Can Gabapentin make neuropathy pain worse?

Posted by cwallen9 @cwallen9, Apr 16, 2019

I started getting peripheral neuropathy pain about nine months ago in my feet and hands right after I received a cervical steroid injection. I started taking gabapentin about 7 months ago. I have gradually increased my dose from 100 mg a day to 1500 mg. I can't say that it has decreased my pain at all. In fact, my pain has gotten steadily worse. I was just wondering if it is possible that gabapentin can sometimes make neuropathy pain worse. My EMG and biopsy results are negative for short fiber neuropathy so far.

Interested in more discussions like this? Go to the Neuropathy Support Group.

@mictim

Lisa,

For myself Gabapentin made my PN worse and made my arms jump and twitch basically controllable, as soon as I quite taking it that was gone.

I can see where some people would benefit from Gabapentin or Pregablin (Lyrica types), but it is not for me.

I do feel that Pharma and the medical community really needs to look at less use of single molecule (man made) internal drug therapy of treating PN, as people are getting tired of treating only symptoms of PN. It maybe that possibly incorporating some of the eastern primary as an more interrogative approach maybe a benefit. Less Opiates (new FDA rules) is good, but at least give us a quality replacement for PN. PN is within the reachable sub-dermal regions even in the feet (dead skin layers) therefore a topical pain relief treatment approach should be very beneficial for people with PN, at least that is my view after living with PN for ~15 years.

Off my soap box, the answer for myself is Gabapentin and Pregablin (Lyrica) simply made things far worse, as it seem to affect the whole CNS and not the PN issue.

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Thank you for your opinion. I have had the same experience. I had an EMG that said I had length dependent neuropathy of my feet. The Gabapentin really made the pins and needles MUCH worse. I am now tapering off it. I honestly hated the drug and so far so good. I am going to ask my PCP to teleconference with me weekly so I have medical supervision. The doctor who prescribed it does not know how to get someone off medication. Withdrawal is not one size fits all.

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Perhaps I am too blunt about my future, I am guessing I only have about 15 more years to live, and if I try too hard to fix everything with pills, I may feel bad regardless of what I do or pills I take. Some of the regimens may make me live longer but be miserable. I know my body has to wear out, get more cancer, or get screwed up on too many pills, in order to die. My heart is o.k. for now do I think about those things which keep it pumping well. That means I work on my hypertension and don't sweat the excema, the allergies, the other sensitivities I have. It is enough work to keep the diabetes at bay. We all can do better with that if we forget how good cinnamon buns, carrot cake, and cheesecake taste. and I can make my own quite well. Dorisena

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I believe Gabapentin has caused my very mild peripheral neuropathy in my feet to worsen. I've only been on 200mg 3x a day for 7 days and each day the pain has increased. I noticed that when I went to bed @ 9pm having taken 200mg Gaba at 8pm my pain continued until I fell asleep. When I awoke after 7 hrs sleep my feet had no pain. Then later in the day having taken 200mg @ 8am & 2pm the pain was unbearable. Then the next morning, no pain upon waking. I just stopped the Gaba this morning so it's too early to tell if the afternoon pain will return. Does anyone have experience with neuropathy stopping & starting like I'm experiencing? I had a pinched nerve at L5/S1 since Dec 2019. On March 30, 2020 I had surgery the successfully fixed the bulging disk and bone spur that was impacting the nerve. Some of the pain-all in my right foot & calf is due to the pinched nerve which is still healing but there was never any pain in my left foot until I started the Gabapentin. Although a nerve conduction test on both legs in Feb 2020 did show mild peripheral neuropathy in both legs. JamesinSonoma

