Do More Pain Meds, Cause More Pain??
 

I hear this from an MD who leans holistically, on the radio...I think about this and do more pain meds, cause us more pain? I work to keep my otc pain meds to a minimum as best I can, I've worked on this and take a couple supplement pain meds in between the ibuprofen.


There is a lot of information on this issue, and something to think about...is what we take for pain, causing more pain. Here is just one informative link on this:


http://www.healthcentral.com/chronic...86/drugs-pain/
Aug 6, 2012 - Unfortunately, some commonly used drugs can cause pain/ ... you are also using a caffeine-containing medication more than two or three times ... by taking Acetyl-L-Carnitine (1000 mg three times daily) which can protect your ...

Yes, it is true.

You can find more information by searching Google using keywords:

"glial cells and opiates"

There is quite a bit of information accruing in the past 5 or so years about opiate tolerance in the brain.

Yes they can.

e.g. Rebound headaches or medication overuse headaches are very common and that includes otc meds like ibuprofen.

Caroline,

For some of us they are necessary just to have any Quality of Life. I have never had any issues with my meds causing MORE pain, rather my visible deterioration corresponds to increased strengths and new meds for my different conditions. All my treatments come after onset of symptoms, usually by years - I tend to let things ride (even colorectal cancer for 3 years due to embarrassment).

My pain meds stand at:

Tramadol/Morphine/Arcoxia for severe musculoskeletal pain and arthritis. Causes, crushed vertebrae and multiple MVAs, sports wear and tear on joints. Arthritis in hands, elbows and knees, probably in neck - but it is SO battered…

Lidocaine Infusions/ Oral Ketamine for excruciating Neurological Hypersensitivity - probably triggered by spinal injuries and neurotoxic chemical exposure in the '80s. TN and chronic Neuropathic Facial Pain/Paresthesia. Compressed Spinal Cord (causes extreme hand, arm and leg numbness and pain).

Topiramate for chronic Cluster Headaches, Attacks running about 5 a week at present. Cluster Headaches are not Rebound headaches in the same way as having your arm ripped off at the shoulder is not a paper cut (just for clarification). Topiramate has the advantageous side effect of dulling most Neuropathic pain by 1-2 points.

I do not self-medicate, I have a great PM Doctor - a Consultant Anaesthetist - who does not rely on Opiates, hence the Lidocaine/Ketamine. Without my current level of treatment Life would not be worth the struggle.

Dave.

The majority of tolerance to OPIATES... involves the brain's glial cells stimulating the formation of new, more numerous receptors.

NSAIDs as a rule do not cause tolerance this way.
NSAIDs used constantly (over about 6 wks) will then block any healing attempts at the tissue level.
NSAIDs in the short run block inflammatory cytokines which can cause pain. In the long run some Cox-2 cytokines are involved with healing so LONG term NSAIDs result in damage.

These issues are reflected in studies over that past 10 yrs or so.

MrsD,

I know we have had the Cox-2 advice from you before, and I would love to come off it. But in my self-imposed annual meds break (Arcoxia first) my joints became ridiculously inflamed, and my neck was so bad I became even more nauseated. I have tried swapping to a Cox-1 in the past with the same result.

Taking Arcoxia means I am permanently on Lansoprazole to protect my stomach as I have had bleeding and perforated ulcers in the past. Without it I could stop, or at least cut down.

Regarding the Tramadol/Morphine. I do not have the problems of tolerance or physical/psychological dependence. Probably because of my other meds?

Dave.

All NSAIDs cause cardiac damage over time... both Cox-1 and 2.
They cause constriction of blood vessels. This may or not be counteracted by your diltiazem mostly or in part.
Your Arcoxia is a selective Cox-2 blocker, and has little effect on Cox-1... Cox-1 blockade is the damaging stomach portion.
However, you face a substantial risk of ischemic blood vessel disease from it.

Lidocaine is a sodium channel blocking agent, which prevents sodium from moving in and out of the cell with potassium which generates a neurochemical electrical pulse. Hence it is numbing.

Ketamine is an NMDA antagonist, affecting glutamate at the NMDA pain receptors. So it won't have that glial response that opiates cause.

It is only the opiates (acting on mu receptors) that show the tolerance and increase in receptor counts that we know of at this time.

I have overall body pain, except above neck. But my issues are not like your's Dave, I know the hip replacement in 2010, has left me with more of a mess of pain issues from a major body alignment SHIFT.....taking out parts, putting in metal and plastic,,,,ugh...I had high hopes I was doing the right thing, but dealing with the mess.

I know the dosing of MSM thru the day calms my pain and pushing myself today to go out for acupuncture, we have a clinic here and they are good and reasonable. Acupuncture does help, but one needs to stay with it.

We do our best... thanks for the good overview MrsD....C

I have Lidocaine patches that a friend gave me, and I don't use them, I tried, they did nothing for me.

If one can afford this work, PRP (platlet rich plasma) injections can work to regenerate our joints...I don't have much extra money so this is a tough one for me ... I did have dextrose prolo years ago on shoulder and it gave me 3 yrs pain free shoulder...it's the lowest price prolo...insurance does not cover these prolo injections.

MrsD,

Sad to say I already have ischaemic heart disease and microvascular disease. The first was the cause of my heart attack in '08, both cause major chest pains without the Diltiazem. Glycerine Trinitrate Spray immediately triggers Cluster Attacks.

I became Brady Hypotensive during an angiogram, then during a chemically induced Stress Test. Like everything, I'm afraid, my heart is a balancing act (except statins - full bloods being done on 12 June, so I can go in armed with figures).

My heart problems predate my Arcoxia use, but without an anti-inflammatory I would be TOTALLY immobile.

Dave.

Well, at extreme times people do what they have to do.

I am only pointing out how the drugs work. Arcoxia is not approved in the US, because of its potent Cox-2 actions. We had Vioxx here, which was quite a huge scandal, as Merck concealed the damaging information from doctors. I don't expect to see another Cox-2 type NSAID here for a LONG time.