Tramadol Use - Long-Term?

Hey all. I'll keep this short:

-I was on Tramadol for 3+ years to help with chronic diffuse body pain -- pain that was likely triggered by an infusion drug.
-I have come completely off Tramadol -- at the request of Mayo -- to see how my body was without any drugs.
-My quality of life is a 4-5 out of 10 right now.
-On Tramadol, my quality of life is a solid 8.

I'm trying LDN out now. Pain doctor told me I could try it (at my request). He is suggesting Nortryptiline or a pain rehabilitation type program.

I'm in a rock/hard-place situation. I want to figure it all out, but am in position of needing to locate and buy a new business (long-story). I'm so much less effective when I hurt -- I find myself laying around or staring off when trying to focus on complex things.

Pain doctor had said tramadol isn't a good long-term option. However, I wonder what the length of time spent suffering with lower quality of life is worth, compared to whatever damage Tramadol could cause. I figure maybe I could do a few months on, a few weeks off, type cycle -- to keep tolerance down.

*I'm aware I can't take tramadol while presently on LDN. Just trying to sort it all out.

LDN -- is a pain management strategy for me -- in the short-term, at least. Really it's more of a "see if this will kick my body into helping heal itself" plan.

My pain doctor prescribes it for fibro patients regularly and sees benefit. We do not know what is wrong with me, so I wanted to try it in case it could help. My body type is very similar to those that seem to benefit from LDN with various issues.

My thoughts have been leaning towards wanting to take the tramadol for another year to get my life straightened out, and then readdress once I'm settled into a familiar routine. The last few years have been turbulent, with big changes (health, living situation, getting married, father developing parkinsons-or-dimentia, having to sell business I owned with my dad, my dog that was my buddy through my late teens and twenties being put down, older friend going to hospice and I was one of his main supports, etc.). I'm craving to be settled in to a life again.

Cary,

Low dose naltrexone (LDN) is indeed used for pain management (although it also has other uses, such as treating Crohn's disease and MS). For pain it is most commonly prescibed for neuropathic pain -- especially conditions like CRPS, which is what I take it for -- as well as central pain. At low doses (usually 1.5 - 4.5 mg, and no more than 10 mg), it works differently than at full strength (50 mg+, which is used to treat opioid and alcohol dependency). At such low doses it is not a strong opioid antagonist, but rather works primarily as a glial cell modulator, reducing inflammatory mediators in the brain & central nervous system, increasing endogenous endorphins and enkephalins, and also strengthening the immune system. Most doctors in the USA don't know much, if anything about LDN, which is why you are probably not familiar with it. Although it is used much more commonly in Europe. It also has to be compounded, so it isn't something a regular pharmacist would mention or suggest, either. But there have been a lot of studies done on LDN for CRPS, fibro, and a whole slew of autoimmune diseases, with promising results. Personally, I have been on it for 4 mo now (put on it by my PM, who is an expert in CRPS, and has been using LDN for many years), and it has made a huge difference in both my pain and fatigue, and works much better for me than any opioid or other nerve pain medication ever did. But you do have to be careful not to take it with opioids (at least not with in a few hours of each other) because the LDN still is a weak opioid antagonist, and could potentially put you into withdrawals if taken together. Which is why Thoreau couldn't take the LDN and tramadol at the same time.

Skeye

Thoreau, I am thinking since no dr can come up with a working diagnosis for you if this will affect the drs from rxing pain medication to you at this time. I know how controlled & strict the environment of pain mgt has become over the years & it is getting tougher every day for chronic pain patients.

There is a Yahoo group that uses LDN & I honestly do not remember if this group uses it for crohns or UC. I do know they have been successful with LDN for some folks. Since you are new to it, you have nothing to lose by giving it a fair trial to see if it will work for you. What dose your PM dr say about the dosing it for his other patients that are similar to what you have going on? It sounds like your dr has experience with it since he is treating Fibro patients with it. Keep us posted.

Skeye,you can handle ketamine! I'm severely allergic to it.

I've taken tramadol for about 10 years. It's the only med of all my opioids that hasn't needed an increase in dose. My favorite effect is it increases serotonin, which really helps with mood.

I've gone off it occasionally for surgeries and treatments with no withdrawal symptoms. .

It's not for everyone. Some people report intolerances. I have to be careful what I take in addition, because I've had serotonin syndrome when taking it with Flexeril.

I've been on Ultracet (Tramadol with acetaminophen) and then Ultram (Tramadol) for years although I don't use it every day, just when the pain is too much to 'go without'. The only problem I've had is that if I take it for 3 days running, I have trouble peeing. I've mentioned this to my doctor who says it's not on the 'side effects list', but I know another person who has had the same difficulty. It doesn't cover all of my pain, just backs it off to a more tolerable level.