Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Remedies For Chronic Pain Syndrome
Question: I suffer from agonizing intractable pain, the result of 27 fractures of major bones. I also suffer from "mal-absorption" a result of acute and chronic reflux disease. Oral opioid medication provides hardly any relief. I have experienced relief to a pain level 5 via use of intravenous morphine (4 mg every 4 hours) with a supplement of morphine sulfate (30 mg every 12 hours). I have no active life right now due to fighting pain. I sleep in increments of two hours only to be awakened by pain. Can you help me? In the dosages I mentioned which worked, I am able to conduct a satisfactory, productive life. I am 65 years old and have been disabled since 1989. Thank you.
Brief Answer:
Nerve blocks and Intrathecal pumps may help.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
I have worked through your query in detail.
You possibly seem to have Chronic pain Syndrome of Non Malignant Origin.
Since you have been taking a very high total dose of Morphine , almost 85 mg / day, further dose escalation is not advisable.
Instead I would like to suggest you two important alterations.
1.Addition of an antidepressant medication( which reduces the need for higher doses of options medications like Morphine and increasing the pain threshold).For this, I generally prescribe 50 mg daily at bedtime for 3 months.Further dose changes can be made based on the response.
Please check with your physician if he shares my view and if can prescribe these pills to you.
2.Additional procedures for adequate pain control Intrathecal Morphine pumps and/or Spinal Nerve blocks.The later is associated with almost complete relief from pain.For these procedures, you need to consult a Neurovascular surgeon.
With the above modalities , a satisfactory and a near pain free life can be attained .
Post your further queries if any.
Thank you.
Nerve blocks and Intrathecal pumps may help.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
I have worked through your query in detail.
You possibly seem to have Chronic pain Syndrome of Non Malignant Origin.
Since you have been taking a very high total dose of Morphine , almost 85 mg / day, further dose escalation is not advisable.
Instead I would like to suggest you two important alterations.
1.Addition of an antidepressant medication( which reduces the need for higher doses of options medications like Morphine and increasing the pain threshold).For this, I generally prescribe 50 mg daily at bedtime for 3 months.Further dose changes can be made based on the response.
Please check with your physician if he shares my view and if can prescribe these pills to you.
2.Additional procedures for adequate pain control Intrathecal Morphine pumps and/or Spinal Nerve blocks.The later is associated with almost complete relief from pain.For these procedures, you need to consult a Neurovascular surgeon.
With the above modalities , a satisfactory and a near pain free life can be attained .
Post your further queries if any.
Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
