Pain Management ideas?
Posted , 11 users are following.
I was wondering what everyone does for pain from inflammation? I have testicular pain from a failed left varicocele procedure a year ago that causes severe inflammatory pain in the groin and scrotum whenever I do a lot of physical activity including sex. I take Ibuprofen with codein and ketorolac and have to lie down with an ice pack for a few hours.
In 2 weeks I will get what is called a scrotal nerve block which is an jnjection of an anti-inflammatory (cortisone) into the spermatic cord that should help for a few months and then repeat.
Does anyone have any other ideas for pain management I could try? When i get these flare-ups they last for days and completely shut me down. Thankfully it does not interfere with my ability to CIC. Thanks. Howard
0 likes, 41 replies
barney34567 Howard31850
Posted
In addition to what you've tried, why don't you use a low dose antidepressant such as
amitriptyline.
I was prescribed this for bladder pain and it worked brilliantly (in low doses). In high doses it is an antidepressant.
Other meds you could investiagte include pregabalin (Lyrica) for neuropathic pain.
Howard31850 barney34567
Posted
Thanks Barney - I tried Lyrica but the side effects were too severe.
I will look into amitriptyline.
Howard31850 barney34567
Posted
Thanks again Barney. What do you mean by "low doses"? I would like to try it.
barney34567 Howard31850
Posted
Sorry for the late reply, but I wasn't well.
By "low dose" I meant 10 mg daily of amitriptyline.
As to Lyrica, I was on 75 mg as needed. What was your dose when you suffered the side effects?
Howard31850 barney34567
Posted
Thanks Barney - I hope you are feeling better now. My dose was also 75mg Lyrica and it just made me feel detached with a foggy brain. I get the scrotal nerve block injection on Tuesday and I sure hope it helps, or at least not make matters worse for me. Howard
barney34567 Howard31850
Posted
Sorry to hear Lyrica created a foggy brain. I know a few folk who experience similar.
As to the injection you're set to get, I assume it is also known as Spermatic cord anesthesia block (SCAB) injection.
If so, my understanding of the treatment from readings are positive.
Best of luck.
Howard31850 barney34567
Posted
Hi Barney - you are correct - it is the SCAB injection. I hope the liquid does not migrate into the prostate and interfere with my ability to CIC. My urologist said he has never given to men with BPH as it usually is given to younger men in their 20s. But I would think that if it did get into the prostate it should help shrink the prostate as the medication is just a potent anti-inflammatory steroid (cortisone). My BPH has been really helped in the past when I took prednisone for other issues.
I'll report back. Thanks. Howard
barney34567 Howard31850
Posted
Interesting what you say about prednisone.
I assume you weaned off it and did not stop cold turkey.
If it helped with your BPH why not ask yr doctor to return to it? I can't see much harm if you're put on low doses and there are no contraindications with yr other meds.
Howard31850 barney34567
Posted
HI Barney - I had the SCAB 2 days ago now. My doctor just used Lydocaine as he said he first wanted to see for sure if the scrotal gnawing pain was in fact nerve pain. He did 2 injections into different areas. I must say that chronic pain has been much better but this afternoon after a lot of physical activity it has come back. So now I will try to redo the injection with a steroid that should last much longer. The procedure itself was simple and painless and took just 5 minutes. It should be a "first stop" for men with chronic scrotal pain.
kenneth1955 Howard31850
Posted
Hey Howard
I have not heard of SCAB in years. I remember when I worked in a nursing home in the 80's we had to deal with that. Where did the doctor say you got it from. Take care of it if you can. It can get real bad.
Take it easy....I guess we can get anything at anytime....Ken
Years ago when my kids were small they are 11 month's apart. One had Measles the other had Chicken Pox and then they switched it was a H??? of 6 week. I ended up in the hospital. I got Roseola. Had 106 fever.
Glad them days are over. Take care buddy
Howard31850 kenneth1955
Posted
HI Ken - thanks for the good wishes. I hope you are feeling better today.
My SCAB stands for Spermatic Cord Anesthesia Block which was a needle injection of Lydocaine into the scrotal region to try and numb the nerve pain. Is that the same SCAB you are referring to? I know it is an old procedure. It is a terrible pain.
Take care
Howard
kenneth1955 Howard31850
Posted
Howard.
Sorry I was reading that wrong I was thinking of Scabies. It a skin rash. I was wondering when you go that. So sorry buddy. I know you got the injection hope it helped. You need some rest sometime.
Doing okay. I made 3 doctor appointments today have a few more to make
I wish you no pain for a few hours at least....Ken
nick21549 Howard31850
Posted
Hi Howard, you have my sympathy! I too have had testicular pain for many months. I have suffered with prostatitis on and off for the past 2 years and 16 months ago, after various procedures and investigations, I started to get pain in my left testicle. (I'm 50.) It was very debilitating waking each day to the ache and getting little or no relief. I too used ice which did help, and I too had a nerve block injection but this didn't help me unfortunately. I think my trouble was epididymitis but happily for me, I have been pain-free for the past 3 months after having it for more than a year! I tried going to the gym 2-3 times a week to try and shake things up a little and get my body in better shape - maybe that helped. I tried ejaculating more often in case the pipework needed a blast (!). I did wonder if the pain continued whether removal might be an option, but there's no guarantee the pain won't continue. I saw a back specialist since I thought I might be suffering from referred pain my my lower back, but drew a blank there. Having said that, I've had no back pain for some time either! This doesn't really answer you request for pain management ideas but I hope it might give you some hope. My pain wrecked a holiday to Greece last year with my wife - the pain was just endless - but I'm so glad I've not had any further surgery. I think any procedures down there can upset things and cause unintended pain. I know of two friends who've had a vasectomy and they had chronic pain afterwards. Maybe best to manage the pain in the best way possible in the hope better days lie ahead. The ice is definitely one to stick with! Good luck!
Howard31850 nick21549
Posted
Hi Nick,
Thanks for your note. I also had a respite from the pain for about 5 months during the summer and then it came roaring back and I've been crippled by it now for the past 2 months. I don't know why it went away or why it came back. It does seem to be triggered partly by sex which is indicative of epididimytis. Did sex trigger it for you?
I live on Keflex which does help but it has side effects. Did you try any antibiotics?
I am sorry to hear your scrotal nerve block did not work. Mine is in 10 days and I pray it will help me.
Also did you ever get checked for a varicocele? The symptoms are also consistent with that condition.
It sure is a miserable condition. Thanks again and all the best. Howard
nick21549 Howard31850
Posted
Hi Howard, yes, sex did trigger it, but sometimes also it helped it. I tried lots of antibiotics (Doxycycline, Ciprofloxacin, Trimethoprim) but none of them helped. They don't for most people it seems! I was never checked for a varicocele but they did various tests and scans and nothing was found.
Howard31850 nick21549
Posted
I would suggest Cephalexin as it was developed specifically for epididimytis and it does help me every time with my flare ups and it has minimal side effects.
I would also ask specifically for a scrotal ultrasound which is different than general ultrasounds. It looks for varicoceles and grades them. My problems started after I was given a varicocele following a botched interventional radiology procedure for my BPH. So if the nerve block does not work then I will get the varicocele ligated by my urologist.
One reason the nerve block does not work sometimes is because the problem does not originate in the epididymis but rather with the varicocele so it is worth tracking down. Good luck.
nick21549 Howard31850
Posted
Interesting Howard. Thanks for the suggestion. Will bear than in mind.