Hi

I posted a few weeks ago, and I have been diagnosed with toxic neuropathy in both feet, most likely caused by a lack of vitamins due to excessive alcohol use in the past. While I no longer drink, I have had classic neuropathic pain for a couple of years now while trying to get a diagnosis. I was recently given neurontin and tramadol, as well as cymbalta. I have been taking the cymbalta daily, but didn't notice any difference in my symptoms, still in a ton of pain. I tried the neurontin, and it doesn't seem to have any effect, and from what I can ascertain, it's strictly for diabetic and other neuropathies not associated with what I have. I was under the impression that nothing could help toxic neuropathy and I was doomed.
I was given tramadol, and it cut the pain WAY down. I'm not even taking the maximum dose. I'm not saying I'm pain free, but all of the stabbing pains, the buzzing and stinging seem to have disappeared. I know that it's a synthetic alternative to opiates, with mild opiate properties and could become addictive. Has anyone else had experience with tramadol here? I read a lot of these threads and I don't see it mentioned, although I'm sure it has been. I just had a couple of the best days I've had in a few years, and I can't believe it's working.

All the best,
Brue

I never was offered tramadol. A little late for me because I have been on Oxycontin and Oxycodone opiads for quite some time now, but wish I had been offered trying Tramadol. I hope you get response to your post since I would like to know if this has helped others as well.


Gerry

I was offered this by my ORTHOPEDIST. I have edema, evidently from the neuropathy, and it would go up my lower leg and surround the knee, and I thought I had problems with the knee itself that was causing the swelling. I had gone to the neurologist, and he gave me the nerve conduction study, but didn't make any recommendations, he let my primary doctor do that. When I mentioned that I had PN to the orthopedist, he prescribed tramadol without telling me why. Then I found out that it was used for PN when I asked my primary doctor about it. All the primary had given me was hyrdrocodone, which didn't work nearly as good as this stuff seems to. You might want to try the tramadol, I think it supposedly does a better job of blocking the specific nerve pain than regular opiates. That is, of course, if it will work for your case. It's easy on my stomach, and doesn't have a lot of side effects.

Gabapentin is prescribed for many kinds of neuropathic pain -- not just PN, and not just diabetic-related PN. Whether it works or not is another issue (~1/3). For some people/situations, it works from the first dose, while for others, it must be titrated up, which can take up to several weeks.

That's significant for PN (Is it cutting down the burning pain if applicable?)
Generally, the goal of pain management is not to be pain free, but to restore functionality -- "to reduce the sense of suffering and improve the quality of life".

When taken as prescribed, the incidence of pain patients with no history of substance abuse becoming "addicted" to opioid pain medications is extremely low (<3%). Patients who take them for chronic conditions usually do become chemically dependent, but that is not the same as addiction, and not limited to opioids. Gabapentin produces dependence, as can things like anti-depressants.

Addiction vs Dependence [Disclaimer: Strong Language]
http://www.theangrypharmacist.com/ar...ion_vs_de.html

Definitions Related to the Use of Opioids for the Treatment of Pain: Consensus Statement
http://www.asam.org/advocacy/find-a-...nsus-statement

Drugs that cause physical dependence
http://en.wikipedia.org/wiki/Physica...cal_dependence

It's great that you found some relief. Like gabapentin and other meds, tramadol works for some and doesn't for others. There are ~500 posts mentioning tramadol in this (PN) forum alone. You can find them in the archives using the Search facility.

Best to you too, Brue,

Doc

I have been on neurontin 1800 a day. Neurotin is slow to work I've been on it a year and two months, it took almost a month to work. See I have been on tramadol, it doesn't cut my pain. I mean its like taking a glass of water is how I feel. I take topamax 400, I take Fentanyl 50mcg and Hydrocodone 7.75mg PRN. You should avoid painkillers especially tramadol at all costs cause your body will build a tolerance. Plus Watch Out for tramadol when added with some anti-dependants it causes serotonin sydrome. OK Im just mumbling now.

Hi Brue - I have a bottle of prescription tramadol that I take with me everywhere but it's something I'm reluctant to use. I have idiopathic PN - feet only -and take 150mg of Lyrica a day for it, along with a ton of supplements. If I have a lot I want to get done (company for dinner, when I can handle it -- gardening to do, etc.) and I'm in pain, I take one - usually to help me sleep at night. It does work; the downside is that if I take it a couple of nights in a row, by day three I can barely walk past a level surface without lying down for a nap. When upright, I'm merely groggy and yawning. So - it's great for pain relief but it's something I use only occasionally.

Best of luck with your pain. It's no bloody fun, is it!
Marcia

I started with gabapentin and it worked right away. This was two years ago. My pain has gotten worse and more widespread. I am now on 2700 mg of gaba and started with 300 mg per day. I probably did build up a tolerance to GABA. I am now on Tramadol about 75 to 100 mg per day. I am fairly careful as it has caused nausea and vomiting. I split my 50 mg pills in half. Tramadol has also seemed to work well. It seems like it makes the GABA work better.

I don't consider tolerance the worst thing. I feel the pain relief is worth it. Hopefully, if it happens I can switch to another drug.

I was wondering about the combination of neurontin and tramadol and whether that might work too, but I had trouble holding out for the neurontin to work. I only took it a couple of weeks and it hadn't started working yet, if it was going to work at all, so I went with the tramadol. I appreciate all of this input, have had many dark days wondering if things were going to improve at all.

I was on Neurontin & Tramadol from the start.
Both were Rx'd by the head of neurology at Johns Hopkins in 1999.
I still take it - 300-400mg/day in 100mg doses, but I switched to Lyrica a few years ago when it became available in the US. I work (use power tools at work), & drive a van in the metro area. No significant s/e and major relief from PN pain and symptoms.
I am a believer of the meds 'cocktail' and feel that the combination of the two are much more efficient than either one, alone.

Thanks. Since I found out that it was ok to take tramadol and neurontin at the same time, I am doing that. I noticed that if I added the neurontin, that the pain relief would not only last longer, but it seemed like it was more effective. After initially getting drowsy (on both), I seem to be back to normal pretty much. You all have been a big help here, believe me!