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I've got OA in my hands - waiting to have my second trapeziectomy - shoulders, knees, feet and spine. I also have bursitis on both sides and fibromyalgia, so pain management is very important.
At the moment I take 50mg of Nortriptyline daily, which does help with sleep. During the day I take Co-codamol 8/500 and paracetamol. However, Co-codamol makes me very constipated and so, on the advice on my nurse practitioner, I take one Co-codamol and one paracetamol in the morning, two paracetamol after lunch, then one Co-codamol and one paracetamol before bed. I do find that I'm often in pain during the day - and at night - and some days I feel generally rubbish!
I'm not keen on going onto stronger opioids like Tramadol - although I understand there is a slow release Tramadol, which might be better - but would also consider taking more, or a stronger Co-codamol if I didn't have to cope with the constipation. What medication do others take and what could I ask my GP to prescribe to help me with the constipation, please? I've tried Lactulose but it just fills me full of wind so not great.
The last time I saw my GP about this we discussed how pain clinics seem to focus on opioids and so I wasn't keen. Has anyone had experience of pain clinics? Thanks in advance for any help.
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