Limited medical reporting seems to indicate that traditional narcotics are not the best solution for pain relief when it comes to nerve pain. At the same time, they definately beat a blank and work better than using OTCs alone.
However, nerve pain is a tricky thing because of the factors surrounding it. The cause of the pain, the nerve area affected, depression, person to person nerve sensetivity, ect, area muscle spasms or reactions, ect ect ect.
From what I've personally learned, it seems some nerve pain responds well to GABA enhancement treatment. Thats why nerve pain that is affected by muscle factors (like spasms) might respond best to treatment with a relaxant like soma or valium.
Lyrica does have a connection to GABA but it seems to be different then traditional relaxants. This medication seems to work very well for some FM patients. However, a lot claim it does NOTHING.
For patients with FM or Sciatica, it seems that the Norephindrine pathways can play a role in providing relief. Therefore tramadol seems to work for some of these folks, as its a very weak opiod but has a somewhat stronger NE and SE reuptake ability. More recently, a newer drug called tapentadol (nucynta) has been put our which has 3x more opoid action than tramadol and 2x the NE reuptake action, but it has low SE action so seratonin syndrome is less of a risk. This medication works great for me and others (ive heard it called a life saver, or the pain medication oxycodone wishes it was), but on the same token, ive heard nerve pain patients declare it does not work for them and causes dizzying side effects.
Everyone is different. A lot will depend on your chemistry and the type of nerve pain.
Keep in mind there is more than just medications. You've also got options like epidurals, nerve blocker injections, ect.
As for your situation, you do seem to be at a block in the road having tried different nerve pain medication. I would suggest bringing up subonex or nucynta, however considering your response to other medications, keep in mind they might only achieve a limited efficiency.
Post Edited (grainofsalt) : 8/28/2010 7:27:05 PM (GMT-6)