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Just so you know, opioid pain killers are actually not useful for chronic pain at all. Over the long term it actually makes patients sense of pain GO UP. It's e

Just so you know, opioid pain killers are actually not useful for chronic pain at all. Over the long term it actually makes patients sense of pain GO UP. It's excellent for non-chronic pain however.

MichaelGG 11y ago
What kind of time range are you talking about here? AFAIK there's no human limit to opiate tolerance - patients can often just take more (over time).
stordoff 11y ago
Not the best choice, certainly, but I would question not useful. I suffer from chronic pain (mostly headaches), and opioids (tramadol/codeine) are the only drugs[1] that have given any relief. I've been using them for about two years; they are still useful, and when I stop using them the pain is about the same it was before. Fortunately I don't appear to find them addictive - I stopped taking the tramadol after about a year's usage (my consultant raised similar concerns to you - restarted them about three months later as it had been shown they weren't worsening the headaches) cold turkey (I was told it would be worse than stopping heroin), and suffering absolutely no ill effects or withdrawal. [1] Multiple others have been tried (ibuprofen/diclofenac/amitriptyline/sodium valproate/naproxen/gabapentin and a few others I can't remember), and made no difference to the headaches. The amitriptyline is helping with pain in my hands though.
- vidarh 11y ago
  Just a suggestion because it is often missed by general practitioners: If you've not tried it already, talk to your dentist. Headaches and migraines are often related to teeth or the jaws. Particularly grinding and clenching. Often it can be reduced significantly or go away entirely with a simple night time biteguard.
  - stordoff 11y ago
    My dentist did note that I seem to be grinding my teeth a little (probably at night), but didn't think the headaches were related. I'll mention it again next time I see him to see if there is anything worse trying, even as a long shot. Thanks for the advise.
    - vidarh 11y ago
      If he's looked at it already he's probably right but doesn't hurt to double check. I mentioned it mainly because I've mentioned my headaches to many doctors over the years and none even raised the possibility or suggested I talked to my dentist about my headaches, so I wasted a lot of time until a dentist happened to bring it up. If your dentist is unsure if it's worth it and you don't want to spend the money on a custom mould on a long shot I suggest asking for a recommendation for a cheap and crappy generic biteguard to try for a few days. It won't be comfortable and may very well affect your sleep, but it'll be enough to verify it there's any point without the cost. Another long shot that you've probably discounted already: Make sure you're not compressing your neck at night e.g. by pushing your head up against the top of your bed. I was doing that too, and fixing that helped a lot as well.

Just so you know, opioid pain killers are actually not useful for chronic pain at all. Over the long term it actually makes patients sense of pain GO UP. It's excellent for non-chronic pain however.

MichaelGG 11y ago

What kind of time range are you talking about here? AFAIK there's no human limit to opiate tolerance - patients can often just take more (over time).

stordoff 11y ago

Not the best choice, certainly, but I would question not useful. I suffer from chronic pain (mostly headaches), and opioids (tramadol/codeine) are the only drugs[1] that have given any relief. I've been using them for about two years; they are still useful, and when I stop using them the pain is about the same it was before. Fortunately I don't appear to find them addictive - I stopped taking the tramadol after about a year's usage (my consultant raised similar concerns to you - restarted them about three months later as it had been shown they weren't worsening the headaches) cold turkey (I was told it would be worse than stopping heroin), and suffering absolutely no ill effects or withdrawal. [1] Multiple others have been tried (ibuprofen/diclofenac/amitriptyline/sodium valproate/naproxen/gabapentin and a few others I can't remember), and made no difference to the headaches. The amitriptyline is helping with pain in my hands though.

vidarh 11y ago
Just a suggestion because it is often missed by general practitioners: If you've not tried it already, talk to your dentist. Headaches and migraines are often related to teeth or the jaws. Particularly grinding and clenching. Often it can be reduced significantly or go away entirely with a simple night time biteguard.
- stordoff 11y ago
  My dentist did note that I seem to be grinding my teeth a little (probably at night), but didn't think the headaches were related. I'll mention it again next time I see him to see if there is anything worse trying, even as a long shot. Thanks for the advise.
  - vidarh 11y ago
    If he's looked at it already he's probably right but doesn't hurt to double check. I mentioned it mainly because I've mentioned my headaches to many doctors over the years and none even raised the possibility or suggested I talked to my dentist about my headaches, so I wasted a lot of time until a dentist happened to bring it up. If your dentist is unsure if it's worth it and you don't want to spend the money on a custom mould on a long shot I suggest asking for a recommendation for a cheap and crappy generic biteguard to try for a few days. It won't be comfortable and may very well affect your sleep, but it'll be enough to verify it there's any point without the cost. Another long shot that you've probably discounted already: Make sure you're not compressing your neck at night e.g. by pushing your head up against the top of your bed. I was doing that too, and fixing that helped a lot as well.