Dave, it is true that ethically one needs to see a
patient to dispense advice.
In a hypothetical situation - with your symtoms - I
would plump for (and this assumes a very sore
patient).
Solpadol cocodamol 30/500 QDS for "breakthrough" pain.
A membrane stabiliser like amytriptilline 25 mg at
night.
Vioxx 25 mg once daily usually in the morning
(assuming no asthma, aspirin allergy etc.)
If this did not work (after say 1 month) I would be
looking at some carbamazepine 100mg BD or 200mg BD
added into this above concotion.
Now, I know that others on the list would probably
go for other regimens (maybe not) but this is what I
mean when I say multimodal analgesia.
Gabapentin is used often instead of amitriptylline.
Remember though, this is an opinion....not dispensing
medical advice over the web.
This has been very successfull in a number of
patients.
I really hope you get this sorted out - I have a
slipped disk at c5/6 and it can be very, very sore -
this above concoction works for me. Chronic pain can
really bring you down after a while, so beleive me
when I tell you you have my sympathy.
(Although, I can adjust what dose and what I take
according to my clinical symtoms at the time - or my
GP can - it comes down to the same thing.
The very best,
Iain
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