Disabled Talk

painkiller options for ppl with chronic pain conditions

bananapeppers:

I’m writing from a chronic fatigue syndrome (myalgic encephalomyelitis, post-viral fatigue syndrome, chronic fatigue immune dysfunction syndrome) perspective. CFS is associated with the following localized and/or widespread chronic pain symptoms: muscle pain and soreness; joint pain, soreness, and stiffness; nerve pain; headaches; migraines (also migraine without headache); abdominal pain (and irritable bowel syndrome); chest pain.

I am blessed with 24/7 access to a massage recliner, and even so, my bod hurts. all the time. searing pain, nauseating pain, nebulous pain, minimal but i n c e s s a n t pain.

analgesics are divided into categories of mechanism, strength, and whatever (and these days, narcotic is primarily a legal term, not a pharmacological class. when people refer to a painkiller as “narcotic” they usually mean “opioid” or “addictive”):

• non-steroid anti-inflammatory drugs (NSAIDs) are available over-the-counter and treat mild pain. common NSAIDs include aspirin, acetaminophen/paracetamol, ibuprofen, and naproxen. they’re not addictive, but taking too many at once or over an extended period of time is bad for you, so don’t do that. aspirin especially thins blood. ppl with liver problems, kidney problems, heart problems and blood disorders need to discuss NSAID/aspirin use with their docs to weigh the pros and cons. womp womp I got my wrist slapped for relying on acetaminophen.

• these are not analgesics per se but they have that effect and therefore are used for chronic pain. they’re actually the first choice for chronic pain because opioids are do not fuck around with opioids.

  • SNRI (e.g., Cymbalta) and tricyclic antidepressants
  • antiepileptics e.g. Lyrica
  • muscle relaxants sometimes

why am I even attempting to flesh out the WHO’s pain ladder when there’s a rung-by-rung breakdown on Wikipedia and here and look at all of these pain ladders.

like I would like to discuss painkillers with one of my many doctors but I know that I am not going to like my options. I do not want to begin an SNRI like Cymbalta because I was on Effexor XR for three years and lost both my appetite and my libido. I have told my therapist and primary that I absolutely should not go back on it because of the likelihood that I would relapse into a restricting-type eating disorder. plus my sex drive. I like that thing. I do not want to go on an opioid or some of the antiepileptics because my father is is addicted to/abuses them and I worry that (1) I would become addicted +/or (2) my father would discover that I am on an opioid/select antiepileptics and steal them because he has stolen my medication (which I needed for a condition [that he knew about]) from me before (it was Ativan then).

ok that leaves some options between tricyclics and the rest of the antiepileptics. cool, good.

bah

help??

Reblogging for good discussion of chronic pain management & medications, and so followers can add their own experience and expertise!