At What Point Did You ask For Pain Treatment?
 

Hey Guys

I'm a 24 y.o Guy and I was Diagnosed with Ulna Neruopathy (suspected compression) after I had numbness and tingeing in my hand i was scheduled for surgery when it magically went away! YAY so i cancelled that. Unfortuantly a nerve in my leg decided it wanted to do a little magic of its own, I was spared the tingeing but instead it was replaced with numbness and a lovely burning sensation, more tests have been run to rule out a systemic cause in any case i have a appointment with my neuro in a little over a week and its been painful for a few months now, its driving me a little crazy, its distracting more than anything i'm considering asking them for medication of some description but its not amazingly painful.. just insessent and constant and annoying like a sun burn that wont heal minus the red irritation.

So back to my topic, at what point did u decide to ask for treatment?, cause i feel a little silly because some people have it so much worse :/

Thanks for any input

Grant.

It may not help but I didn't ask. My Doc prescribed me the Lyrica. It was day 3 of my sudden onset of undiagnosed suspected PN. That was 3rd Jan 2014.

If it is only "distracting" then it is not time for medication. IMO

Mine is way more than distracting, but I have not given in yet, but I am not dissing anyone on medication, and one day I may/will give in to medication. My thought is, as long as I can get by without it I will. I am young and I believe once I get on it, I wont get off it and there are too many side effects to deal with and the dose has to keep getting upped.

I wont live in misery or pain but as long as I can manage it through life style changes, diet, and supplements, then I will.

I am usually an advocate for aggressive pain management as it can be so important to having any quality of life, but as we are discussing about Gabapentin in another thread, all of these medications carry some drawback. Long term use, and if your neuropathy is permanent so will your medication be, can cause memory loss. More aggressive pain killers may need to be titrated up and can be a problem for some people, as well as not being very effective for some neuropathic pain. It can be a long trial and error period to find an anti-depressant that helps the pain and those have many side effects as well.

I am not trying to discourage you from seeking relief, only saying that is it is truly just uncomfortable and distracting rather than painful you are wise to wait. There are a number of over the counter remedies and supplements that you will find here which may help the symptoms, or even aid recovery if yours is treatable.

If and when you find that you would benefit from pain management, almost any doctor would agree to trying Gabapentin. It is considered to be very safe and they are comfortable writing a prescription for it as it is non-abusable, and is the first line treatment for neuropathy. The next step is usually an anti-depressant, and later a pain medication if necessary. If they follow this protocol with physical therapy and other treatments as indicated they have covered themselves.

Many of us here do experience considerable lessening of the burning and electrical zapping with Gabapentin. Some of us get similar results from supplements such as R- Lipoic acid.

No one can decide for you whether it is time to treat the pain, but the longer you put it off the longer up you put off the side effects. Pain that disrupts your life and your mood, however, should be treated.

Actually there is some evidence of abuse potential.

its very hard to describe honestly, it feels like when you have a sun burn and you have a hot shower and the pain is very dependent on what position i'm in, like laying down it hurts the most while I'm walking it tends to go away a bit. when I'm bored its SOOO annoying because all you can do is focus on it. luckily the numbness isn't nearly as noticeable as it was in my hand, obviously because you have less to feel. OTC pain medications are absolutely useless which is a shame but like i said i occasionally suffer form a actual wound and i'm reminded of how bad it really isn't. the most annoying part is when the pain spikes and it feels like being pricked with a few needles which happens in a few private situations

So at times i'm fully up for medication, however as the first responded pointed out side effects can be an issue, also i'm already on a couple medications for some depression and anxiety issues, so it'd b adding to a list of medications
argh complected situation because at times especially when im bored and depressed all i can do is focus on it, but i've also read that treatment is occasionally partially effective :/

It also sounds--
 

--barring any obvious causes of nerve compression, such as certain heavily-engaged in exercises/athletics or blunt trauma, as if you could use a more comprehensive work-up to see, yes, if there is something more systemic going on here.

There are certainly systemic causes of neuropathy, many of them autoimmune or nutritional, that may present as multiple mononeuropathies that may wax and wane over time and show up in different body parts.

You might want to look at the following sites to get a sense of the many different possible causes of neuropathy and the testing that might be involved; I suspect you've likely only had a fraction of these tests as it takes real specialists to be familiar with many of them:

www.lizajane.org

http://www.questdiagnostics.com/test...ripheralNeurop

Oh i'm already under the care of a Neurologist :), unfortunately the appointments are few and far between :/ last time i said my ulna nerve was healed and there was a slight pain in my leg that tended to go away had some follow up tests blood tests and a never conduction study (again) :/ the pain got a lot worse than it was during that appointment, always when you go 2 get something fixed it always fixes itself haha

blood tests as far as i know, showed sub-clinical hypothyroidism, ruled out the autoimmune disorders they tested for and liver function is fine, however they didn't test kidneys and it was far from comprehensive, pain management aside i would like to know why my nerves arn't playing nice with me :P

I completely get the sunburned feeling, it is a good description, several of us suffer with that and I am on pain medication and have not found that it helps that symptom. I get severe shooting pains in my legs from muscle atrophy and the medication helps with that so I can walk and function, but it doesn't touch the burning feeling.
You are so very young, I would try not to take any medication for now and concentrate on finding a cause, as Glenn suggested. Also, video games have been found to help with pain by offering a compelling distraction. I know my son who is your age finds them a great help in coping with pain and psychological issues. Is this something that you enjoy? Are you able to play? I cannot for long because of hand issues, but find that while I can I forget everything going on.

