Managing Neuropathic Pain

I’m about to give a talk for Pain Australia on managing neuropathic pain.

Any comments or feedback, feel free to post in the discussion below. I’m always keen to know how it all went.

3 thoughts on “Managing Neuropathic Pain”

  1. I know you cannot discuss specific patients. but I am interested if I should follow up on your discussion with my gp.

    I have lupus, so inflammation is a general problem for me.
    I also have fibromyalgia, and a few other secondary conditions.
    I also have inflammation in my spine at about L4/L5. (yes in the bone itself)
    I currently use weekly norspan patches, to help lower my overall pain.

    is low dose naltrexone something that would be worth discussing as an alternative to the pain patches ?

    other medications include methotrexate, plaquenil, folic acid, indocid, kenocomb, minipress, omega ease, Panadol osteo, panafcortelone, pristiq, Topamax, twynsta and vit d.

    1. Stephen,

      I can’t talk about other patients, but I’m happy to talk about you and your pain.

      Please bear in mind the following:
      1. This is a forum that can be viewed publicly. (Its not facebook, but its still accessable to anyone who wants to look at it).

      2. I’m working on what you write, and so this isn’t a complete assessment of where you are at. If you want that you need a referral. I will however give it my best.

      Low dose naltrexone (LDN) is always worth considering. It is generally difficult if you are on opioid patches, and I would suggest coming off them (if that is possible) before starting LDN. It is possible to mix the two but there is certainly a risk of withdrawal, and also there is no evidence I am aware of to know if its beneficial in this circumstance. Some people do prescribe very low doses while continuing opioids. Personally I think its better to come off them altogether.

      Your doctor may not be familiar with LDN, and if so I’m more than happy to give advice. I think at that point I’d suggest you get seen by a pain specialist to make sure that its all reasonable from a prescribing point of view.

      Michael

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