A Nurse in Constant Pain.

QUESTION:  I am in constant pain that I cannot function. I am a nurse and am on my feet for 9 hours straight with this pain. If I sit down to rest its worse because getting up is even more painful. Please help me feel better. I asked my doctor for a small amount of pain med thinking it would break the pain cycle but it did not.

LARRY’S REPLY:  It seems you may be in the throes of a systemic inflammatory situation - sometimes referred to as RSD or fibromyalgia. To reduce inflammation takes an effort but the results are worth it.

• First, eliminate all wheat - other grains too if possible. In itself, going wheat-free can help a lot.
• Next, ask your doctor about prescribing low dose naltrexone - 3mg, for example. Taken at bedtime, many people who suffer chronic conditions find relief that lasts all day. We sell it to people who are suffering symptoms of Multiple Sclerosis, Irritable Bowel Syndrome, psoriasis, arthritis, and practically any condition associated with the immune system and inflammation.

Nobody is certain of how LDN works; just that it seems very effective for a large percentage of people with chronic conditions. Dr. Bernard Bhari observed the effectiveness of this drug – referred to as LDN – many years ago and once told me that he can't think of any reason to not prescribe a trial of it to anyone suffering from chronic health situations. The dose is low and there are very few side effects or interactions – the most prominent interaction is with opioids (narcotics).

Of course, there are other things to consider, but these two can likely give you some of the relief you're seeking.

Relieve Itching with Naltrexone Cream?

Naltrexone seems to offer numerous health benefits, particularly at low doses. For years, we've been making naltrexone HCl capsules. We can make any strength the doctor orders, but the most common are 3.0mg and 4.5mg. Lower strengths are often ordered so the patient can adjust their dose to find one that's best for them. These oral doses are taken at bedtime and seem to offer great symptom relief for many people with immune disorders (multiple sclerosis, arthritis, psoriasis, irritable bowel disease, Crohn's, and so on). Dr. Bernard Bhari (one of the original prescribers of LDN) once told me that he'd suggest trying LDN for any and all conditions that are associated with the immune system. It is safe and there have been limited reports of side effects - which is to be expected in that the daily doses are in the range of 1% of the standard approved amounts.

In addition, some doctors order transdermal doses (applied to the skin in a base that helps drive the medication into the body). There are many reports about how effective this can be for the treatment of conditions such as ADHD. This is particularly helpful for people who respond well to naltrexone, but who cannot swallow capsules or tablets.

I have recently become aware of studies in Korea where naltrexone is made into a cream and applied to burn patients to relieve itching. The authors report relief in about 40% of the patients and claim that scratching is reduced in 44.5% of the users. This suggests that naltrexone topical cream would also be helpful for relieving itching from any cause - from bug bites, to severe topical rashes, such as eczema.

People who suffer from itches to the point where their scratching can be harmful might want to talk to their doctor and compounding pharmacist about using a naltrexone cream for relief. We've made such a preparation and find that strengths of 0.5% to 1.0% seem to be equally effective against minor itching.

People who find the common anti-itching products ineffective may want to try naltrexone. It isn't available commercially, but your compounding pharmacist can make it for you. Naltrexone is a drug that requires a prescription, but that shouldn't be difficult to obtain. Just ask your doctor to order "Naltrexone 0.5% Topical Cream", specify the amount and allowed refills. The cream is applied 3 to 5 times daily as needed to relieve itching. 

J Burn Care Res. 2009 Mar-Apr;30(2):257-60; discussion 261. Efficacy of naltrexone in the treatment of chronic refractory itching in burn patients: preliminary report of an open trial. Authors: Jung SI, Seo CH, Jang K, Ham BJ, Choi IG, Kim JH, Lee BC. Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea.

Abstract

Pruritus (itching) constitutes a source of severe distress for burn patients. The authors administered naltrexone to burn patients suffering from itching that was refractory to treatment with antihistamine and anticonvulsant medications to examine the efficacy of this medication as a treatment for pruritus in burn patients. Nineteen burn patients admitted to the Hallym Burn Center at Hangang Sacred Heart Hospital in Seoul, Korea, with burns over 40.32% (+/-18.3) of their total body surface were recruited for this study. The mean number of postburn days before naltrexone treatment was 157.3 days (+/-114.7). The authors observed a significant decrease in itching sensations after 2 weeks of treatment with naltrexone (z = -3.32, P = .001). Scratching activity was also decreased in 44.5% (+/-20.5) of subjects. The authors propose that naltrexone constitutes a potential antipruritic medication for burn patients suffering from treatment-refractory itching.