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.

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@dorisena

I am getting confused about the different types of neuropathy depending on whether it is a pinched nerve or from diabetes or surgery problems. My early neuropathy from prediabetes went away quickly with diet and mild exercise, especially before bedtime. My pinched nerve pain was confirmed with a conduction test on my arm, and I had various physical therapy to get it released and the pain gone. I took some medication for pain and inflammation and when I went off them, I couldn't sleep and worked compulsively for several days until I came down from the drugs. My doctor laughed at me. After that, I relied on the Chiropractor for sciatica, stenosis pain, and a fabulous therapist. I purchased orthotic shoes. I have not relied on pain medicine for such things because the opioids before my back surgery didn't stop the pain but I couldn't function at home to take care of myself. So for my problems I always rely on physical therapy and adjustments, and simple exercises and no pills anymore. I avoid alcohol as well. I don't have much pain anymore. Dorisena

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You are very right, there are several types of neuropathies. Did anyone notice that RF-EMF make the pain worse ? I even saw article about it : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712049/

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@dorisena

James, do you have any diabetes or prediabetes that could cause the neuropathy? The reason I ask is that I was not aware there was such a thing with diabetes when my husband was diagnosed, and most people I have met since do not know that diabetes can cause such a condition which is relieved by diet change and exercise. My doctor never mentioned it to me. My husband's doctor told him to eat beef since he didn't like chicken so he ate one and a half pounds of prime rib a day in restaurants. It was too much of a good thing, of course and his foot went numb and he could barely walk before he died of the cancer in his spine and other conditions. Dorisena

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Hi Dorisena, I am prediabetic but my HgA1C is tested every 3 months and it's 5.4 to 5.6. It's possible that my neuropathy is due to being prediabetic. However, I thought that diabetic caused neuropathy results in numbness and I don't have any numbness. My feet feel tight – like the skin has been shrunk. They also feel heavy. But it's the tightness that is painful. I'm not overweight, less than 120 lbs for a slender 5'4'' frame. I also don't eat many carbs. My wife & I eat fish and chicken mostly, lots of veggies and when we have a steak it's 4oz or less.
James

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You don't sound like you have any diabetes indications at all, with A1C that low, with your weight, and diet being in good order. I only had some pain and tingling before I was diagnosed, and with exercise it went away. The neurologist said my big toe didn't have feeling, and she thought the problem was nerve damage from my knee surgery and/or back surgery. She said exercise wouldn't help, but I do it anyway and it helps. I have no pain at this time. My son learned, as a paramedic, that swollen ankles and feet in the elderly indicate heart problems due to poor circulation, so exercise is indicated to help that.
If you have a pinched nerve, I don't understand why a doctor is not having you in physical therapy to correct the spine, joint, or bone that is impinging on a nerve. Pills don't move a nerve over, and pills don't strengthen muscles to hold the bones or spine in place. They may alleviate inflammation, as does an anti-inflammatory diet sometimes. My simple exercises, which I continue to do long after the pain is gone, keep my spine straight and keep me pain free.
Of course, my spine has dried and shrunk, but there is little I can do about that at age 84. If I slump a lot at the computer or the sewing machine, I can cause a pain in my left arm and I know the source of the pinch in my upper spine. As for tightness in the feet, I had that on a long plane trip and arrived home with fat feet from sitting so long. No more alcohol during a flight, and I drank water to correct it. I keep moving. But I don't turn to pills unless I need an antibiotic for bladder infections. It doesn't happen often because I don't eat sugar. I wish I had learned to be an athlete when I was young. I'd rather read a book.
Sorry I can't come up with a quick cure for pain. It has a cause, but it is sometimes difficult to discover. Dorisena

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@dorisena

You don't sound like you have any diabetes indications at all, with A1C that low, with your weight, and diet being in good order. I only had some pain and tingling before I was diagnosed, and with exercise it went away. The neurologist said my big toe didn't have feeling, and she thought the problem was nerve damage from my knee surgery and/or back surgery. She said exercise wouldn't help, but I do it anyway and it helps. I have no pain at this time. My son learned, as a paramedic, that swollen ankles and feet in the elderly indicate heart problems due to poor circulation, so exercise is indicated to help that.
If you have a pinched nerve, I don't understand why a doctor is not having you in physical therapy to correct the spine, joint, or bone that is impinging on a nerve. Pills don't move a nerve over, and pills don't strengthen muscles to hold the bones or spine in place. They may alleviate inflammation, as does an anti-inflammatory diet sometimes. My simple exercises, which I continue to do long after the pain is gone, keep my spine straight and keep me pain free.
Of course, my spine has dried and shrunk, but there is little I can do about that at age 84. If I slump a lot at the computer or the sewing machine, I can cause a pain in my left arm and I know the source of the pinch in my upper spine. As for tightness in the feet, I had that on a long plane trip and arrived home with fat feet from sitting so long. No more alcohol during a flight, and I drank water to correct it. I keep moving. But I don't turn to pills unless I need an antibiotic for bladder infections. It doesn't happen often because I don't eat sugar. I wish I had learned to be an athlete when I was young. I'd rather read a book.
Sorry I can't come up with a quick cure for pain. It has a cause, but it is sometimes difficult to discover. Dorisena

