(www.91outcome.com) -- Chronic pain can be debilitating. Sadly, it affects tens of thousands of veterans of the 1991 Gulf War suffering from Gulf War Illness and related chronic health conditions. Worst of all, many of these patients report not receiving effective treatments for these debilitating symptoms.
There are many ways of treating pain beyond over the counter NSAIDs like Tylenol, Advil, or Motrin, which are often reported to not help at all when dealing with debilitating chronic pain.
And, before resorting to the effective, but also addictive and potentially mind-numbing narcotic or opioid controlled substance prescription pain drugs like Oxycodone, Hydrocodone, Oxycontin, or even Morphine and its derivatives, there are a lot of other options.
1. For fibromyalgia, a presumptive service-connected condition for Gulf War veterans, there are now several approved prescription medications that have been proven to help many affected.
- Savella (Milnacipran HCl);
- Lyrica (Pregabalin), and
- Cymbalta (Duloxetine).
2. Neuropathic and neurologic pain (including burning pain, tingling, twitching, numbness, buzzing, electric shock feelings, parasthesias, Restless Leg, etc.) is increasingly being reported in many Gulf War veterans (including myself).
In fact, one current CDMRP study is investigating the prevalence of Small Fiber Peripheral Neuropathy in Gulf War veterans with chronic pain in their extremities, likes feet, legs, hands, and/or arms.
In addition to trying the prescription drugs listed above, neuropathic and neurologic pain are often successfully treated with a number of types of prescription medications normally prescribed for Parkinson's Disease (PD) called non-ergoline dopamine agonists.
Not only do these medications often effectively help keep these terrible neuro symptoms at bay, they also can have the welcome side effect of countering the negative sexual function side effects caused by some of the other medications listed here.
The non-ergoline dopamine agonists include:
- Ropinirole (Requip, Ropark, Adartrel, Ropinotergotirole);
- Rotigotine (Neupro); and
- Pramipexole (Mirapex, Mirapexin, Sifrol).
Additionally, medications that affect GABA, a brain chemical, may help. In addition to Lyrica (Pregabalin), listed above, this includes:
- Gabapentin (Fanatrex, Gabarone, Gralise, Neurontin, Nupentin)
3. Depression and Anxiety. Surprisingly to many people, drugs to treat depression and anxiety affect the same parts of the brain involved in some types of pain and so may help relieve pain as well.
Tricylcic antidepressants (TCAs), including Amytriptyline (Elavil, Endep, Dohme, Sharpe), are often prescribed for fibromyalgia and neurologic pain before trying the more advanced (and more expensive) other treatments listed above.
SSRI’s, which affect the Serotoin levels in the brain that are also known to be associated with pain, may also be helpful.
4. Sleep. Finally, getting restful sleep is critically important to keeping pain at bay and keeping other GWI symptoms at their minimum.
One medication being used frequently off-label in Iraq and Afghanistan veterans to help ensure restful sleep is Quetiapine (Seroquel).
This medication is also sometimes prescribed to help with Restless Leg Syndrome.
I take it too, and while there are definitely side effects, I’ll take the trade off any day.
5. Combinations of these. Like for many people with chronic pain, in my case a combination of several of these -- plus a LOT of rest and carefully safeguarding against any form of physical or emotional stress -- is what helps keep the pain and neuro symptoms at bay.
For me, Seroquel has been a life saver in getting me to sleep, keeping me asleep, and waking up feeling rested again after nearly two decades of not feeling rested after my terribly fragmented sleep. I combat the weight gain with an over the counter supplement called CLA, available online from www.swansonvitamins.com.
And the PD medications are genuinely effective in keeping my worst neuro burning and other symptoms at a minimum. If I miss just one day, wow am I reminded how well they work with the immediate recurrence of the worst of the neuro symptoms!