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@jamesinsonoma

I believe Gabapentin has caused my very mild peripheral neuropathy in my feet to worsen. I've only been on 200mg 3x a day for 7 days and each day the pain has increased. I noticed that when I went to bed @ 9pm having taken 200mg Gaba at 8pm my pain continued until I fell asleep. When I awoke after 7 hrs sleep my feet had no pain. Then later in the day having taken 200mg @ 8am & 2pm the pain was unbearable. Then the next morning, no pain upon waking. I just stopped the Gaba this morning so it's too early to tell if the afternoon pain will return. Does anyone have experience with neuropathy stopping & starting like I'm experiencing? I had a pinched nerve at L5/S1 since Dec 2019. On March 30, 2020 I had surgery the successfully fixed the bulging disk and bone spur that was impacting the nerve. Some of the pain-all in my right foot & calf is due to the pinched nerve which is still healing but there was never any pain in my left foot until I started the Gabapentin. Although a nerve conduction test on both legs in Feb 2020 did show mild peripheral neuropathy in both legs. JamesinSonoma

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Hello @jamesinsonoma, Welcome to Mayo Clinic Connect. Thank your for sharing your experience with Gabapentin. Have you mentioned to your neurologist/doctor that your pain has increased every day since starting the treatment?

Since you mentioned you also had a pinched nerve at L5/S1 you may be interested in the Myofascial Release Therapy discussion started by @jenniferhunter -- https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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@johnbishop

Hello @jamesinsonoma, Welcome to Mayo Clinic Connect. Thank your for sharing your experience with Gabapentin. Have you mentioned to your neurologist/doctor that your pain has increased every day since starting the treatment?

Since you mentioned you also had a pinched nerve at L5/S1 you may be interested in the Myofascial Release Therapy discussion started by @jenniferhunter -- https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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I have some neuropathy from surgery, I think, which comes and goes. The Neurologist said my left toe had no feeling in it. She said exercise would not help but I do exercise anyway. She said I didn't need to take medication for trigeminal neuropathy unless I had a bad attack, so if I get that pain in my face, I press hard and relax. It stops. I get by without any medicine for these problems ever since I spent a month in the nursing home after back surgery. I had enough oxycodone and such to last me the rest of my life and I quit pain pills as soon as I got home. So I have become anti-pain pills for four years and am getting by with gentle stretching, heel lifts for my balance and neuropathy in my left foot, standing in the shower, and sitting in the sun when it shines. Call me lucky. These pills are not a cure.
Yes, I had therapy for a pinched nerve in 1970 and 1971 in my upper spine which was unbearable but it is fine now. Yes, it could come back. I straighten my back while sitting and get up often. I no longer lift much weight. I have a large laundry basket which rolls well all over the house. It carried the crock pot of bean soup to the cold porch for overnight chilling. Keep moving, gently. Dorisena

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@dorisena

I have some neuropathy from surgery, I think, which comes and goes. The Neurologist said my left toe had no feeling in it. She said exercise would not help but I do exercise anyway. She said I didn't need to take medication for trigeminal neuropathy unless I had a bad attack, so if I get that pain in my face, I press hard and relax. It stops. I get by without any medicine for these problems ever since I spent a month in the nursing home after back surgery. I had enough oxycodone and such to last me the rest of my life and I quit pain pills as soon as I got home. So I have become anti-pain pills for four years and am getting by with gentle stretching, heel lifts for my balance and neuropathy in my left foot, standing in the shower, and sitting in the sun when it shines. Call me lucky. These pills are not a cure.
Yes, I had therapy for a pinched nerve in 1970 and 1971 in my upper spine which was unbearable but it is fine now. Yes, it could come back. I straighten my back while sitting and get up often. I no longer lift much weight. I have a large laundry basket which rolls well all over the house. It carried the crock pot of bean soup to the cold porch for overnight chilling. Keep moving, gently. Dorisena

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@dorisena I love your innovativeness! 👍
Keep up the good work. -Rachel

