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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is There Any Topical Pain Relief Ointment Or Cream For Arthritis Related Pain With No Help From Hydro Codon In A 90 Years Old Female?

Hi, I care for my 90 yr. old mother that has developed shingles. I took her to the dr. and she is on the meds to protect from nerv damage. However the Lyrica he prescribed for pain to be given only at night had a very strange reaction with her. She very soon displayed signs of extreme dementia. I had only given her one dose so stopped. Her regular regiment of hydro codon for her arthritis doesn't seem to be helping her with this additional pain. Is ther something topical I can apply to help? Thank you!

Mon, 20 Jan 2014
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Neurologist, Surgical 's  Response
Hi there. My name is Vinay. I'm so sorry your having difficulty caring for your Mom. Let me see if I can help give you some options tword her pain relief.

From the sound of it.. you actually have 2 different pain issues that need dealing with..

1) is the "neuropathic" (nerve related) pain from the shingles (the areas that hurt because of that are going to be following along a single nerve track on the body, they won't generally bother the joints).

This kind of pain is caused by a single spinal nerve that is being irritated by the same virus that causes Chicken Pox (we never really get rid of it when we get it as kids.. our immune systems just beat it senseless and it hangs around inside our nerves waiting for the immune system to weaken.)

Treatments for this involve drugs like Pregabalin (Lyrica) and Gabapentin (Neurontin) and yes.. they have side effects.. Have personally seen the confusion some patients can get from a single dose of lyrica.. so i'm happy you discontinued..

The next steps in the management of this kind of pain are trying other drugs... like neurontin.. or using stronger and stronger narcotics... luckily.. the disease shingles is generally self limiting and your mom will not have to be on these drugs forever.

2) Is the arthritic pain that i'm betting hits her joints and her back.. Low grade anti inflammatory drugs like asprin and ibuprofen are great for occasional relief. There are some long term COX-2 inhibitor drugs available by prescription that you can talk to her doctor about. I've never been very happy with any of them myself.. But they are an option you can discuss.

Further management of this kind of pain also depends on lifestyle.. Do you think Mom could stand to lose a few Kilo's? Weight loss is known to bring down a patients arthritic symptoms very effectively and very quickly. Secondly look at habits... smoking and alcohol consumption tend to worsen inflammatory issues (arthritis is chronic joint inflammation). Exercise is important too! Low impact aerobic exercise (think poolside or water based aerobics, walking, tai chi etc) have been shown to help arthritic pain.

I hope this information can help you in managing moms pain once and for all. If you feel you need any clarification or that I can help you further, feel free to contact me through HCM.

Thank You
Vinay
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Is There Any Topical Pain Relief Ointment Or Cream For Arthritis Related Pain With No Help From Hydro Codon In A 90 Years Old Female?

Hi there. My name is Vinay. I m so sorry your having difficulty caring for your Mom. Let me see if I can help give you some options tword her pain relief. From the sound of it.. you actually have 2 different pain issues that need dealing with.. 1) is the neuropathic (nerve related) pain from the shingles (the areas that hurt because of that are going to be following along a single nerve track on the body, they won t generally bother the joints). This kind of pain is caused by a single spinal nerve that is being irritated by the same virus that causes Chicken Pox (we never really get rid of it when we get it as kids.. our immune systems just beat it senseless and it hangs around inside our nerves waiting for the immune system to weaken.) Treatments for this involve drugs like Pregabalin (Lyrica) and Gabapentin (Neurontin) and yes.. they have side effects.. Have personally seen the confusion some patients can get from a single dose of lyrica.. so i m happy you discontinued.. The next steps in the management of this kind of pain are trying other drugs... like neurontin.. or using stronger and stronger narcotics... luckily.. the disease shingles is generally self limiting and your mom will not have to be on these drugs forever. 2) Is the arthritic pain that i m betting hits her joints and her back.. Low grade anti inflammatory drugs like asprin and ibuprofen are great for occasional relief. There are some long term COX-2 inhibitor drugs available by prescription that you can talk to her doctor about. I ve never been very happy with any of them myself.. But they are an option you can discuss. Further management of this kind of pain also depends on lifestyle.. Do you think Mom could stand to lose a few Kilo s? Weight loss is known to bring down a patients arthritic symptoms very effectively and very quickly. Secondly look at habits... smoking and alcohol consumption tend to worsen inflammatory issues (arthritis is chronic joint inflammation). Exercise is important too! Low impact aerobic exercise (think poolside or water based aerobics, walking, tai chi etc) have been shown to help arthritic pain. I hope this information can help you in managing moms pain once and for all. If you feel you need any clarification or that I can help you further, feel free to contact me through HCM. Thank You Vinay