One For Sqad....

[DTCwordfan]

A question for you, Sqad, given your famed love of Ibuprofen.

Recently, I damaged my median nerve, left shoulder, the trapezium stiffening up to protect it. Pretty painful this last three weeks.

I've found Ibuprofen to be pretty useless, though normally for musuclar pain I would endorse it. The Doctor, who I saw eight days ago, switched me onto a regime of paracetemol (2x3 or 4 times a day) and a strong codeine, 1 to2 3 or 4 times a day, - I've usually taken the last paracetomol around 4pm because of the caffeine and the codeine around 9pm as that can have a sleep effect.

It's been far better than Ibu - is this a consequence of the chemistry involved, the regime more effective on a stretched nerve....?

Curious?

And thanks.....

[Psybbo]

Hi DTC, can't help but just want to wish you well x

[Peter Pedant]

woddeva works for you dear boy

well done the doctor for getting you onto a regime that works

codeine can be used up to they say 240-360 mg a day
but should cause pretty heroic constipation

nerve pain can be very difficult to treat
and dont change your doctor !

[Sqad]

Well......it depends upon what dose of Ibuprofen you used and whether you used it in combination.
The UK is "measly" with it's dose of ibuprofen whereas on the Continent they are "braver" with higher doses.
Codamol in combination with Ibuprofen is often used and seems to be successful.
Horses for courses, I suppose.

[Sqad]

P.S as for the chemistry, Ibuprofen has greater anti-inflammatory powers than paracetamol or codeine........BUT....you have to be prepared to prescribe the right dose of ibuprofen.

[237SJ]

Does Ibruprofen accumulate in your system? I know Paracetamol does which means that when you keep taking it, you are just topping up with each dose rather than starting from scratch so to speak. That might be why Paracetamol is more effective.

[DTCwordfan]

thanks folk, no constipation I hasten to add, maybe that's my sister's cooking as I am some volunteer for a bowel cancer check at the moment - gross that this is three samples x 2 sticks for 6 smears......

The chemistry may be such, as the Ibu is 200 mg per tab, the paracetemol, 500 mg per capsule, the codeine phosphate, 15mg.....

[DTCwordfan]

thanks too, Psybbs, not the best of pains to have, not least it bounces out down the respective nerves...now mainly a dull thud on the vertebra between the neck and the main spine and a slight twinge on the outer triceps...at least the ulnar nerve has lessened - that one was quite acute this time last week.

[Sqad]

The lovely 237 may have a point...........may!

Half life of 500mgms Paracetamol is about 3 hours.
Half life of 200mgms Ibuprofen is about 2 hours.
Half life means the time that half the dose remains in the system.

Not much in it, but probably......probably Paracetamol has it.

However if one took Ibuprofen 600mgms (as they do on the Continent) then Ibuprofen would win.

[DTCwordfan]

so just drug oneself up to the eyeballs is the conclusion, within safety limits.....I'm coming through and on the wane now, so hopefully not needed from now on.

Just interested to see and the 'horses for courses' is perhaps the best conclusion.......

[Ann]

Sorry to hear about your shoulder DT, not pleasant to be in such pain. I had a shoulder op some years ago so I can sympathise! Get well soon x

[tonyav]

Blimey DT, how did you mange to do that ?.
Hope it heals quickly.

[AdaBrown]

A same drug may not function on everybody, and I think that's why you found Ibu is useless for you.
Ibuprofen http://www.bocsci.com/description.asp?cas=156787-27-1&cid=1

[slaney]

Glad you are on something that works DTC.
Ibuprofen not always effective for nerve pain.

Disagree with Sqad - upping the dose of Ibuprofen to 600mg would not have helped as there is a ceiling level of 400mg - no better pain relief over this dose , just more side effects...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886920/figure/i0003-3006-57-2-67-f02/

..as some Spanish doctors know

http://www.thinkspain.com/news-spain/22531/ibuprofen-doses-of-600mg-too-large-and-not-effective-says-hospital-in-asturias

[Sqad]

Slaney

\\\..as some Spanish doctors know \\\\

ONE Spanish DOCTOR.

I find it difficult to believe that this "Ceiling Dose" is the same for ALL patients, whether 9 stone 5ft woman or 20 stone 6 foot man.

I agree with your comments about Ibuprofen and nerve pain.

[slaney]

Yep - should have said "one enlightened Spanish doctor" :)
As regards the weight of patient I suspect this is like 500mg Amoxicillin which suitable dose for all weights as there is a high therapeutic index.

[Sqad]

;-)......right!

[jourdain2]

Just to say that I hope the pain has eased off a bit by now. Nerve pain is terrible, I know. Out of interest, after my replacement hip op last year (in France) I said after about 4 days that I was OK with 500g paracetamol and did not want the other tablet. The nurse looked at me severely and told me that 500g was for children - so take the gram! I certainly took more than I think would have been authorised in UK. It is rare that I take painkillers, maybe that's why they are so effective when I do. Anyway, hope you're feeling better. :)

[Khandro]

Sqad; May I butt in? I have been suffering with a chronic sprained ankle for10 months, - I asked about which way round I'll be inserted into the tube for next week's MRI scan, if you recall.- Doc put me on Diclofenac (aka Voltaren) caps and said try to keep the dose as low as poss. and stop if any adverse effects.
After taking them for 10 days I noticed to my horror, tea-leaf looking spots in my pee, which on closer examination were clotted blood specks (never beheld anything like it!) so of course stopped taking them and it immediately stopped . My Doc is on Holiday, I could got to another but would rather wait.
I have replaced them with 400mg ibupfrofen which helps with the pain.
What was that about and could the dosage increased please?

[Sqad]

Khandro...I understand your concern re the side effects of Voltaren that of blood in your urine, but changing over to Ibuprofen seem to have solved that problem but clearly 400mgms of Ibuprofen is not doing the trick.

I wouldn't hesitate to increase the dose of Ibuprofen to 600 mgms if and when required.

[Khandro]

Thanks sqad