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pain from nerve regeneration

      Re: pain from nerve regeneration

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Posted by CCF MD-Neurology on January 23, 1998 at 11:08:17:

In Reply to: pain from nerve regeneration posted by Shawn Bland on January 17, 1998 at 16:06:13:

: my mother has CIDP (Chronic Inflammatory Deyelinating Polyneuropathy), her
  nerves are regenerating which is causing her to be in excruciating pain, her
  neurolgist tried several medications, including Tegretol, Amitriptyline, Tylenol
  #3, and Emla cream, she is currently seeing a pain specialist, he initially started
  with Neurontin and then tried Duragesic patches, the patches were the first thing
  that really provided any relief and she had her first pain-free 24 hours in MONTHS,
  however, she soon developed severe itching and nausea, her doctor recommended
  reducing the dose, the symptoms decreased in intensity, but the pain also came
  back, my question is WHAT that has not been tried MAY work for my mother, we would
  prefer to find a medication that works, is there something similar to the Duragesic
  patch?, would some sort of local anesthetic work?, other than the Emla cream which
  has already been tried, we would appreciate any advice on what other options/medications
  exist, her pain specialist is recommending a nerve block but the neurologist
  does not think it will work for this type of pain, the only thing the neurologist is
  recommending is giving acupuncture a try, we would be so appreciative if you
  could answer the above questions and give us some advice on what else to try, the
  pain is so intense and it is hard to get doctors to understand just how bad
  the situation is
=Dear Mrs. S. Bland, The treatment of such pain is always difficult for both the patient and the physician. Standard treatments for such pain would include NSAID's, Anti-Depreswents (Tricyclics and SSRI's), Anti-epileptic Drugs and Narcotic's. With such medication, only experimentation with various combination of medications can lead to pain relief (and often only partial). Less standard would include accupuncture and herbal remedies which are much more variable than medication in their ability in supplying pain relief. Also, since this is an inflamatory process that is chronic, the question arises if your mother is having a relapse that is manifesting itself as primarily pain and thus a course of SAID's (such as prednisone) shoud therefore be considered. I would discuss such issues with your neurologist and pain specialist. Finally, I would consider an evaluation by a peripheral nerve specialist if this has not already been done. "This information is provided for general medical education purposes only. please consult your physician for diagnostic and treatment options of your specific medical condition."

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