Question
I have several soft tissue and skeletal issues due to various injuries over the years. Arthritis in my knee due to no ACL for 30 years and missing meniscus, herniated disc at C-7, recurring hip pain, and I have been diagnosed with thoracic outlet syndrome on the right side. I fell from a trapeze when I was child and landed on my head and shoulder. Have been told that resulted in cervical facet syndrome and the TOS I have today. I am now 56 and work as a massage therapist. I do yoga for stretching and conditioning and get massages as well. For the most part these things have helped to reduce the pain I experience. I had been taking Advil/Ibuprofen but after 2 years of this, I ended up with severe rectal bleeding and colitis. I have been told that I should stay away from NSAIDS. My doctor wants to try imiprimine, pamelor, or neurontin. I think this requires daily long-term use to be effective. Is this correct and how effective are these drugs for someone whith my history? What are the pros and cons? Are there any other medications that I could use that would not have to be taken daily.
Answer
The medications you list are often used for chronic pain, but I think the response to them is variable. I think you have to try them to find out. They should be taken on a regular basis to have a benefit. Other options for intermittent use include pain medications such as acetaminophen (Tylenol) up to 3000 mg daily, tramadol, or low dose opioids (hydrocodone, oxymorphone, oxycodone, codeine).
