Pain medication

[Adam Eason]

Hello Jen, have you explored or considered the option of hypnosis for pain relief? Pain relief is one of the best evidence-supported applications of hypnosis and self-hypnosis. I shall not bore you with a wide range of studies, though if you or anyone else reading this would like some references, you can contact me directly and I'll happily forward a bibliography of sorts.

That said, there was an 'instrumental' hypnosis study that investigated the brain mechanisms underlying clinically reported fibromyalgia pain, Derbyshire et al (2007) used mental imagery techniques of a 'pain dial' with subjects while they were hypnotised and showed encouraging responses with the intensity of subjectively reported pain.

This is just one process that once learned can be utilised personally in a self-directed fashion without the need for a therapist being present thereafter. Evidence suggests that the more you practice with such ongoing self-hypnosis techniques, the more efficacious the technique.

Many consider the best way to learn self-hypnosis is to see a hypnotherapist in the first instance, then be taught the processes for you to practice and develop for yourself and thus build self-efficacy. However, there are other ways and means to learn self-hypnosis via books and audio programmes which I can recommend if you'd like to contact me directly.

The previously mentioned 'pain dial' involves you inducing self-hypnosis, then imagining a dial which is directly connected to your pain response which you then gradually learn to control and turn down the intensity of the pain being experienced. It sounds simplistic, but has proven incredibly successful with my own clients. I have an article that I will post here as a TalkHealth blog in the next couple of days that is a step-by-step guide to use such a process with self-hypnosis, do look out for it - I hope it is of some use to you.

Best wishes, Adam.

[Adam Eason]

Further to my previous post, the first of two articles offering up a tangible self-hypnosis pain-relief strategy has been posted here on this website:

http://www.talkhealthpartnership.com/bl ... -blocking/

Another is going to follow, so keep tuned in to the blog here. If you have any queries, get in touch and let me know.

[Dr Charles Shepherd]

You have clearly tried, or been using, most of the drugs that are prescribed for pain relief in ME/CFS without any great success.

Have you asked your GP about being referred to a hospital pain clinic or a hospital based pain management course?

This is something that I often recommend when all other options have failed and some people report that this type of multidisciplinary approach - which can involve drugs, non drug treatments and alternative treatments such as acupuncture - has been of considerable help.

For example in Wales, there is a specialist pain referral service that is well used to dealing with people with ME/CFS.

[Dr Charles Shepherd]

NHS pain and fatigue management in Wales:

http://www.wales.nhs.uk/sites3/home.cfm ... direct=yes

At the MEA we receive some good reports about this NHS service and when I gave a lecture to Welsh GPs last year there was a specialist from this centre present who clearly understoond the problems that pain can create for people with ME/CFS...

[poorlyone]

I have a question rather than a reply but don't know how to post it! I may need a steroid injection/s for lower back pain and am concerned that this may exacerbate my ME symptoms particularly as I am frequently feverish and suffer from rosacea flushing. I have had ME for 20+ years.

[Dr Charles Shepherd]

As you may have seen in another reply there is consistent research evidence relating to a problem with the hypothalamic-pituitary-adrenal axis in ME/CFS

This may result in what is called hypocortisolaemia (= slightly lowered levels of cortisol) and hydrocortisone has been assessed as a possible form of treatment for ME/CFS

So there should not be any problem (as far as ME/CFS is concerned) in having a steroid injection for a back problem

If you have any signs of an infection this will obviously need to be discussed with the doctor giving the injection

[Neuroimmune Alliance]

I found pregabalin much better than gabapentin.

Also magnesium malate is a great pain reliever.

[Dolphinmum]

I found pregabalin much better than gabapentin.

Also magnesium malate is a great pain reliever.

Can you please tell me what is the difference between the two Gabapentin and pregabalin? I've been on 2700mg dose per day and the neuro advised changing to pregabalin but apparently my gp said no she ccouldn't as the pharmacy only dispense gabpentin and I have to wait to see the CFS clinic (up to 18 wks waiting). Surely if pregabalin is better for my condition as I'm becoming more confused, off balance and basically a crawling idiot with stupid comments coming out a her mouth, who is it for the pharmacy t refuse the GP advice? Don't tell me its something to do with cost yet again.

I've also had a bad reaction to Neproxen so been prescribed Codiene, which my husband is not happy about after reading internet. What are the risks pls. I have been DX fibro 2010 and CFS 2013. Thanks for this clinic its a godsend to read that we are not a minority and need to be heard.

[kittycat2000]

Hi Dolphinmum, is your GP saying that he can't prescribe pregabalin or that the pharmacies don't stock it? The reason I ask is because I get pregabalin on prescription from my GP and have no problem getting it at my local pharmacy. I'm in N. Ireland so I don't know if things are different here.