Thread: Nerve Pain

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    Brewmaster Pejo's Avatar
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    Nerve Pain

    Hey guys,

    I'm not seeking medical advice but rather curious about experiences with nerve pain. In December, I was in a major accident and one of the surgeries they had to do is cut a nerve out of my right calf and try to hook the other one up as best they could. Because of that, I do not have any feeling of the right foot and can't control it - one caveat to that though is that I feel pain perfectly fine -_- the spasms first occurred back in February and were extremely intense in pain ('biting the pillow, please don't go in dry' kind of painful). They occurred at approximately 30 second interval and last for 4-6 on average with my longest one at about 20 seconds (almost passed out), with the spasms occurring for about 17 hours straight. As you may be able to tell, it is extremely uncomfortable and very difficult to sleep. They've occurred very rarely up until May (about once a month) but since then, they have occurred approximately once a week with the longest occurring for 35 hours. The good news they have stepped down from intense pain (definitely a 10) to about a 7 on the scale...still not very nice but am at least able to function.

    I have tried different things during this time. I have been on tylenol/oxycodone everyday since the accident for just overall pain, was on Gabapentan until May and thinking that they were muscle spasms, I have been using cyclobenzaprine and Valium since then. From what I could tell, none of these have helped at lowering the pain. I am thinking about trying Gabapentan again due to it being for nerves. I am working closely with my doctor on this but it's 5:52am here and it has been occurring since 2:30 so have to wait until at least 9 to meet with him.

    My question is if anyone has experience with nerve pain, and what may have you tried to deal with it?

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    The Insane Catta's Avatar
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    I believe Whitey has a lot of experience with it iirc from his posts. You could try PM him

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    Immortal Sigma's Avatar
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    if the pain is truly that bad, and you have exhausted other methods of pain control, then you should go to the hospital.
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  4. #4
    I have not personally dealt with nerve pain but I have had plenty of chronic pain clients that have. The psychiatrist I work with tends to believe that anticonvulsants are the first line of defense in treating nerve pain. That would be your Gabapentan. If its not working there should be other drugs of the same class that your doctor can try.


    EDIT: Also be very mindful of your intake of oxycodone. I know chronic pain is miserable, but there is evidence to suggest that long term use of opiates can strengthen the perception of pain. Not to mention some of the other, well known, issues with opiate medications.
    Last edited by Beenie; 2013-06-29 at 01:42 PM.

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    Scarab Lord Mokoshne's Avatar
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    id go to the emergency room.
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  6. #6
    I've been a nurse for 10 years, and pretty evenly split between Internal Medicine and Emergency Room medicine. Remember I'm just a lowly nurse, so take everything with a grain of salt. Pain becomes a medical emergency when it's A. Intractable, meaning never goes away or B. is a 10/10. The issue is most "nerve pain" doesn't react well with acute treatment regimes, ie. morphine, percocet etc. There isn't alot we can do in the ER except medicate you in sedation. Ideally you'll need to see a pain management provider or neurologist and be put on a GABA analog ie. Gabapentin, or one of the new anti-depressants we use for pain or neruopathy ie. lyrica or cymballta. All that is assuming it's nerve pain.

    Unilateral calf pain could also be a DVT (clot in your leg), if you have previous trauma your likelihood of a clot is astronomical. If you leg becomes warmer, redder or more swollen than normal and the pain is bad I would go to the ER. A quick ultrasound can find a clot. If there is one you'll be placed on blood thinners for 3 to 6 months.

    Again, this is just the advice of some guy who plays WoW, and happens to have experience in this field. Good luck

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    The Insane Catta's Avatar
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    Quote Originally Posted by options View Post
    I've been a nurse for 10 years, and pretty evenly split between Internal Medicine and Emergency Room medicine. Remember I'm just a lowly nurse, so take everything with a grain of salt. Pain becomes a medical emergency when it's A. Intractable, meaning never goes away or B. is a 10/10. The issue is most "nerve pain" doesn't react well with acute treatment regimes, ie. morphine, percocet etc. There isn't alot we can do in the ER except medicate you in sedation. Ideally you'll need to see a pain management provider or neurologist and be put on a GABA analog ie. Gabapentin, or one of the new anti-depressants we use for pain or neruopathy ie. lyrica or cymballta. All that is assuming it's nerve pain.

    Unilateral calf pain could also be a DVT (clot in your leg), if you have previous trauma your likelihood of a clot is astronomical. If you leg becomes warmer, redder or more swollen than normal and the pain is bad I would go to the ER. A quick ultrasound can find a clot. If there is one you'll be placed on blood thinners for 3 to 6 months.

    Again, this is just the advice of some guy who plays WoW, and happens to have experience in this field. Good luck
    Couldnt the nerve pain be from the nerve he had cut and sown together is misinterpreting signals? As in they arent grown together properly and wont react properly to things that are supposed to work in the synapses.

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    Brewmaster Pejo's Avatar
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    Thanks for all of the replies, I will try Whitey and see their experience. Going to the hospital, sadly, is more trouble than it's worth as they haven't been able to do much with it - basically, some kind of pain med and ride it out has been their advice. Due to the complexities of the injuries, I tend to speak with people more versed with my case. There is a clinic nearby open at 9, will try to get an appt today and see what my doctor there says.


