How to ameliorate chronic peripheral neuropathy?
April 4, 2006 9:51 PM   Subscribe

Solutions for Chronic Peripheral Neuropathy?

I had an anterior cervical discectomy and fusion about four years ago, for a ruptured disc at C4-C5. I still have chronic peripheral neuropathic pain in my left [dominant] arm, presumably from nerve root compression/damage. This pain manifests as either a dull ache or sharp “shocks” in my forearm, along the radius, extending to the lateral aspect of my index finger and thumb. I would say that my baseline pain level [reference here] is two or three out of ten, occasionally spiking to a four. While I may have 'adapted' to the pain, my sense is that that only means that I am still able to function; it is still taking a toll on my consciousness--using processing power that would be better suited to dealing with emotions, tasks, etc. When I’m stressed, it becomes much harder to deal with, decreasing my tolerance for everything else in my life, making it near impossible to do the work I need to do, and creating a sort of vicious cycle—I am less able to deal with life, and therefore leaving me more sensitive to the pain. After my surgery, I was told that I might have pain to varying degrees, and that there’s no way to predict how long it might go on- could be months, years, forever. I’m fine with this, but I’m curious as to what others experiences with this sort of pain have been: are there supplements that you have taken that have helped? (i.e. particular vitamins, prescription medication like Gabapentin/ Neurontin®, antidepressants, etc) I try to meditate, and it helps some, but when this flares, it’s more like “grit your teeth and sit on your arm”. I’m a college student, with terrible medical insurance, so that needs to be taken into account, but really, any advice is appreciated. How do you deal with your pain?
posted by exlotuseater to Health & Fitness (2 answers total) 3 users marked this as a favorite
Best answer: While researching central sensitization I've come across two resources that are immensely helpful in getting beyond the BS: the Coventry Pain Clinic's website and a copy of Clinical Evidence (CE). Both recommended amitriptyline to treat my symptoms and what I'm learning is that it works not because of it's effect on serotonin but due to it's effect on glutamate. Long story made very short, for peripheral neuropathy Coventry says:

"the commonest combination is amitriptyline (10 - 50 mg) with either gabapentin (2400 mg per day) or pregabalin (600 mg per day). Topical capsaicin is used frequently for diabetic neuropathy. Intravenous lignocaine can be useful in some people."

That entry is worth a full read even if the specifics are hard to understand. If your interested in the "long story" I skipped above, I've written my experiences up here.
posted by jwells at 6:36 AM on April 5, 2006

The obvious answer is to find a pain clinic for a consultation. Absent that you might discuss with your physician the possible use of Trazodone as a pain medication. While it is primarily an antidepressant it is used in subtherapeutic doses for sleep and pain mangement. If you decide to read about it I want to stress that its use for pain and sleep is at dosages considerable less than for depression hence it has very few side effects at low dosage. One advantage of trazodone is that it is available as a generic drug and is very inexpensive--also it is not habit forming. (IANAD)
posted by rmhsinc at 6:38 AM on April 5, 2006

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