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Hi Dorisena, I forgot to mention that I exercise & go to physical therapy 2x/week. I do this to keep blood flowing to the peripheral nerves to keep them health with the hope that they will stop sending crazy messages to the brain's pain center. I'm reading the book, Life After Pain by Dr Kuttner, that I found on this site. It's helpful explaining how to retrain your nerveous system to stop creating pain where there is no injury. I also failed to mention that I did have a pinched nerve at L5/S1 and had successful surgery 2 months ago. My PCP, the neurologist who made the diagnosis of mild PN, and the neurosugeon all believe that some if not all of my PN is from the pinched nerve which is still healing. Maybe another month before it's completely healed. I'm praying that the most of the PN pain will go away. If not, i'll have to try some other drugs. I had mentioned in a previous post that I've tried several of the salves and creams that others have said stops their pain. None of these had any affect on my pain which encourages my belief that the PN is due to the impacted, now free, nerve
Stay positive,
James

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@dorisena

I am getting confused about the different types of neuropathy depending on whether it is a pinched nerve or from diabetes or surgery problems. My early neuropathy from prediabetes went away quickly with diet and mild exercise, especially before bedtime. My pinched nerve pain was confirmed with a conduction test on my arm, and I had various physical therapy to get it released and the pain gone. I took some medication for pain and inflammation and when I went off them, I couldn't sleep and worked compulsively for several days until I came down from the drugs. My doctor laughed at me. After that, I relied on the Chiropractor for sciatica, stenosis pain, and a fabulous therapist. I purchased orthotic shoes. I have not relied on pain medicine for such things because the opioids before my back surgery didn't stop the pain but I couldn't function at home to take care of myself. So for my problems I always rely on physical therapy and adjustments, and simple exercises and no pills anymore. I avoid alcohol as well. I don't have much pain anymore. Dorisena

Jump to this post

“ I am getting confused about the different types of neuropathy”
I think we’re all somewhat confused about all the different Neuropathies all 100+ of them.
Jake

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@jamesinsonoma

Hi Dorisena, I forgot to mention that I exercise & go to physical therapy 2x/week. I do this to keep blood flowing to the peripheral nerves to keep them health with the hope that they will stop sending crazy messages to the brain's pain center. I'm reading the book, Life After Pain by Dr Kuttner, that I found on this site. It's helpful explaining how to retrain your nerveous system to stop creating pain where there is no injury. I also failed to mention that I did have a pinched nerve at L5/S1 and had successful surgery 2 months ago. My PCP, the neurologist who made the diagnosis of mild PN, and the neurosugeon all believe that some if not all of my PN is from the pinched nerve which is still healing. Maybe another month before it's completely healed. I'm praying that the most of the PN pain will go away. If not, i'll have to try some other drugs. I had mentioned in a previous post that I've tried several of the salves and creams that others have said stops their pain. None of these had any affect on my pain which encourages my belief that the PN is due to the impacted, now free, nerve
Stay positive,
James

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Thanks for sharing, James. You are on the right track, based on my experiences and study. I agree that it takes a long time for healing, and for the pain to go away. From all my past problems, however, I don't understand why the doctors are prescribing pills that don't heal or stop pain after a while. My Chiropractor had me doing gait exercises and walking practice to try to correct my posture because he said that every step I took was damaging my spine, because of the arthritic knee which was soon replaced. My back was better after the knee surgery but the numbness lasted a year before it went away. It itched a lot of the time. After the therapist showed me how the plastic model of the spine works, I knew how to stretch to restore the spine without the pinching. With the back surgery, it has been four years and yesterday I was able to bend over and lift some but still have weakness for carrying flats of flowers. I was able to enjoy the work, however and had help for some of the lifting. I didn't have pain, just tiredness and exhaustion. I have learned that pills don't help in some cases, and taking more of the stuff is not the answer, for me. I avoid my primary doctor because the blood pressure pills make me feel bad and I can't do my work. He doesn't advise on the diabetes at all. I see orthopedic doctors for joint problems but have decided on no more surgery at my age. I will do less and ride it out in a rocker with my knitting needles. Thanks again for helping me think things out.
Dorisena

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@jamesinsonoma I read your note in the discussion where we share our stories. I imagine you've researched all of the stimulators, read the pros and cons, discussed your options with your doctor, and so on. I had a Burst DR Stimulator implant in June of 2015. The first year it gave me up to 80% relief from the pain in my feet. After a year, I started having the settings adjusted every 3 months, but now, 5 years later, it's not helping me at all.

I tried everything doctors could come up with to treat my neuropathy pain, including Gabapentin, but nothing has been effective. My siblings all say that Gabapentin did the job for them. I have an appointment with my pain specialist, and one with a neurospecilist the next day. I hope one or both of them have some idea for me, and I hope the same for you.

