Any meds for chronic pelvic and rectal pain after prolapse surgery?

Managing chronic pelvic/rectal pain and Restless Legs Syndrome (RLS) post-surgery often involves overlapping treatments, as both conditions are linked to nerve sensitivity. Treatment usually requires specialized medications, as standard painkillers are often ineffective for nerve and neuropathic pain.

Drugs like gabapentin or pregabalin are often the first line of defense. They calm overactive nerves, effectively treating RLS and radiating neuropathic pain.

So you’ve had the chronic pain prior to surgery or is the pain from the surgery? When was the surgery and have you been to PT since?

@jenatsky I had a rectcel prolaps repair surgery and have had chronic pain when sitting and lying down with RLS in my legs ever since. It was 3 years ago and been put on nerve medication and antidepressant to sleep. Didnt have this problem befor op.

Sounds like Complex Regional Pain Syndrome, aka RSD. A Good dr can help. Try rsds.org. It can happen from just having surgery, stubbing a toe, a broken bone…. Hope you find some relief.

@lae65 Any meds you can recommend?

@jenatsky Pain from surgery 3 years ago . Cant sit or lay down and have had RLS down my legs as well from the pelvis and rectum. On 300mg 3 times a day and 50mg Trazodone just to be able to sleep. Never had this problem before surgery. Not sure why I need to take Gabapentin 3 times a day when I need it for sleep. Any advice would be helpful.

@sharshy I went thru so many but what finally helped. Hydromorphone for pain and baclofen for muscle spasms. Lyrica for nerve pain. I would suggest no matter what you try take one med at a time and start with a low dose. So you can figure out what is working. Another suggestion and I know this is difficult some type of PT, exercise, or stretches. I personally found it hurts at first but then it helps. Start out slow and easy. I went from walker/wheelchair to needing nothing. It took a while.
Another thing that helped me greatly is a DRG -similar to SCS- you do not feel unless you turn it up too high. I found the SCS made the pain worse.

@sharshy I believe you are on gabapentin for pain relief as an alternative to an opiate for pain but it appears to not be helping you. Depending on what comorbidies have you considered something like buprenorphine for 24/7 pain relief? I attached an article on gabapentin and another on covering buprenorphine. You cannot use both simultaneously.
https://www.mayoclinic.org/drugs-supplements/gabapentin-oral-route/description/drg-20064011
https://pmc.ncbi.nlm.nih.gov/articles/PMC4675640/

@jenatsky Can you get Buprennorphine in the UK? I am confused when to take the Gabapentin. it says 300mg take 3 times during the day but I need it to sleep. Also on 50mg Trazodone. Seems after the op, I have some sort of nerve entrapment and the RLS is really bad at night as soon as I lie down to sleep it kicks off. I try to take the Gabapentin 2 hours apart in the evening and Trazodone at 8 pm, but very sedated and tired the next day. Thanks for listening. The whole thing is why I m on an antidepressans fearing going to bed.

Buprenorphine is available in the UK as “Butrans, Transtec, and BuTrans: Skin patches (transdermal) for chronic or moderate pain.” Here are UK narcotic list for your benefit. https://www.britishpainsociety.org/opioids-prescribed-in-the-uk/
Regarding your RLS do you do any stretches? I too had something like RLS but I started stretching before bed and upon waking and I have no further issue. I went to PT to obtain my home exercise program. I also walk 2 miles daily so I’m working my muscles. I don’t believe that our muscles like to be stagnant so when your nervous system is sending out signals and don’t receive any activity payback we develop problems. Man was made to walk upright after all.