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Had painful disc rupture. MRI shows L5 S1 rupture. Taking hydromorphone. Will gabapentin or pregabalin be more effective?

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Hello I am a 42 year old woman who is traveling in NYC, I have experienced a very painful disc rupture 10 days ago. Had MRI to confirm it's my L5 S1. Neuro has recommended minimally invasive procedure as I am in a lot of pain and almost completely bed ridden. However I think I would like to get home for treatment in Sydney as has also been recommended via Australia that it would be good to give it a month if at all possible to see if it can settle before any surgery. My problem is the pain in getting on a plane. I can't sit and can only hobble from one room to the next, at this stage of pain I can't get on a plane. Also I've been given Hydromorphone as my pain relief but it's really not working at all, I've been recommended via friend of friend Dr that' it's not the best pain relief for nerve pain that Gabapentin or Pregabalin would be far more effective for this kind of pain. What do you think? Thank you
Posted Fri, 9 Aug 2013 in General Health
Answered by Dr. Alekhya 2 hours later

Thank you for choosing healthcare magic for your query.

L5 - S1 disc rupture will be least affected with medical therapy and little affected with epidural injections (cortisone). The best pain relief can be obtained with surgery(microdiscectomy). Since you are planning the treatment after awhile, gabapentine or pregabalin (as your friend suggested) can be useful.

Please be aware that these drugs are associated with side effects. Hence do not start them without your doctor's guidance.

Hope I have answered you question.You can ask if you have any followup queries.

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Follow-up: Had painful disc rupture. MRI shows L5 S1 rupture. Taking hydromorphone. Will gabapentin or pregabalin be more effective? 1 hour later
Thank you.
I understand you think the best pain relief is microdiscetomy but I have also
been told that a lot of ruptures can settle over time and not need surgery. What do you think? I am unable to get surgery in the States as my travel insurancers are being very difficult.
And could I do it any further damage by traveling on a plane as I will be flying for 15 hours. I know I will need to upgrade to a flat sleeper seat as can't sit without bad pain.
Do you think gabapentine or pregabalin would relieve the pain enough to travel?
Thank you

Answered by Dr. Alekhya 3 hours later

Thank you for followup query.

Without an opportunity to examine, I would be unable to predict if it will settle on its own. However disc ruptures can settle spontaneously without surgery.

Any form of travel is restricted in the presence of back injury. However in your case since travelling is essential you can discuss with your current doctor about the travel plans. And yes, take good precautions while travelling.

Gabapentine is more than useful drug in such condition. I hope you will find beneficial results. The dose of the medication needs to be adjusted weighing the benefits and risks

Hope I have answered your query now.

Wish you a safe journey and a good health.

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