What medication has worked best for your PN pain?

Discuss different Pain Management Options; Medication options including side effects and Worldwide variances in names etc.
April
Posts: 737
Joined: Fri Jun 19, 2015 9:59 am

Re: What medication has worked best for your PN pain?

Post by April »

Hi Bart,

I think Lyrica and gabapentin are really similar---in fact, I thought they were almost same drug---so I would not try Lyrica, given your experience with gabapentin. I was on three medications at once for almost all three years (tramadol or a slightly stronger opioid, gabapentin, and either amitriptyline or nortriptyline), so it was hard for me to know how much each was helping. But I was on amitriptyline for a while alone at the beginning, and I think I thought it helped a little.

So very sorry to hear that your pain returned after 14 years. This is such a difficult, confusing, and emotionally challenging problem. I still have fairly low level of pain that comes and goes (though I always have at least a little discomfort), and I do not know what creates the flares.

Take care,
April
bartland
Posts: 62
Joined: Fri Aug 04, 2023 10:27 pm

Re: What medication has worked best for your PN pain?

Post by bartland »

Thank you so much for the feedback April. Wishing you comfort and healing 🙏
April wrote: ↑Mon Apr 07, 2025 6:58 am Hi Bart,

I think Lyrica and gabapentin are really similar---in fact, I thought they were almost same drug---so I would not try Lyrica, given your experience with gabapentin. I was on three medications at once for almost all three years (tramadol or a slightly stronger opioid, gabapentin, and either amitriptyline or nortriptyline), so it was hard for me to know how much each was helping. But I was on amitriptyline for a while alone at the beginning, and I think I thought it helped a little.

So very sorry to hear that your pain returned after 14 years. This is such a difficult, confusing, and emotionally challenging problem. I still have fairly low level of pain that comes and goes (though I always have at least a little discomfort), and I do not know what creates the flares.

Take care,
April
May 2002 - developed disabling PN.

Aug 2002 - started 4 rounds of CT scan guided nerve blocks

Feb 2003 - had bilateral decompression surgery. The surgeon found a very obvious abnormal issue on the left side that was wrapped around my nerve and squeezing it flat. Slow improvement over the next 6 years.

6 years after surgery Egoscue Method helped me completely get rid of lingering symptoms.

No issues with PN for 14 years.

Nov 2023 - accident triggered disabling PN again
April
Posts: 737
Joined: Fri Jun 19, 2015 9:59 am

Re: What medication has worked best for your PN pain?

Post by April »

Many thanks, Bart. I wish the same for you!

April
onlysams
Posts: 56
Joined: Fri Aug 25, 2023 7:49 pm

Re: What medication has worked best for your PN pain?

Post by onlysams »

Like some of you, I’ve been through the med roulette too. Gabapentin was a nightmare for me as well, terrible withdrawal and only marginal relief. Tramadol didn’t do much, and I had the same concerns as Bart with opioids in general.

The one thing that actually helped me noticeably was medical cannabis, specifically strains high in CBD with just enough THC to take the edge off. I didn’t expect much, but it gave me real relief without the zombified side effects I got from other meds. If you’re curious, I got mine through a medical cannabis prescription, the process was way smoother than I expected and the consultation was thorough.

I’ve also tried low-dose amitriptyline (10mg) and while it helped with sleep, it didn’t touch the pain unless I increased the dose, which came with more side effects than I could handle. Right now, cannabis combined with heat, light movement, and pacing has been the most sustainable combo for me.
Last edited by onlysams on Sat Apr 26, 2025 8:20 pm, edited 1 time in total.
bartland
Posts: 62
Joined: Fri Aug 04, 2023 10:27 pm

Re: What medication has worked best for your PN pain?

Post by bartland »

Whatever you found to be the right blend of CBD to THC? Is there a product link you would be open to sharing?

Thanks,
Bart
onlysams wrote: ↑Thu Apr 17, 2025 9:50 pm Like some of you, I’ve been through the med roulette too. Gabapentin was a nightmare for me as well, terrible withdrawal and only marginal relief. Tramadol didn’t do much, and I had the same concerns as Bart with opioids in general.

The one thing that actually helped me noticeably was medical cannabis, specifically strains high in CBD with just enough THC to take the edge off. I didn’t expect much, but it gave me real relief without the zombified side effects I got from other meds.

I’ve also tried low-dose amitriptyline (10mg) and while it helped with sleep, it didn’t touch the pain unless I increased the dose, which came with more side effects than I could handle. Right now, cannabis combined with heat, light movement, and pacing has been the most sustainable combo for me.
May 2002 - developed disabling PN.

Aug 2002 - started 4 rounds of CT scan guided nerve blocks

Feb 2003 - had bilateral decompression surgery. The surgeon found a very obvious abnormal issue on the left side that was wrapped around my nerve and squeezing it flat. Slow improvement over the next 6 years.

6 years after surgery Egoscue Method helped me completely get rid of lingering symptoms.

No issues with PN for 14 years.

Nov 2023 - accident triggered disabling PN again
Balenul
Posts: 135
Joined: Mon Jun 13, 2022 2:20 pm

Re: What medication has worked best for your PN pain?

Post by Balenul »

By far gapanetin until it stopped working.only urethral symptoms horrible ones....had also pgad but it was prolly from Zoloft stopping so i am a unlucky guy.Pgad is gone but gabapentin stopped working and i am back at horrible urinary symptoms again in urethra
missvicky
Posts: 1
Joined: Sat Oct 04, 2025 9:22 pm

Pudendal neuralgia

Post by missvicky »

Do not loose hope on this condition. My Primary Doctor recommended Cymbalta(Duloxitine). It works. Years ago they wanted to send us to a Phsyc Doc because it was all in our head! I suffered for years with this condition but primary Doc was on the ball.
bartland
Posts: 62
Joined: Fri Aug 04, 2023 10:27 pm

Re: Pudendal neuralgia

Post by bartland »

I'm so glad duloxetine is helping you! I have been talking to my doctor about trying it for my pain .May I ask what dosage you're taking?
missvicky wrote: ↑Sat Oct 04, 2025 9:51 pm Do not loose hope on this condition. My Primary Doctor recommended Cymbalta(Duloxitine). It works. Years ago they wanted to send us to a Phsyc Doc because it was all in our head! I suffered for years with this condition but primary Doc was on the ball.
May 2002 - developed disabling PN.

Aug 2002 - started 4 rounds of CT scan guided nerve blocks

Feb 2003 - had bilateral decompression surgery. The surgeon found a very obvious abnormal issue on the left side that was wrapped around my nerve and squeezing it flat. Slow improvement over the next 6 years.

6 years after surgery Egoscue Method helped me completely get rid of lingering symptoms.

No issues with PN for 14 years.

Nov 2023 - accident triggered disabling PN again
eraser
Posts: 155
Joined: Thu Dec 25, 2025 1:41 am

Re: Pudendal neuralgia

Post by eraser »

bartland wrote: ↑Sat Oct 04, 2025 11:00 pm I'm so glad duloxetine is helping you! I have been talking to my doctor about trying it for my pain .May I ask what dosage you're taking?
missvicky wrote: ↑Sat Oct 04, 2025 9:51 pm Do not loose hope on this condition. My Primary Doctor recommended Cymbalta(Duloxitine). It works. Years ago they wanted to send us to a Phsyc Doc because it was all in our head! I suffered for years with this condition but primary Doc was on the ball.
All I'd say for these agents that are used to treat neuropathic pain, individuals respond very differently but it's certainly not a wonder drug!

This will answer your question: -

https://cks.nice.org.uk/topics/neuropat ... uloxetine/
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