Suggestions needed for too much Pain

[AndrewB]

Hello All,

I am the son of a woman who has a very severe case of MS. She is practically immobile, has no balance, and struggles with almost every physical aspect of her day. But, like many other people with MS she has one of the best attitudes and is a joy to be around (her strength amazes me everyday). For years she has had a burning nerve pain in her right shoulder that comes and goes, not desirable, but manageable. Over the last two weeks her pain has increased to almost constant suffering. It is the first time I have ever seen her remarkable spirit crack slightly and there is nothing I can do to help her as her pain is internal and all the help I provide is largely physical. She is on a plethora of anti-seizure medications for the pain. Does anybody have any ideas or suggestions about what she can do to help manage or eliminate her pain. Thank you all for ANY ideas.

[HarryZ]

Sorry to hear that your mom is suffering from so much pain.

You may want to ask your neuro about Lyrica. It doesn't have too many side effects and works for some who use it for their MS pain.

When it comes to MS, different medications work for some and not at all for others. It becomes a trial and error situation until you find the right one. The best of luck.

Harry

[TwistedHelix]

Hello Andrew,
It's an awful situation to be in: having to watch your mother in pain like this, but there are medications which can help with nerve pain – gabapentin and amitriptyline, for example – but they all have potential interactions with other drugs, so need to be chosen carefully by your mother's doctor. Harry is right: it's a process of trial and error. A particular drug may seem to be not working, but a subtle tweak of the dosage can have dramatic effects.
It'll take time, but I'm sure it's worth it!

[jimmylegs]

hi there sorry to hear about this! here is the nutrition contribution (a long read but all great info)

http://www.blatmanpainclinic.com/blat_articles_12.htm

the article puts this last, but it looks like it ought to go first!

General Rules
* No aspartame in diet
* Try to avoid use of statin medications
* Seriously limit
o Sugar (especially soda)
o Hydrogenated oil
* Add nutrients
o Essential fatty acids, especially omega 3
o Magnesium
o B vitamins
o Alpha lipoic acid
* Go SLOW
* The sicker the patient, the slower to go
* These dietary changes induce detoxification
o Rapid change may cause
+ Fever, increased pain, nausea, vomiting (ugly sick)
* Patients may go back to previous diet and will feel better
* Return to the practitioner and say they feel better eating ‘bad food’

i'm going to go out on a limb here and suggest that adding nutrients won't be as huge a part of any bad feelings from detox - more the transition from fats/sugars/sweeteners to healthier alternatives.
you may want to consider adding the good stuff first to see how it goes. wouldn't want the beneficial effects to be associated with any withdrawal from the baddies! should be fine to give each new supplement a few days to settle in before adding the next one, to see how your poor mother reacts to it. i really hope she can find some relief one way or another!!!

below are some more highlights, much more detail if you follow the link above. please note they mention specific b-vitamins but it's much better to take b in a strong complex containing the entire b group. b vitamins are not found separately from each other in natural food.

How Does Nutrition Impact Neuropathic Pain
* Nutrition has some impact on causation
o Foods may contribute to nervous system damage
* Nutrition has some impact on healing
o Foods may facilitate the healing process
* Nutrition has some impact on treatment
o Foods and supplements may directly treat the nervous system injury

Foods and Medications That Contribute to Nervous System Damage Should Not Be Eaten
* Nutrasweet/Aspartame
* Olestra
* Margarine
* Aspartame (conversion to methanol)

Methanol Is Neurotoxic
* CNS dysfunction
* Brain tumors
* Chronic widespread body pain in some patients

Prepared Food – Shelf Life
* The reason it [hydrogenated oil] was put into food in 1940’s was to increase shelf life
* Essential fatty acids decrease shelf life
* Go rancid when exposed to heat, light, oxygen
* Hydrogenation improves shelf life
* Example: peanut butter can be kept unrefrigerated in the pantry, never growing mold
* And if food won’t grow mold, it won’t grow people i like that one!

Membrane Fatty Acids Are Important
* Cell nutrition
* Inflammation
* Pain

How Are They Important in Inflammation
* Local redness
* Heat
* Pain
* Swelling

Metabolic Pathways [of essential fatty acids]
* Can increase levels of DGLA (Dihomo-Gamma-Linolenic Acid) by ingesting oils rich in GLA (gamma linolenic acid)
o Evening primrose oil
o Borage oil
o Black currant seed oil

Alpha-linolenic Acid (LNA – w3) – From Diet
* Green leafy vegetables
* Soybeans
* Spirulina
* Canola oil
* Flaxseed oil

Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA)
* Derivatives from LNA (alpha linolenic)
* Occur naturally in fish, esp. cold water

Fish Oil Supplementation
* Significant improvement in joint tenderness and joint swelling in RA patients after 24 weeks
o Kremer et al. Arth and Rheum 1990;33(6):810-20.

