Medications for treatment of meralgia paresthetica (MP) pain include nonsteroidal anti-inflammatory drugs (NSAIDs), narcotics, and other agents like amitriptyline, Neurontin, and Tegretol. In general, avoid prolonged use of NSAIDs and narcotics. The painkillers recommended here not only greatly reduce pain from MP, they also create a pleasant drowsiness at night and allow 8 hours sleep, making additional sleeping pills unnecessary. In addition, GABA drugs produce a pleasant euphoria throughout the next morning, which provides a welcome break from feeling “sick”.
My favourite is Sandoz 300 mg. Gabapentin. Its action is fairly subtle but is has four advantages:
1. It does not leave you feeling hungover.
2. It makes you feel euphoric until noon the next day (there’s no reaction in the afternoon; the euphoria simply fades.). “GABA Euphoria” is a well-known phenomenon in medicine. Why not take advantage of it?
3. It’s non-habit forming.
4. It helps you sleep, and so to avoid taking sleeping pills.
2. Neofenac (Diclofenac Potassium)
Neofenac is a brand name for Diclofenac, a non steroidal anti inflammatory drug (NSAID). It works by reducing substances in the body that cause pain inflammation. I used it simply because my local pharmacist recommended (I live in Thailand where prescriptions are unnecessary) it and it seemed to work. If you have a recommendation for a painkiller that works, and knocks the pain out for 6-8 hours, let us know.
50 mg orally 3 times a day. In some patients an initial dose of 100 mg of diclofenac potassium, followed by 50 mg doses, will provide better relief. After the first day, the total daily dose generally should not (and need not, if you use the regime suggested in this website) exceed 150 mg. Diclofenac Potassium liquid filled capsules (Zipsor[R]) are only approved by the FDA for mild to moderate acute pain. The dosage for this product is 25 mg orally 4 times a day.
Sleeping pills should not be necessary if you use the combination recommended above along with the evening and morning regimes. But just in case, here’s some information about them:
- Non-benzodiazepine sedative hypnotic sleeping pills: some newer medications don’t have the same chemical structure as a benzodiazepine, but act on the same area in the brain. They are thought to have fewer side effects, and less risk of dependency, but are still considered controlled substances. They include
- zalepon (Sonata)
- zolpidem (Ambien)
- eszopiclone (Lunesta) which has been tested for longer-term use, up to six months.
Drawbacks to non-benzodiazepine sleeping pills
Generally, non-benzodiazepines have fewer drawbacks than benzodiazepines, but that doesn’t make them suitable for everyone. Some may find this type of sleep medication ineffective at helping them sleep, while the long-term effects remain unknown. Side-effects include:
- Morning grogginess
- Drug tolerance
- Rebound insomnia
- Headaches, dizziness, nausea
- In rare cases, dangerous sleep-related behaviors such as sleep-walking, sleep-driving, and sleep-eating
Some people get relief from repeated application of LIDODERM patches. Talk to your doctor or, better still, neurologist.
One or more of these drugs for Meralgia Parasthetica should give you temporary relief and help get you ready to start the meralgia exercises in this blog.