Pain meds?

[oggy]

What is the doctor likely to proscribe me for bad feet pain? Can't be an opiate as he knows about my opiate habit.
The type of pain is like joint/athritis type foot pain. I was on strong co-codamol for it 30/500 but they don't work now as I've been binging on opiates.

Any ideas?

[Nagognog2]

A rheumatologist might try you on naproxen sodium (naprosyn). This being a NSAID commonly used for arthritis and gout. It's rather like ibuprofen, only stronger. It has no abuse potential. It can cause bleeding in the stomach like aspirin, so it's use should be closely monitored, even if the doctor doesn't know this.

Another that might be tried, and should be refused, is indomethacin (Indocin). While commonly prescribed for arthritis, it has a lovely side-effect: Permanent blindness. As most doctors get their information on drugs from the PDR - Physician's Desk Reference - their knowledge is thereby limited to what the pharmaceutical industry cares to publish. The PDR is compiled by the drug companies. Rather like letting the mice guard the cheese. So, while blindness is mentioned in the PDR, the data on this side-effect is in small type and well buried in the literature. Read: If doctor says "Indomethacin," then you say "NO!"

[oggy]

Ok thanks for your help. One thing about ibuprofen is that it stop protein synthesis witch means muscle break down and I train 3 times a week so it would be no good for me. I'm not sure if its only ibuprofen that does this or all anti inflamatory drugs. I know the Dr wont know so I'll have to do some reserch.

[Silver Fox]

The best type of analgesic medication for pain of muscular or joint origin - arthritic-type pain, inflammatory pain - are the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). This group of medications includes ibuprofen, diclofenac / Voltarol, naproxen, to mention but a few. Aspirin is also a type of NSAID.
As mentioned by Nagognog, they can cause bleeding of the stomach lining, or stomach ulcers, so they maust be taken cautiously, even though they are freely available over the counter.

I need to refute your statement that NSAIDs cause muscle breakdown. NSAIDs can decrease post-exercise muscle synthesis, but as exercise greatly stimulates muscle synthesis, the effect of NSAIDs only offsets this effect to a minor degree. It certainly does not actually cause muscle breakdown.
An interesting article can be found at www.mindandmuscle.net

For severe pain, it is possible to combine the effects of analgesics, for example alternating the use of ibuprofen and paracetamol. eg 1g paracetamol, then two hours later 400mg ibuprofen, then 1g paracetamol, then 400mg ibuprofen, to a maximum of 8g paracetamol in 24hrs and 1600mh ibuprofen in four hours. Each of these medications has a different mode of action, so they don't interfere with each other, but rather reinforce each other for a good level of pain relief.

What is underlying your foot pain? It may be worth having your gait checked by a physiotherapist or a podiatrist. If it is postural / structural, then orthotics may help.