QUOTE (araitn @ Oct 13 2009, 04:15 PM)

I have the same pain all day, every day. Some days are worse than others. I've not found any medication that can touch it. Others have some success with Lyrica, Neurontin, Amitriptyline, and some depression medications.
What to do when you can't sleep
& what meds help with neuropathy
will get 2 different answers from me...
I spent 2 years where I literally did not sleep, could barely get out of bed... I got an average of 4 hours of sleep every 4 days, and let me tell you, the world did not look good from this side of things. I was extremely sick in so many ways, and after insomnia med after insomnia med, they finally just put me on a double dose of Duragesic -- fentanyl patch. It saved my life because I was at the point where no part of my body or mind could sustain that amount of sleeplessness. I soon, however, developed a bad reaction to the fentanyl, though did not realize this medicine was the cause. My hands and feet were swollen all the time, I had a constant low grade fever, a sensation of being freezing cold and burning hot at the same time (unlike any fever chills, it's hard to describe, a uniquely miserable feeling), and all my joints seized up like the tin man (polyarthritis?). They tested me for lyme disease, lupus, and all the other autoimmune stuff which all came back negative. So, I started trying to discern if there was any pattern to my symptoms, and it turned out that I flared more on the 3rd day when I would change the patch -- so, I realized it must be the fentanyl doing this to me. My doctor was out of town at the time, so instead of waiting for his return so he could prescribe titrating doses, I just ripped the patch off and then went into a narcotic withdrawal like what you see on drug films. Indescribable. But, eventually I came out of it, the neck pain reached its normal baseline, I stopped sleeping again, but soon enough to spare my life I found an interventional treatment injection that helped with the neck problems and reduced the pain from a 9 to a 7. Moral of this story -- be careful with medications, but get the pain relief you need. Don't waste your life suffering so much you are unable to eat, drink, and sleep, because your body will shut down if you don't meet your most basic biological needs.
On a much more optimistic note...
With regard to neurogenic pain (mine is caused by nerve root compression at several joints in the lumbar region), I have found that Cymbalta works wonders. The pain is still there, I go more quickly from moderate pain in my legs to numbness of the legs (--used to go more predictably from moderate pain to severe pain then to numbness), but the pain is no longer that severe intensity where you are crawling the walls all night long and imagining things best not uttered.
The only downside to Cymbalta -- extreme nightsweats as a side effect, and it does interrupt my sleep. But, better to have to get up a few times to change my clothes or rotate towels on the bed than not sleep at all. So, see if Cymbalta is something your doctor feels appropriate for you. Cymbalta is in the class of SNRI antidepressants (serotonin/norepinephrine re-uptake inhibitors) and is labeled for diabetic neuropathy in addition to depression. And hey, who in this amount of pain over a long period of time couldn't benefit from a mental boost, eh?! Downside to SNRI meds -- not many choices. The classic SNRI prescribed for nerve pain at Spaudling Rehab (where I did all the outpatient spinal injections) is Effexor, but I have heard too many horror stories about side effects and withdrawal to want to try that one. As for Lyrica -- helped with the widespread muscle soreness from my fibromyalgia, but did not have a noticeable effect on the nerve pain, and rendered me as forgetful and befuddled as an Alzheimer's patient -- so glad the doctor listened to me when I said I need something that will not interfere with my cognitive skills as I was soon starting law school! Withdrawal from that was unpleasant, but I made it. As for Neurontin -- I took this years ago before the nerve root compression was an issue; was prescribed for my constant muscle spasms surrounding my unstable cervical joints. Result -- didn't notice any relief of spasm or pain, but I did develop an increasing amount of muscle twitches that got so frequent and forceful that my limbs were flying all over the place to the point where all that was missing for it to be a seizure was the lack of consciousness. But, I have learned from others who take Neurontin for nerve pain that it does help them and does not cause the seizure-like issue I had. These kinds of meds are trial and error, and everyone's bodies and circumstances (diagnoses, symptoms, other meds, etc.) are different. But, I try to warn people about potential side effects to prevent them from enduring some of the misery I have dealt with. I feel that it gives meaning to my suffering when I use it to spare another person's suffering.
So, in summary, if you're in pain, you have the right to relief -- so don't let idiot doctors deny you what you need or give up on you. And, if nerve pain is part of your constellation of pain symptoms, Cymbalta might help.
Best of luck. I hope you feel better soon.