medication for chronic pain being withheld

Waylaid

Possible explanation (in addition to your GP being crap): In 2018-2019, the NHS limited the prescription of a long list of items by GPs, including many over-the-counter meds. I can't post links, but search for "items which should not be routinely prescribed in primary care" on google if you want more info.

I note that this applies to "minor conditions" only, and that GP's can still prescribe these meds for vulnerable patients, so it's still likely to be your GP being an !!!!!!.  

Also, I'm not a doctor, so take this with a grain of salt, but naproxen might work better for you than ibuprofen. It's a similar medication, but stronger and lasts longer. I was on it for chronic pain. It is prescription, tho.

Good luck...

meadowgrass

Thanks Waylaid; really appreciate, and great to hear about an alternative, which I can see is available on independentpharmacy at 250mg and 500mg! I was just able to order 2 boxes of 400mg ibuprofen from them, without issue, so i know it'll be straightforward to try these out, before asking about prescription, although I'm not sure how the doses compare ... is the 250mg as strong as 400mg of ibuprofen? (I go up to 3200mg ibuprofen daily, but only if genuinely needed, although I know 2400mg is sometimes stated as highest dose daily too.) So far I'm seeing something saying 440mg naproxen equals 400mg ibuprofen

Independentpharmacy advise omeprazole (consultation necessary though) along with naproxen, but I already have lanzaprazole, and am seeing online that lanzaprazole does get prescribed alongside naproxen. Never heard of naproxen before, so it's really good to learn of a non-opiate stronger option!

Sorry you've had cause to use strong pain killers; I notice you said 'was on it', so it's great you're well now.

Regarding crap GP, dreadful that they do this limiting, and have never mentioned that; quite happy to let me think they just don't give a stuff about chronic pain. Despite online purchases probably feeding back into nhs, it feels good to bypass such an unpleasant gp surgery, and, most of all, be able to access critical pain relief.

whizzywoo

meadowgrass said:

Thanks Waylaid; really appreciate, and great to hear about an alternative, which I can see is available on independentpharmacy at 250mg and 500mg! I was just able to order 2 boxes of 400mg ibuprofen from them, without issue, so i know it'll be straightforward to try these out, before asking about prescription, although I'm not sure how the doses compare ... is the 250mg as strong as 400mg of ibuprofen? (I go up to 3200mg ibuprofen daily, but only if genuinely needed, although I know 2400mg is sometimes stated as highest dose daily too.) So far I'm seeing something saying 440mg naproxen equals 400mg ibuprofen

Independentpharmacy advise omeprazole (consultation necessary though) along with naproxen, but I already have lanzaprazole, and am seeing online that lanzaprazole does get prescribed alongside naproxen. Never heard of naproxen before, so it's really good to learn of a non-opiate stronger option!

Sorry you've had cause to use strong pain killers; I notice you said 'was on it', so it's great you're well now.

Regarding crap GP, dreadful that they do this limiting, and have never mentioned that; quite happy to let me think they just don't give a stuff about chronic pain. Despite online purchases probably feeding back into nhs, it feels good to bypass such an unpleasant gp surgery, and, most of all, be able to access critical pain relief.

Regarding Naproxen, it is a non-steroidal anti-inflammatory drug (NSAID) which is routinely prescribed for osteo-arthritis.  I was on it for about 20 years and it works considerably better than ibuprofen which is also a NSAID.  It is prescription only though.  I cannot understand why you are not being prescribed it for osteo-arthritis.

You do need to take it with a proton pump inhibitor like lanzaprazole or omeprazole in order to protect you from stomach ulcers.  I no longer take it because I did eventually develop a duodenal ulcer.  

Have you tried any of the topical pain relief gels?  These can work quite well.  I use Voltarol gel and ibuprofen gel.  The Voltarol gel is best but my doctor will only prescibe ibuprofen gel because it's cheaper.  I buy the Voltarol myself to top up the ibuprofen gel.

Also have you asked to be referred to an orthopaedic surgeon about your arthritis?  I have now had five joint replacement operations over the last few years and my joints, mobility and general dexterity is much improved because of the operations.

meadowgrass

Hi whizzywoo and thanks so much for your response. Great to learn more about naproxen, but sorry to hear you ended up with an ulcer; hopefully have some good meds for that. I've been on strong ibuprofen for about 20 years, and, aside from feeling a trace of nausea if I don't eat for about 5 hours, I seem okay; no tests done, which had been going to be done last April, but things were shut down.

Great idea about gel ... I have pain in hands, that gets worse when needing to use crutches more, and it's hard to get to my back, but I'll certainly look into the gels regarding pain in hands.

There's a big back story about surgeries, including nhs abuses. I'd really tried to move forward with that, even taking myself into hospital many years ago, despite lack of support ... was sent home, as a verrucae was found, which I hadn't seen or been told could be something that could block surgery! Then more bad stuff happened. I think now that I would need more complex surgeries and have too many other complaints that don't have medical attention and would affect ability to cope/recover from any surgeries, as well as GP not being good.

Great that your surgeries went well, and thanks again for advice on things that can help with pain.

teddysmum

I used a local pharmacy that did repeat prescriptions and delivered, but after they started charging £5 for each delivery and being only a few minutes by car, so my husband has to collect. I considered online with free delivery, but they can't supply classified drugs. The pharmacy is right by our GP so they deal with the required paperwork and nip across the road if there is a problem with a prescription.

Do you have a local pharmacy like this, but delivers free of charge?

