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Can Gabapentin Dose Be Increased To Relieve Pain In Back And Neck?
I am 47 years old and have had Fibromyalgia for just over 30 years, am on permanent CPP disability. The pain is way worse now then when I was 17, could be that I ve raised three children since then! If it weren t for my children, I wouldn t be here right now - everything I do is painful, exhausting, and depressing.... The way I explain my unrelenting pain to some people has been telling them that just because I m smiling today doesn t mean that I am not in pain, doesn t mean every single joint, muscle etc... isn t driving me mad, every second of every minute of every hour of every day etc... and that I m a good actress when I need to be! I also explain my situation this way: if I were a dog, that felt all of the above...would you not have it put down so it wouldn t have to suffer one more horrible/painful minute? I ve been very careful not raise my pain meds (I just try to increase for a while, then decrease to the initial dosage etc...) I m trying to keep the dosages low (and not getting much relief) because of all the hoopla and the abuse of pain meds lately in both Canada and the US. Drs. now afraid to write higher dosage scripts for fear that the gov t will come down on them, and then before you know it, I will be stuck in the middle and have to try something else etc... The problem is I am in so much pain all the time, (even my pain Dr. told me that I will probably never not be completely pain free. I understand that I need to enjoy reduction in pain no matter how small or for how long... I see him every week to pick up my prescriptions but what makes the hour long (hard, painful, tiring) drive to see him worth it, is the Nerve Blocking Injections in my back, shoulders, and neck areas! (where were these injections 20-30 years ago?) I feel really good and abnormally energetic for a day or two after the injections, then it stops working, but I do appreciate the one or two days - very much! So, my first question is: along with my daily dose (2400mg of Gabapentin), should I stop worrying so much about the actual dosages and just keep raising it over time until I start to feel better, then level off? Right now I am on: 6mg 3x/day of extended release morphine, oxycodone 10mg 3x/day and cyclobenzaprine 10mg 2x/day. My second question is: How safe are these injections over time? Can I just keep getting them every week, after week for years? Thank you for your time, Diana
Tue, 6 Dec 2016
Ok, the top question I do not see the milligram of gabapentin. 800 mg three times a day is the usual top dose.
However, a key point on medications is the dose dependence of bad things happening. The relationship between drug and bad things varies all over the place.
Gabapentin is extremely LOW RISK, HIGH SAFETY, but, it's side effect curve (sleepiness) is weird in that it starts at about 1 in three people at the low dose having sleepiness and it doesn't really change much with higher dosing. Bad stuff doesn't seem to happen with much higher doses as opposed to most things (like water) where going up 3 to 5 fold is dangerous.
Flexeril is dangerous above the recommended dose which is the MAXIMUM SAFE DOSE. It affects muscle including heart. Bad.
Narcotics are the more usual case. low low doses don't do much. Average doses have some risks and some help. Going above the recommended dose increases both some pain relief but vastly increases the danger of stopping breathing, addiction, etc.
Can't say about the back injections because I do not know what is injected. Steroids would typically stick in any space they are put into for weeks not days, but this depends on if it is steroids injected and what type of steroid. Lidocaine wouldn't last as long but it's quite safe except for the needle which can hit something each time. Steroids in theory weaken muscle, tendon, bone, but I've never seen anyone who's gotten 10 injections in their entire lives so, I cannot comment on actual problems. The near 100% risk of local minor bruising and local pain and significant risk of spinal fluid leak with spinal injections are the biggest risk (of minor seriousness). Back muscle injections....the injections themselves are really close to zero risk; we do antibiotic shots daily. Thousands. Not much risk. Oh wait flu shots. tens of thousands. Not much risk.
However, a key point on medications is the dose dependence of bad things happening. The relationship between drug and bad things varies all over the place.
Gabapentin is extremely LOW RISK, HIGH SAFETY, but, it's side effect curve (sleepiness) is weird in that it starts at about 1 in three people at the low dose having sleepiness and it doesn't really change much with higher dosing. Bad stuff doesn't seem to happen with much higher doses as opposed to most things (like water) where going up 3 to 5 fold is dangerous.
Flexeril is dangerous above the recommended dose which is the MAXIMUM SAFE DOSE. It affects muscle including heart. Bad.
Narcotics are the more usual case. low low doses don't do much. Average doses have some risks and some help. Going above the recommended dose increases both some pain relief but vastly increases the danger of stopping breathing, addiction, etc.
Can't say about the back injections because I do not know what is injected. Steroids would typically stick in any space they are put into for weeks not days, but this depends on if it is steroids injected and what type of steroid. Lidocaine wouldn't last as long but it's quite safe except for the needle which can hit something each time. Steroids in theory weaken muscle, tendon, bone, but I've never seen anyone who's gotten 10 injections in their entire lives so, I cannot comment on actual problems. The near 100% risk of local minor bruising and local pain and significant risk of spinal fluid leak with spinal injections are the biggest risk (of minor seriousness). Back muscle injections....the injections themselves are really close to zero risk; we do antibiotic shots daily. Thousands. Not much risk. Oh wait flu shots. tens of thousands. Not much risk.
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