Also mentioned:
lecithin (1200mg each meal);
b100-complex;
Alpha Lipoic Acid (300-600mg/d) - helps with insulin regulation and burning mouth syndrome too

Foods to Increase Nutrients
* Vitamin E
o Vegetable oils, wheat germ, nuts, green leafy vegetables
* Pantothenic acid
o Animal tissues, whole grain cereals, legumes
* Magnesium
o Seeds, nuts, legumes, unmilled grains, chlorophyll of green vegetables
* Potassium
o Nuts, whole grains, meats, fruits
* Vitamin B-6
o Chicken, fish, liver, eggs, unmilled rice, oats, soy beans, walnuts
* Vitamin B-12
o Animal products (produced by bacteria)

Olive Oil
* Antioxidant, able to scavenge free radicals
* Protection against peroxidation
o Decreased LDL, increased HDL
* Improves control of hypertriglyceridemia associated with diabetes
* Modifies production of inflammatory cytokines
* Enhances gall bladder emptying
* Assists in gastric ulcer healing, promotes resistance to NSAID induced ulcerogenesis

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[mrhodes40]

If you can afford it I find good massage therapy to be a great help with the pain I have down my weaker leg. Mine is in part caused by spasms in my muscles that pinch peripheral nerves. Good deep massage that focuses on releasing the pinching muscles helps this for me. My insurance covers it and I get one a week.

ANother strategy that I find helpful is the over the TENS type units. You can buy and interferential type unit online but I would suggest getting help from a physical therapist or someone to giude these purchases. If money is a real issue then pay the PT for her expertise ask a million questions about these kinds of units and see if there is anything online that matches her recommend. In my community I notice they seem to want to direct you to a certain local distributor, but in my case I did better over the net.
Good luck!
marie

[AllyB]

Hi there

So sorry that your Mom finds herself in this awful situation. It shows how much you love and admire her, that you are so involved in her care - you are fortunate to have each other!
I would concur with Harry re: Lyrica. I have awful nerve pain in my right shoulder/arm/hand (also leg, but arm is worse!) to the point that it makes me very irritable, and I even cry when it just goes on and on; I used to take Neurontin and Amitriptyline and I recently moved to Lyrica (continued the Ami) and have found an improvement.

Otherwise - the sudden (almost acute) worsening of your Mom's pain might not be from her ms at all - I would imagine that she must be in late middle age, probably post-menopausal, and possible prone to osteoarthritis or osteoporosis.
It is possible that she has a osteophyte causing nerve root entrapment in the c-spine (probably at c5 or c6), or maybe a 'crumbling of the vertebra or intervertebral discs, also causing nerve root entrapment.
This should be checked out as the treatment would be different than that for an ms lesion.
You could also try her on a good oral anti-inflammatory (not ibuprofen!) - if it helps, even just a little, it could point to it being a mechanical issue with her neck, rather than ms.
The treatment for nerve root entrapment varies from country to country and depends on the severity of the condition. Usually, conservative treatment is tried first - anti-inflammatories, pain killers (proper ones), and some sort of relaxant (like Xanor/Xanax), some traction to try to relieve pressure in the c-spine by opening up the spaces between the vertebra, maybe physio and massage.
If the condition is too severe to respond to conservative treatment, then surgery would be considered as a last resort, depending on the patient's overall condition.
Also, direct injection of steroids into the inflammed nerve root (under CT scan direction) has been known to give relief.

I am by no means diagnosing your Mom, just offering an alternative scenario, given the sudden increase in pain - alternatively, if she is still having relapses, maybe this indicates a re-inflammation of an old lesion and some IV Solumedrol would give some relief.

One last thing - just because there is a probable explanation for the worsening pain (ms), it might not be the only cause, and it might be worthwhile to look at other possible diagnoses.

I really wish your Mom all the best - let us knoww how she does.

[Muu]

Someone else mentioned the TENS machine and i second that but it is crucial to find someone to explain how it works and exactly what to do. My oesteopath also administers TENS and whilst he's never had to use that on me i have acupuncture and general bone crunching every couple of months. I used to be sniffy about it but I have seen and benfited from these methods and perhaps they can offer your mother some relief too.
muu

[robbie]

andrew there are so many drugs to stop pain there is no reason in this day in age for your mom to be in pain.

[Nenu]

andrew there are so many drugs to stop pain there is no reason in this day in age for your mom to be in pain.

Agreed.

[AndrewB]

Hello all,

First off, thank you all for your kind words and suggestions. My mother and I both appreciate everyone for taking the time to respond to my posting. She has taken many of your suggestions to her doctor. As of now she started taking Lyrica with mixed results, but the pain has definitely gotten back down to more manageable levels (never know if its the drug or the static nature of MS). Were keeping our fingers crossed that it works. We are both still very interested in hearing how other people deal with MS and chronic pain. Thanks again.

Andrew