Waylaid

meadowgrass said:

Thanks Waylaid; really appreciate, and great to hear about an alternative, which I can see is available on independentpharmacy at 250mg and 500mg! I was just able to order 2 boxes of 400mg ibuprofen from them, without issue, so i know it'll be straightforward to try these out, before asking about prescription, although I'm not sure how the doses compare ... is the 250mg as strong as 400mg of ibuprofen? (I go up to 3200mg ibuprofen daily, but only if genuinely needed, although I know 2400mg is sometimes stated as highest dose daily too.) So far I'm seeing something saying 440mg naproxen equals 400mg ibuprofen

Independentpharmacy advise omeprazole (consultation necessary though) along with naproxen, but I already have lanzaprazole, and am seeing online that lanzaprazole does get prescribed alongside naproxen. Never heard of naproxen before, so it's really good to learn of a non-opiate stronger option!

Sorry you've had cause to use strong pain killers; I notice you said 'was on it', so it's great you're well now.

Regarding crap GP, dreadful that they do this limiting, and have never mentioned that; quite happy to let me think they just don't give a stuff about chronic pain. Despite online purchases probably feeding back into nhs, it feels good to bypass such an unpleasant gp surgery, and, most of all, be able to access critical pain relief.

Hi there,

Glad I could help! As whizzywoo said, naproxen is in the same class of drugs as ibuprofen (NSAIDs), but is stronger and lasts longer. I was taking 2x 750mg/day (w/ 2x daily omeprazole), which I believe was the maximum dose.

Unfortunately, nobody mentioned that it shouldn't be taken for more than 6 months at those doses, and my prescription just continued, so I kept taking it. I developed an ulcer and GERD after 14 months (I'd been on diclofenac, another NSAID, for a few months before that, too). No more NSAIDs for me!

FYI, ibuprofen can have similar effects over the long term (I think the max dose is 2400mg, btw). Please do consult a doctor or pharmacist about long-term NSAID use. They can kill you if you develop a bleed in your stomach, cause kidney damage, etc. 

Unfortunately, long-term paracetamol use eventually affected my liver, so I'm now stuck on tramadol. It works, but I don't like it. I use various non-pharma methods to manage my pain, too, but can't make it through the muscle spasms and sciatica w/o a med of some kind. 

Your surgery (and medical experience in general) sound pretty awful. So sorry. Can you find a way to get referred to a pain service or pain management programme?

Good luck!!

Waylaid

Oh, Andi second the Voltarol gel recommendation.

meadowgrass

teddysmum said:

Do you have a local pharmacy like this, but delivers free of charge?

Yes, thanks teddysmum; they at least are pleasant on the phone and prescriptions turn up fine.

meadowgrass

Waylaid said:

I was taking 2x 750mg/day (w/ 2x daily omeprazole), which I believe was the maximum dose.

Unfortunately, nobody mentioned that it shouldn't be taken for more than 6 months at those doses, and my prescription just continued, so I kept taking it. I developed an ulcer and GERD after 14 months (I'd been on diclofenac, another NSAID, for a few months before that, too). No more NSAIDs for me!

FYI, ibuprofen can have similar effects over the long term (I think the max dose is 2400mg, btw). Please do consult a doctor or pharmacist about long-term NSAID use. They can kill you if you develop a bleed in your stomach, cause kidney damage, etc. 

Unfortunately, long-term paracetamol use eventually affected my liver, so I'm now stuck on tramadol. It works, but I don't like it. I use various non-pharma methods to manage my pain, too, but can't make it through the muscle spasms and sciatica w/o a med of some kind. 

Your surgery (and medical experience in general) sound pretty awful. So sorry. Can you find a way to get referred to a pain service or pain management programme?

Good luck!!

Thanks Waylaid, and sorry to hear about the medicine effects on you; a lot I could say along the lines of 'why on earth isn't non-harmful pain medication produced', but I imagine we all feel the same about that. It's not pain relief if medicines cause other painful conditions. Glad the non-pharma  and gel methods help you, but, yes, certain pain needs the hard stuff, for sure. I'll make a note to see if trying eg turmeric might work now ... tried it once before, but felt sick, eek. Good to try to reduce the pharma stuff, and supplement it, definitely, so I hope that continues to help you, and will look into that further myself too.

Thank you for your good wishes and comments about surgical/medical experience; hard to get medical help, and, when I say I can't get to the pain clinic and it's left at that, just is shocking, as you can't believe they're fine with letting someone suffer. Sick of the criticisms too, because they've not bothered to read my records. The experience recently, when I started this thread, has left me far more avoidant of having anything to do with the nhs; I appreciate the pharmacy staff are nice though, luckily, regarding deliveries, but am between a rock and a hard place regarding trying to find help and coping in the meantime. One thing I have made a note to do soon (health's a bit too bad right now) is to find a new GP surgery. The warden buzzes about once a year, to do a review, and she mentioned a surgery to me, so I'll follow that up. She said she's been with them for 36 years and they've been fine. Maybe I'm at a dead end right now as I know I'll get nowhere with the current GP surgery, so, once rested up a bit more, I'll get on with contacting a new surgery and see what new options that opens up.

Manxman_in_exile

I haven't read through all of this and I don't know if it's still an issue or not, but if you have a complaint about your GP surgery and the Practice Manager can't resolve it, your first recourse should be to your local Clinical Commissioning Group.  They are the body responsible for commissioning GP services in your area and GP practices are accountable to them.

Find Clinical Commissioning Group services - NHS (www.nhs.uk)