Tricyclics for back pain

CelicaStorm

Hi there,
Has anyone been prescribed Tricyclics for pain management?
This is an antidepressant but my gp told me it can be used to relax the muscles also..
Are there any common side effects to taking this as I am sceptical about taking it
thanks in advance :rolleyes:

SomeDose

Tricyclic antidepressants (TCAs) are frequently used for the management of neuropathic (nerve) pain, since conventional painkillers are often ineffective in such cases. They do not relax muscles, however, and there are some significant side-effects associated with them. This is also an unlicensed use of the drug, so I'm not sure how comfortable a GP might be in starting treatment with them.

As you probably know yourself, back pain is often a complex issue which can require a variety of different therapies. A specialist would be able to advise you on the best options available.

CelicaStorm

Thanks for your reply SomeDose,
I've been down several avenues such as physio, Spinologist, chiropractor, physical therapy and seen an orthopedic specialist.

My problematic area is the gluteus maximus but, depending on the severity of the pain, it causes additional pain in my lower back, shoulders and neck.

My GP recently prescribed Tricyclics as an alternative treatment as I've tried everything that I can think of (as the list above shows).

I exercise regularly i.e. walking, gym and recently took up pilates.

You mentioned side effects....do you know what the most common/harmful ones are?

Has anyone been in a similar situation and is now in control of their back pain? If so, can you please suggest alternatives for me to try.

thanks in advance...

DrIndy

SomeDose wrote: »

Tricyclic antidepressants (TCAs) are frequently used for the management of neuropathic (nerve) pain, since conventional painkillers are often ineffective in such cases. They do not relax muscles, however, and there are some significant side-effects associated with them. This is also an unlicensed use of the drug, so I'm not sure how comfortable a GP might be in starting treatment with them.

As you probably know yourself, back pain is often a complex issue which can require a variety of different therapies. A specialist would be able to advise you on the best options available.

The doses of tricyclics used to treat neuropathic pain are much, much lower than to treat depression. Tricyclics act on noradrenergic pain pathways and attenuate sodium channels centrally and alter perception of pain. Gabapentin/pregabalin alter calcium channels and one agent or the other can sometimes work.

They can be very effective - but take a week or sometimes a lot longer to reach full effect - but often your doctor will be trialling them with you to see if it works. If you are concerned about side effects and indications for it, you should discuss this with your doctor.

CelicaStorm

Thanks DrIndy for your informative reply, it was much appreciated
I did discuss the side effects with my doctor, who advised me they may cause tiredness and a dry mouth. Since this I have researched the drug on-line and I am coming across mixed reviews about taking it. As it is something I have not tried yet I am hoping it will help me. You have given the same information as my gp and again I thank you. If anyone else has used this drug for pain relief and found it beneifical and has/has not experienced side effects please let me know.

Odysseus

My mum was on amitriptyline whilst waiting for a hip op. In conjunction with the other pain relife they worked well. Initially she complained of a dry mouth maybe the first couple of months, but it was difficult to tell if the amitriptyline caused it as the other pain relife she was taking had the same side effect. However, she did find them useful and experienced no other side effects.

Everybodies experience of taking a drug is somewhat subjective, and me telling you that my mum's experience was benefical may help you make you decision, but until you take them you really won't know how they will effect you. Hope this helps.

CelicaStorm

thanks odysseus for your reply, it is good to hear other people's experiences.