Posted by Elizabeth on January 30, 2002, at 6:37:35
In reply to Re: p.s. chronic pain » Elizabeth, posted by BarbaraCat on January 25, 2002, at 14:25:01
> I take hydrocodone when the pain is bad, although it doesn't really help that much except to improve my general mood.
I think that mood, anxiety, and sleep problems are often tied up with fibromyalgia and perhaps other types of chronic pain. But anyway -- what dose of hydrocodone do you take?
> I also take baclofen which supposedly relaxes the spasms.
I tried it -- it had no effect at all, as far as I could tell. Didn't even help me sleep. It's labeled for "spasticity" (it's a direct GABA-B agonist) -- I'm not sure what that is exactly, but I think it's different from the muscle spasms which can be implicated in musculoskeletal pain.
Pretty much anything sedating can help somewhat, although I've found that things like antihistamines (which I call "incidentally" sedating) are only minimally and unreliably useful, and generally not worth the trouble.
> When I'm having a really bad spell about the only thing I can do is sedate myself with enough klonopin and baclofen to render myself unconscious, coming up only to eat and excrete. This, as you can imagine, is not what I'd call a life.
Jeez. If you have chronic pain, you need chronic treatment. (That makes sense, right?) That might mean taking a modest dose of Klonopin (or another benzo -- they might differ in muscle-relaxant effects, not sure) on a daily basis. I don't know. Chronic pain is very hard to treat, I think. Personally, I've found that buprenorphine helps *without causing tolerance*. I wonder if it would work for you too?
> Do you know of any true 'muscle relaxants'?
Soma (carisoprodol) and Miltown (meprobamate) seem to be good ones, although they can be sedating too. Benzos work for many people; I think that they could be taken on a regular basis and still work, especially since part of your problem is the pain - > anxiety - > more pain - > more anxiety ... cycle. (That is also a problem for me.) These can all be sedating, although most people will become tolerant to the sedation if they take them regularly for a little while. I can't think of anything else off the top of my head, but I'll let you know if I do.
Exercise -- just something simple like walking -- is often good, as you know. I think it's important to make a point of being active -- not necessarily becoming an exercise buff, just being active.
> I've heard some good reports on prolo therapy.
"Prolo therapy?"
> I've also received cortisone injections which help for structural related problems (old mountain climbing and car accidents), but the pain of fibromyalgia is a different animal.
Steroid injections really aren't something you should do on a regular basis, anyway.
> The pain is a migrating, all over deep muscle ache, like the pain felt with a flu.
Mine is sort of like that -- it "migrates," although it's limited to my back/neck/shoulders. In particular, it's usually concentrated on one side, although it may be either the left or the right. I don't really know much about flu pains -- I haven't had the flu in years, and these days I try to get the flu shot every year.
> It's accompanied by severe fatigue and weakness, cognitive problems, and depression.
Mine doesn't seem to be absolutely correlated with my mood or energy level, although there are some ways that my mood can affect the pain (e.g., inactivity from depression, muscle tension related to anxiety). I often have pain when I'm not depressed or anxious, though. (I recall one summer when my back pain was really bad and was present almost all the time -- that was when I decided to go to the pain clinic and got the steroid injection, the diagnosis, and the Soma -- when I was on Parnate and really wasn't doing too badly mood-wise. I was fairly active too -- did a lot of walking around Cambridge and Boston.)
> I can't tell any longer where the division is between the fibro and the depression. I know they're interrelated, but to what extent are they the same disease?
I don't know. Fibro is not very well-understood. It seems likely that there might be a common cause to the pain and the depression, though.
Have you checked out some of the fibromyalgia chat boards on the web, and if so, what sorts of things do other people find helpful?
> I wonder how many others out there are afflicted with very severe somatic complaints -- think I'll start a new poll/thread.
"Somatic complaints" is pretty broad -- it could include GI distress, skin problems such as psoriasis and eczema, appetite and sleep disturbances, and low energy (all of which are sometimes associated with anxiety and/or depression) as well as pain.
> Isn't soma a benzo?
No, although it's related to meprobamate (the predecessor to the benzos). I don't think anybody is sure how Soma works.
> BTW, are you taking the buprenorphine primarily as an antidepressant or as a pain reliever?
Antidepressant. Although maybe it would be easier to get it if I saw a pain doc. < sigh >
> Thanks for your input, Elizabeth. I always enjoy reading your posts.
Thanks :) It's nice to chat with you!
-elizabeth
poster:Elizabeth
thread:4588
URL: http://www.dr-bob.org/babble/20020124/msgs/92159.html