Effective painkillers for OA and medication for constipation?

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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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12 Replies

  • Posted

    hello, i have OA In my feet ankles and knees, i take 2 500/30 cocodomol of a morning two of an afternoon and two before bed. im also on gabapentine 3 times aday and if things are really bad 500mg of NAPROXEN 3x aday. i also use the ibrufen gel. good luck

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  • Posted

    Although everyone has different responses to pain killers, I used Diclofenac Sodium 50 mg suppositories when the pain got bad.

    Good luck..

    Zvi2369

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  • Posted

    When I was very very badly constipated after taking cocodamol following an operation I found the only thing that worked was suppositories. I know that you are taking a lot of beds but if it doesn't interfere with them, try taking a magnesium supplement. Magnesium helps to relax muscles and I think it loosens bowels as well! Good luck, chronic constipation is awful so I sympathise.

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  • Posted

    have you tried CBD balm to rub on . i couldnt believe how effective it was . It may not work for you as I know its not for everyone but its worth a try.

    I found a shop that specializes in CBD products .

    Try to find if you have one in your area or maybe online

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  • Posted

    Thank you all for your really helpful replies. I'm sure the suppositories work fine, but I think I'd prefer to take something to prevent the constipation in the first place. I'll try some magnesium supplements, Linda, thanks for that tip. I've only recently heard about CBD oils, Wendy, so will definitely look into that. If I could get some relief from the bursitis pain it would help, so the CBD might be just the thing. Thanks again.

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  • Posted

    Hi Cheetah so sorry to hear your pain & constipation with your meds. I can totally sympathise. I have OA in both knees. I was prescribed a cocktail of

    amatriptiline to help with sleep

    co-codamol for pain

    ibuprofen for anti inflamation

    omeprazole an antacid

    and finally

    paracetamol.

    I took these religiously as prescribed and apart from feeling like a zombie in the mornings I was also extremely constipated. I was beside myself.

    A friends cousin came over from America. He was using CBD daily intensive cream (thc free) for his arthritis. we both tried it and felt almost immediate relief. Was so impressed that I researched it and found I couldn't get it delivered to Europe (I'm in Scotland). BUT I could get CBD oil (thc free) delivered.

    I have been taking the oil now for 2 months and after the 1st 2 weeks I took myself off ALL my prescribed meds.

    I feel totally free, I feel almost reborn!

    I've been to the docs and of course they couldn't agree or disagree with my taking it but said go ahead, if it works then go for it, if I want to revert back to prescribed meds I've just to let them know.

    Hope this helps and best of luck.

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    • Posted

      Thanks for your reply Chisi.

      I've started looking into the CBD oil and where I can get it in the UK. So pleased that it has worked so well for you and hope it continues to do so.

      All the best.

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  • Posted

    I take senna to prevent constipation. I take opioids for my leg spasms. You have to start out slow and adjust as you see what works for your body. I take 3 in am and 2 or 3 in evening, everyday. It has mild laxative and has a stool softener in it.

    For you I would start out with one in am and see what happens. If you need more then add one in evening. When you find what works for your body, stay with it everyday. Don't stop unless you stop opioids. If you get too loose of stool, cut back one. Sometimes people take them every other day. Everyone is different.

    Drink water !

    Pain clinics are starting to go away from opioids. There might be some alternatives that you haven't considered.

    I have done injections which helped in certain joints. I also have done several joint replacements. No more pain there for me. Before mine got bad I also did some natural supplements.

    Good luck.

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    • Posted

      Thank you for your very helpful reply Deb. I've had injections too, mainly in my hands, but they only work for so long, then it's surgery, which is why I'm now waiting for this trapeziectomy. Others have mentioned CBD oil and I'm going to look into that, but I may also ask the GP about the pain clinic and discuss everything with them. It may well be worth it if they're moving away from opioids. However, it's good to know about the Senna and how it works - I'd forgotten all about it, to be honest and can remember taking it many, many years ago. Thanks again, much appreciated.

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