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@jamesinsonoma

I believe Gabapentin has caused my very mild peripheral neuropathy in my feet to worsen. I've only been on 200mg 3x a day for 7 days and each day the pain has increased. I noticed that when I went to bed @ 9pm having taken 200mg Gaba at 8pm my pain continued until I fell asleep. When I awoke after 7 hrs sleep my feet had no pain. Then later in the day having taken 200mg @ 8am & 2pm the pain was unbearable. Then the next morning, no pain upon waking. I just stopped the Gaba this morning so it's too early to tell if the afternoon pain will return. Does anyone have experience with neuropathy stopping & starting like I'm experiencing? I had a pinched nerve at L5/S1 since Dec 2019. On March 30, 2020 I had surgery the successfully fixed the bulging disk and bone spur that was impacting the nerve. Some of the pain-all in my right foot & calf is due to the pinched nerve which is still healing but there was never any pain in my left foot until I started the Gabapentin. Although a nerve conduction test on both legs in Feb 2020 did show mild peripheral neuropathy in both legs. JamesinSonoma

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@james, When I was first diagnosed with SFN I was prescribed gabapentin 3xday. My pain was only at night in my feet and hands. I couldn’t keep a thought in my head on that regimen so I cut back to 200mg. 2hrs. before bed. I have since upped the dosage to 300mg. but sleep pain free through the night. I have noticed that if my feet/hands are not too bad right before taking gabapentin at night, the pain will increase for a while but then goes away which is weird. I am good most of the day. Nsaids and R-Ala lessens any pain which I take 2xday. I wish you luck finding something which works for you.

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@rwinney

@dorisena I love your innovativeness! 👍
Keep up the good work. -Rachel

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rwinney, I am not so smart, just experienced living on a farm, helping to run a business, and working too hard to manage the household and feed my family. When you don't have any money despite your hard work, you learn to improvise and make do. Now that I am a widow with adequate resources, I feel victorious over my past, despite my ailments. For instance, I can do the necessary therapy for my bad shoulders by rubbing a certain way with the glass stove cleaner and the work keeps my shoulders loose enough to avoid surgery.
I haven't won this issue yet, but I keep trying. No more surgeries unless I get hit by a truck or something. Dorisena

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@nanashelly

I'm right there with you my neuropathy is in both my legs clear up to the middle of my thighs and my right foot is really bad but I manage but like you I am in constant pain and it never ends.

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It does not sound like you have neuropathy but rather a pinched nerve. I was told I had nonspecific neuropathy but when tests were done I had two pinched nerves, a herniated disc, an annular tear and Radiculopathy. I would see a spine doctor before things get very bad. I waited too long and the pain became unbearable.

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@cwalkowicz

It does not sound like you have neuropathy but rather a pinched nerve. I was told I had nonspecific neuropathy but when tests were done I had two pinched nerves, a herniated disc, an annular tear and Radiculopathy. I would see a spine doctor before things get very bad. I waited too long and the pain became unbearable.

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Now that I think back on previous pain, the worst I ever had was a pinched nerve in my upper spine that the doctor was slow to diagnose and treat. He prescribed Naproxen which did no good so he doubled the dose until I could not think and cried from the pain. It took two months for my doctor to prescribe physical therapy which took two months but I learned how to keep it from happening again after many months of exercise. If I had found a gun I might have killed myself because of the pain. I had a nerve test in my arms which had me screaming and I had therapy at the hospital with sandbags which didn't stop the pain. A substitute doctor threatened to have me involuntarily committed to a psychology ward if I didn't stop the complaining. Thinking about all my past experiences and back surgery, I am inclined to believe that pinched nerves are a common problem and require therapy to resolve the pain. If the doctor doesn't live with you, he or she is not always able to get to the bottom of the pain problem. We can learn basic exercises to strengthen the shoulders and back and prevent pinched nerves in the first place. And I no longer carry heavy loads. Pills do not cure. Sometimes our old bodies get so out of shape that only surgery will repair the damage. Then we must stretch and exercise the rest of our lives anyway. Dorisena

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