Jim

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@jimhd

@jamesinsonoma I read your note in the discussion where we share our stories. I imagine you've researched all of the stimulators, read the pros and cons, discussed your options with your doctor, and so on. I had a Burst DR Stimulator implant in June of 2015. The first year it gave me up to 80% relief from the pain in my feet. After a year, I started having the settings adjusted every 3 months, but now, 5 years later, it's not helping me at all.

I tried everything doctors could come up with to treat my neuropathy pain, including Gabapentin, but nothing has been effective. My siblings all say that Gabapentin did the job for them. I have an appointment with my pain specialist, and one with a neurospecilist the next day. I hope one or both of them have some idea for me, and I hope the same for you.

Jim

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My primary doctor only wanted me on opioids before my back surgery and wanted to wait four month before during a scan of any kind.
My neurologist did not suggest anything about therapy or pain control after the surgery, so I took myself off opioids one month after the surgery and was on my own with the pain. I learned to control it by avoiding constipation which put pressure on my back. I have a metal cage in my lower spine to hold things in place. I have been four years learning to bed over and not have pain, so that is quite an achievement. I can do small exercises and enjoy my work outside so long as I don't have to lift much or walk very far. I don't need any medication but I can't tell anyone why I am better except I have made progress, slowly. If I have pain in the future, I will see my Chiropractor, who says he can't really do much anymore, and I will do acupuncture, knowing it only relieves pain temporarily. There's always the hot shower, but my son insists on icing down his back for relief. Sorry I don't have more answers. My neighbor had a stimulator inserted in his back and it did not turn out well. He is now deceased. He never was without pain. He took a lot of drugs, bled internally, became paralyzed, and really went downhill. I didn't learn much from his experiences. I am a do it yourself type of person, living alone on my farm, and each day is a little challenge, but I am doing better this spring. I am blessed. Dorisena

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@jamesinsonoma @dorisena I didn't mention what medications I take, some for arthritis and some for neuropathy. For arthritis, I take meloxicam in the morning and Tylenol in the morning and at bedtime. In addition to Gabapentin, I tried meds my pcp prescribed, then the neurologist went through his list, and the pain specialist. Down ar the bottom of the pain doctor's list was desipramine, which helped with the pain but made me need urgently to go to the bathroom, up to 24 times in one day. I stopped taking it, and he moved to the next med on his list, imipramine. It really made a difference. I started taking it last September, and I think it still helps, but the pain is increasing, and Imipramine can't keep pace. I don't have a note in my journal when I started taking Morphine Sulfate Contin, 30mg tid. In 2016 I was trying Cymbalta, and decided to taper off the morphine, to see if my pain noticed. It Did! After taking none for 3 weeks, I restarted, but found I only needed 15mg tid. Unfortunately, I need to increase the dosage, and my pcp won't do it. I usually only take 15mg in the morning and a second 15mg at bedtime, usually skipping the third one midday. Sometimes I should have taken that third pill, when I walk or stand more than usual.

So, for neuropathy pain, I have a spinal cord stimulator, no longer helping, Morphine Sulfate Contin and Imipramine. But at this point, the pain has outpaced the treatment, and last night the pain woke me up. It was level 10. I took 15mg of morphine and 50mg of Imipramine (my daily prescribed dosage is 100mg at bedtime), and put Lidocaine cream on my feet. After a couple of hours, the pain went down to 8 or 9, so I got a few more hours of sleep. I don't know where this is going. There doesn't seem to be any way to know a prognosis. I'm glad I have appointments with the neurologist, pain specialist and neurospecialist in the next 3 weeks.

Jim

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I know nothing at all about all those drugs except Meloxicam which I took for years for arthritis. It did not slow down the arthritis and it quit working in the end before knee replacement. The only thing that helped was giving up sweets and eating foods known for anti-inflammatory factors. Cutting out sugar stopped most of the pain for a while and helped with the swelling. Exercise helped in the summer but winters were painful. I had cortisone shots for my spine pain before surgery and that helped for a while. Finally nothing stopped the pain and I refused to live on opioids as I couldn't function. Exercise helps my occasional neuropathy but I am not sure of the cause or source. Most days I have no pain but some discomfort from the neuropathy. The surgery for the stenosis in the spine did a lot of good because it made room for the nerves to function. It took three years to recover and I eat prunes and dates, which I love, for constipation so I have no pressure on the spine. I have pain in both shoulders but rehab has helped and I get by without any medication for that.
It is difficult to lay in bed at night but I use a cream and massage. I am refusing shoulder surgery. I don't know what to suggest to be helpful. But I couldn't live on all those meds, which my doctor wanted me to do for back pain. Luckily I had a wonderful surgeon but he doesn't push therapy. I suspect we need to keep stretching and moving every day the rest of our lives until the damaged nerves heal and keep in a safe place without pinching. Dorisena

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