Low-dose Naltrexone for lower back pain

It may depend on the cause of your lower back pain. My CRPS and SFN pain are not interfering with my life as before. I still have back pain but I have several options to help with that. I use lidocaine 5% pain patches by Endo, lidocaine prilocaine cream, and I have a spinal cord stimulator implanted. I am allergic to a lot of meds so pain management works for me as I have an excellent doctor who is very conscious of my allergies. Epidural and RFAs help my neck and low back pain. I recently had a sympathetic nerve block which has lasted most of the month. Hope you might find an excellent pain management doctor!

I have osteoarthritis all along my spine. I've used tramadol, oxycontin and oxycodone but the side effects were pretty bad. 5 years ago, I was put on buprenorphine patches (generic BuTrans) at a dose of 10μg/hour, 1 patch every 7 days. What a WONDERFUL change! I'm mostly pain free (no more than 5 on the pain scale) and NO NAUSEA! At such a low dose, you may be able to use the patches despite your allergies, so talk to your doctor. Every 6-12 months, I get bilateral radiofrequency ablations at L1-L2 through L5-S1. This is the true pain relief and allows me to stay on such a low opioid dose. I stopped getting them in my neck because my muscles got so stiff and painful that it was defeating the purpose. When I lived in Indiana, I received lidocaine infusions with some effect and later ketamine infusions that helped tremendously. I hope you find the solution that works for you.

tootire - I'm glad you found some relief. I take Suboxone, a combination of buprenorphine and naloxone to keep from using opiates. I've been sober about 12 years now.

Buprenorphine is an opiate. For anyone considering this, stopping it usually involves withdrawal. I'm at a very low dose, 2mg 2x day but can't stop completely without going into withdrawal. Had I known this 12 years ago, I might have just roughed out withdrawal from opiates.

All that said, physicians will use buprenorphine for pain management. I would just ask a lotto questions of the Dr first.

Another side effect, opiates don't work for me while I'm on buprenorphine. That's kind of the idea. So when I have surgery, I'm pretty much limited to non-narcotic pain management. It's possible, just not always easy.

Bill - sorry for what you';re going through.

Naltrexone is used to treat opiate abuse. As far as I know, it has no pain-relief purpose. Tramadol is an opiate, and if you take naltrexone, the tramadol won't work.

Check with your Dr. I do wish you the best.

LDN resets your immune system. Mostly it is used to treat auti-immune disorders. However, they are finding more and more illnesses are auto-immune and at very least, being in pain 24/7, affects our immune systems as we will always have too much cortisol and adrenaline floating about. Fight or flight. It is best for inflammatory disorders and I'm sure, where there is pain, there is inflammation.

Remember, the lower the dose the better and begin very, very slowly. It is also said when you first go on, it can cause your systemic yeast to proliferate which will make you feel back so you will want to get on something to treat yeast overgrowth. You can google and read about that online. Not a lot of drs are aware. Our damaged colons allow yeast to hide in every pocket of our being. We must treat that as well.

Start at 0.5mg for 2 weeks, 1.0 for two weeks etc. Rarely should anyone need to go higher than 4/4.5. The higher the dose, the less it will help. Please study a lot how it functions. Its not the taking it that helps, its when the halflife gets low enough to kickstart your adrenals again (hopefully ~2 hours while you sleep) that it helps.

You want a short halflife therefore a lower dose. Ive studied and taken it for years. As a nurse, my doctor allows me to crush the 50mg tablet into 50ml of water which equals 1mg/1ml. I am right now taking 3.5 ml, 3 5 mg, at night mixed with a jigger of whatever.

Hope that helps. If you start with a huge dose or go up too fast, you might well suffer insomnia or bad dreams and want to come off. Going very slowly is the answer for success.

This is a long term decision as yoy will need to stop all opoiods. When people cintinue to take pain meds on LDN, they will get no relief and unintentional OD can occur. It could be 6 month or more before you see any benefit. Its a commitment to endure your pain for a while hoping thus will help.

Once you start, know yoy are committing to minimum 2 years. This is not a quick fix.

I've gone off for surgery (you must be off for weeks before surgery and I didn't thinj it was helping a lot till I had veen off if it for a month or more and wham. Pain back. It was indeed helping. It was just so gradual, you forget to notice.

Hope this was helpful.

Helo, my wife has very similar spinal pain similar to what you are suffering with. She is having some difficulty getting to the point where she can get the spinal cord stimulator implant. Must see a psychiatrist first, and now they are making comments like she must have had spinal surgery before the SCS implant can be approved. Sounds nuts to me. She has had a lot of epidurals and at least 2 nerve block procedures. Nevertheless, by itself, do you think the SCS implant is effective without necessitating many of the other pain blockers? By the way, what is an RFA? Thanks!

Seeing a psychiatrist is normal before an implant. No big deal. Before approval about scs I have had a trial with leads placed but control is outside of body. I wonder if that was what was intended. An RFA is radio frequency ablation. That fries nerves. I have had relief from such for as long as a year or so. It got rid of occipital
headaches.
In my case I still have pain procedures which takes care of a level of pain that perhaps the scs doesn't cover. My last implant was poorly done. I am looking forward to having previous two implants removed and starting from scratch by a surgeon who is more competent than the last one.
Mine is primarily a Workers Comp case and scs helps while waiting on permission for other pain procedures. Months can go by before things happen.
I did recently have a sympathetic nerve block and that has helped my CRPS and SFN a lot. I can tell because the block was on one side only!
Thanks for asking questions. Feel free if something needs better explanation to get back to me.

Actually @heyjoe415. Doctors prescribe low dose Naltroxone for chronic back pain. I was put on 4.5mg of low dose Naltrxone but unfortunatly it had some strong side effects and didn't help with my back pain. I then went on 1mg and it had no effect positive or negative for me. However many people who suffer with chronic pain are using the Low dose Naltrexone and have positive results. It has to be compounded at a specialty pharmacy since you can't purchase a dose lower than 50mg from your routine pharmacy. If you do take this medication it will cancel out any opioid you take. Hope this helps.

Low dose Naltrexone didn't work for me. I was put on a 4.5mg and took it for a week, I had some negative side effects so I asked my compounding pharmacy to reduce the amount to 1mg. They got permission from my pain specialist and I began to take the 1mg. it had no effect wither positive or negative so I went off of it. I do know that a lot of doctor's are putting their chronic pain patients on this medication and I have heard it helps some people. For me, it just didn't work.

I was told the spinal cord stimulators are prescribed for patients with a failed lumbar surgery. Ask your surgeon.