    As for the opiates, definitely being mindful there. In the accident, I broke my left orbital socket, mandible, left forearm, right wrist, both hips (front and back), pelvis, four fractured vèrtebre, both femur (heads I believe, the one further up by hip), right tibia, massive tissue damage in legs including the vascular system and suffered a pretty good traumatic brain injury. Definitely lucky to be alive, but been cutting down pain meds where I can - down to 5mg 3 times a day since Tylenol 500mg just doesn't cut it yet. I can attest to them lowering the pain threshold as even skinning my foot hurts more than it used to (and heals a shitload slower, 2 months so far when it would have been 4 days before).

    Sorry for the tirade, and I greatly appreciate the replies. If people have tried heat/massage, I would be curious about that as I may be doing that wrong

    Edit: Thanks for that, Options - that is my experience with ER so far. I think I will contact my primary trauma doctor and see if they can recommend a good pain management specialist. Will probably lead back to Gabapentan but hell, it's something! There is no redness and the spasms are occurring in my foot (usually smaller toes which sadly increases the intensity of it). I do believe they are rewiring/firing but was seeing if anyone else had dealt with this on this lovely forum as to see any differences.
    Last edited by Pejo; 2013-06-29 at 02:05 PM.

  9. #9
    Quote Originally Posted by Pejo View Post
    As for the opiates, definitely being mindful there. In the accident, I broke my left orbital socket, mandible, left forearm, right wrist, both hips (front and back), pelvis, four fractured vèrtebre, both femur (heads I believe, the one further up by hip), right tibia, massive tissue damage in legs including the vascular system and suffered a pretty good traumatic brain injury. Definitely lucky to be alive, but been cutting down pain meds where I can - down to 5mg 3 times a day since Tylenol 500mg just doesn't cut it yet. I can attest to them lowering the pain threshold as even skinning my foot hurts more than it used to (and heals a shitload slower, 2 months so far when it would have been 4 days before).
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    Brewmaster Pejo's Avatar
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    Quote Originally Posted by smelltheglove View Post
    fucking hell, did you play chicken with a freight train?!?
    Hah, sounds like it eh. Sadly, a tree fell onto our car while we were driving on a freeway. Freak accident all around, but left us well and damaged. We're all recovering though!

  11. #11
    Quote Originally Posted by Cattaclysmic View Post
    Couldnt the nerve pain be from the nerve he had cut and sown together is misinterpreting signals? As in they arent grown together properly and wont react properly to things that are supposed to work in the synapses.
    I think there is a little confusion here, the synapse is actually an empty space between dendrites and axon. It's more practical to think of a nerve as a long piece of electrical cord with tiny gaps (synapses) between them. IF the surgeon botched the repair, generally no impulse passes. ie. no electicity makes it to the end. A majority of interpretation of the impulse happens in the brain, which is why nerve pain is so difficult to treat. It really seems like Pejo has just had enough trauma that he's more than liekly going to have like lony 4-5/10 pain. Patient's in my clinic would end up on long term pain meds 300mg Gaba bid for starters, and some break thru meds like Tramadol 50 or 100 + tylenol 500 (for bad pain days), Gabapentin can go up to well over 900mg tid assuming renal function stays in tact, but we end up switching people to Lyrica instead most of the time.

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  12. #12
    Quote Originally Posted by Pejo View Post
    Hah, sounds like it eh. Sadly, a tree fell onto our car while we were driving on a freeway. Freak accident all around, but left us well and damaged. We're all recovering though!
    im a furniture maker that frequently snatches up trees and takes them to the sawmill... so my initial thought was "what kind of tree was it, how big was it, and did you get to keep it?" i guess im not terribly helpful, lol
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    The Insane Catta's Avatar
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    Quote Originally Posted by options View Post
    I think there is a little confusion here, the synapse is actually an empty space between dendrites and axon. It's more practical to think of a nerve as a long piece of electrical cord with tiny gaps (synapses) between them. IF the surgeon botched the repair, generally no impulse passes. ie. no electicity makes it to the end. A majority of interpretation of the impulse happens in the brain, which is why nerve pain is so difficult to treat. It really seems like Pejo has just had enough trauma that he's more than liekly going to have like lony 4-5/10 pain. Patient's in my clinic would end up on long term pain meds 300mg Gaba bid for starters, and some break thru meds like Tramadol 50 or 100 + tylenol 500 (for bad pain days), Gabapentin can go up to well over 900mg tid assuming renal function stays in tact, but we end up switching people to Lyrica instead most of the time.
    I know the synapses are an empty space - but I also know that many meds - and drugs - work by altering the stuff that is transferred in it - or received.

    Also the nerve he had cut is fucking huge! I thought it was a muscle back when i dissected.
    Last edited by Catta; 2013-06-29 at 09:30 PM.

  14. #14
    I am Murloc! Peaky Blinder's Avatar
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    You could try fentanyl patches for pain

    That shit is strong but addictive as fuck

  15. #15
    If you haven't tried it yet, ask your doctor for a gabapentin aka Neurontin prescription. Neurontin is the name brand, gabapentin is the generic. It directly targets nerve pain and is not digested in the liver like opiates. It's worked wonders for some nerve pain I had, although it wasn't nearly as severe as yours. Give it a try. It's not physically/physiologically addicting either.

    http://en.wikipedia.org/wiki/Gabapentin
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  16. #16
    Brewmaster Pejo's Avatar
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    Thanks for all of the replies. I am back on Gabapentan so hopefully iy'll help reduce the pain - hell, I'll take it lowering the frequency. I did try Fentanyl but stopped that as it helped my other pain but didnt effect my spasms. Here's hoping

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