Biological Psychiatry recommends pregabalin as one of several first line agents for the treatment of generalized anxiety disorder.

(1) And particularly, since I am using Benzos, and I suffer from some psychosomatic pain:

It appears to have anxiolytic effects similar to benzodiazepines with less risk of dependence. The effects of pregabalin appear after 1 week of use and is similar in effectiveness to lorazepam, alprazolam, and venlafaxine, but pregabalin has demonstrated superiority by producing more consistent therapeutic effects for psychosomatic anxiety symptoms. Long-term trials have shown continued effectiveness without the development of tolerance.

(2) And even more, since I am using Zolpidem for insomnia:

Unlike benzodiazepines, it has a beneficial effect on sleep and sleep architecture, characterized by the enhancement of slow-wave sleep. It produces less severe cognitive and psychomotor impairment compared to those drugs; it also has a low potential for abuse and dependence and may be preferred over the benzodiazepines for these reasons.

So this would appear to solve 3 problems for me. Anxiety, Insomnia, and Pain. Now I don't know if gabapentin is as beneficial as pregabalin in all those conditions.

TLDR:

pregabalin !​

 

[laserfocus111]

Pregabalin is the precursor to gabapentin. It's much more expensive as well but seems to work better.