Nerve conduction studies are notorious for stirring up the pain for a few weeks. Does anyone in your family have neuropathy?

oh yeh when I find a video game I like it defiantly helps the pain! being that engrossed in something virtually eliminates it for the duration of the activity :)

[QUOTE=Susanne C.;1050308]
almost any doctor would agree to trying Gabapentin. It is considered to be very safe and they are comfortable writing a prescription for it.

The primary doctor, podiatrist, and neurologist that I saw regarding burning pain on the soles of my feet all seemed not only comfortable, but even eager to give a prescription for gabapentin. With my pain being limited to one specific area, I found it disturbing that their solution was to offer a systemic drug that is effective for only a minority of patients, and has a lot of potential side effects. From info gained on this forum, I asked the last doctor for the lidocaine patch, which turned out to work adequately. There are various topical creams, lotions, and patches, which you can read about by searching the forum.

Hi Grant,

On one hand, many doctors won't prescribe any kind of treatment unless asked, because they feel if a patient doesn't ask then they don't need it.

OTOH, if/when it comes to pain medications, doctors are hesitant/reluctant to prescribe if asked because they may think the patient is 'drug-seeking'.

IMO, the time to ask/seek treatment is when pain/symptoms interfere with your ability to function—inability to sleep, do your job, take care of self & family.... In these cases, it's best to talk to your doctor about the symptoms and the effects they are having on your day-to-day life, and ask the doctor if there's anything that can be done to help. Then a variety of options are open to discussion, and any decisions about prescribing are left up to the doctor.

How to talk to your doctor about pain

One thing to be checked (if they haven't already) are certain vitamin levels—in particular, B-12 and D. With neuropathy, you want your B12 above 400 pg/ml (regardless of what they say is normal) and preferably much higher.

In a perfect world... Most everyone coming here wants to know that same thing (self included). Unfortunately the reality is that somewhere (depending on how the counting is done) between 40-60% of neuropathies are deemed idiopathic. Hopefully a cause can/will be found, but regardless, you still have to live with & treat what you've got for now.

As has been pointed out distraction is often the best pain med.
distraction pain medication
but distraction can only go so far, and isn't very helpful at night while trying to sleep.

IME, the numbness, tingling, jabs/shocks are going to be difficult to treat (at first, anyway). Some of the prescription meds can alter your brain chemistry and be as difficult (or worse) to get off of as narcotics. So for the burning (and other pain if applicable), I think the preferred route is trying the supplements first, and save the prescription meds (gabapentin, pregabalin, antidepressants, pain meds) for 'plan B'. I've had really good results with R-Lipoic Acid (killed the burning completely) and then adding Pantothenic Acid (vitamin B5) later, which along with the RLA helped most of the zapping. But like the anti-seizure meds (gabapentin & pregabalin) RLA doen't work for everyone. If there were something that worked for all of us, you can bet we'd probably all be on it.

Doc

Did your neurologist talk to you about trying any of the meds like Neurontin or even since you stated you deal with depression Cymbalta which can help with nerve conditions but depression too? When I first got dx my neurologist started with meds like Neurontin etc. Then I went to see a pain management doctor and have seen many since then. For myself the pain management doctors have not only tried to treat the pain but also tried to identify why I have this and other diagnosis that could have been missed.
Often pain doctors work not only with meds but encourage you to see a therapist/psych to deal with the mental impact the pain has, physical and occupational therapy, other therapies that could help too.

Having doctors you trust and know over time also helps. I live rural and our DR knows us quite well. They also know we normally use medication as a last resort and expect to be told the facts even if it is we are being paranoid so we often get told to take it before it gets to the point where we can't stand it. My DR pointed out with a back injury that waiting just meant that the pain relief couldn't block the pain requiring a higher dose.

If you can't talk to your DR then they are not for you and if possible finding one you are comfortable with makes all the difference.

I would agree if you don't need the meds keeping them as plan B is worth it but not at the cost of quality of life.

I grew up with a chronically ill mother and watched her deal with heavy medications for 17 years. She had to go through the trouble of her body getting used to the pain meds and sometimes addiction requiring them to have to switch her medications. We did have the best medicine cabinet I ever saw though. Even the paramedics would be amazed when they came to take her to hospital as we were better equipped than them let alone an 8 year old being capable of pulling the right drugs out and laying out bandaging, catheters and so on in order they would be required. We were never allowed to prep the injections.

:Good-Post:

Doc

Grant,
One bad thing about starting on drugs is that, if they give you relief then you become complacent about trying to pursue actually healing your condition. There is the temptation to go back to life as usual.

If your symptoms are 'tolerable', whatever that is for you, then I urge you to continue pursuing a cause for your PN and attempt to reverse it, or at least manage it, with exercise, a healthy diet, stress management, supplements, and maybe certain foods that you find to help. And for me, a healthy diet does not mean switching from beef to chicken, or eating a smaller portion of pizza, it means eliminating animal products and loading up on fresh vegetables (especially leafy greens), fruits, legumes, and whole grains.

If you get to a point where you cannot function normally (school, work, etc.), you are just miserable, or your relationships are suffering, then I think it is time to get on some medications.

You have found a good group here, so just keep posting your thoughts and you're sure to get some good feedback. Good luck down there.
Ron

Oh don't worry my neurologist is still running tests and stuff, we'll see what happens in that regard, i'm praying that it's something simple! not sure how i'd be able to handle something progressive