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    Includes Expert Content
    best stroke pain meds?
    jcm56 posted:
    the stroke was 2-26-13.. the pain started 2 months later when the right side was coming back alive... and i understand it could be many months if not years to get from the 80% i am now to something better?.. but Lots of pain on the right side from the shoulders to the right foot.. especially first thing in the morning and after sitting and watching tv at nite..i stoke up after 20-30 min. it seems.. i actually was able to go back to my p/t job cleaning a Huge retail space on sunday..and the smaller side of that business on monday.. on tues i only have to go buy needed supplies.. wed. thurs and friday i go to our new Kroc Center only 1.2 miles from home(very lucky with that).. i currently take hydro 7.5/200 mg advil.(4 a day). Is this the best or average/ok meds for helping what can get to a 8-9-10 pain in the mornings .. i read one post that a patient was on some kind of time released pain meds that i am not familiar with...All docs these days seem hard pressed to give the opiads due to govt regulations etc etc..tried tramadol at first and it was no better than sugar pill.. the hydro's at this point in recovery seems to be the difference in being able to Work and carry on with basic day to day duties.. living alone and with no family in the area is somewhat of a tough pill to swallow at times..and making only p/t $ (if not for my FDX pension of $800 a month i would be in deep trouble).. My dad was a WW2 unsung hero with USMC in 3 huge pacific battles and i was brought up to not Not file for any govt help if i can avoid.. sadly i think the pain meds are the only reason i can carry on almost like it was pre-stroke..I am not worried at this point about getting 'hooked' as i was on like meds in 2006/07 for herniated disc which healed up.. i tried nerve pain meds gaba____? and it was a 2 day nightmare and stopped it right away..i cant find a spot on the net to advise what others in like situations take for pain in but for a few limited posts.. thanks for any advise on pain meds others are taking to help with the lifting of the paralysis.. thanks so much..
    Peter Abaci, MD responded:
    Pain that begins after a stroke can be a very challenging situation to live with, and I am sorry that you have had such a difficult time getting relief from this problem. The pain syndrome that can occur after a stoke is sometimes called Central Pain Syndrome or Thalamic Pain Syndrome because of damage that may have occurred to a part of the brain known as the thalamus. The thalamus works as a sensory relay station for the nervous system, and a stroke can interfere with the normal activity that goes on in the thalamus leading to what can become symptoms of sever pain on one side of the body. The symptomatic side of the body can feel a burning pain and can be sensitive to touch or temperature changes.

    Pain like this that is generated within the central nervous system is often treated as a nerve pain problem, also referred to as neuropathic pain. Unfortunately, many typical pain medications often don't work as well on central-mediated nerve pain, but sometimes better results are found with what are called anti-neuropathic medications, which are medications primarily used for nerve pain. Gabapentin is a common and popular medication used to treat nerve pain, and I have seen patients with bad central-mediated pain respond well to it. Unfortunately, you had a bad reaction to it in the past, but it might be worth having your doctors look carefully at how it was started and what doses were used before writing it off completely. Other types of anti-neuropathic medications to consider would include tricyclics like nortriptyline, Lyrica, which is similar to gabapentin, and Cymbalta. The tricyclics are all now in generic form, and would be the most cost-effective to try first.

    Beyond medications, learning how to control activity within your central nervous system can also help reduce this type of pain. These more behavioral-based approaches could include things like biofeedback, meditation, relaxing breathing exercises, and even listening to calming music.
    jcm56 replied to Peter Abaci, MD's response:
    thanks so much... but there is no doubt the hydro helps with the soreness and stiffness but of course it just helps me get thru the day since i stay as active as possible... and is another hydro like med out there that could be worth a shot...i still dont know what this time released pain med is ive read others in my situation have taken.. but it makes sense?? thanks

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