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Hi Caroline,
Not knowing the "why" of the pain it appears the symptoms have now become the diagnosis which is typical of a diagnosis that is truly sypmptomatic, not diagnostic.
Here are a couple of thoughts and ideas that may help you.
* As is pointed out in the previous post there are what are called "afferent" and "efferent" pathways for pain. Basically pain has been thought to be a directional path from the area where pain is experienced to the brain as the receptor site.
The stimulus originates distally and arrives proximally at the brain before we have the perception. Some of the antidepressants may change the receptor sites and/or introduce endogenous ( from the body ) opioid peptides
( enkelphalins, endorphins) which could possibly affect the stimulus strength.
Enough talk and theory so let's move on to rarely using any drugs or possibly not at all.
If you have not tried interferential therapy ( 8,000+ pulses per second ) of a small pleasant electrical current into the area of pain then I would encourage you to do so. If the therapy works you will know within 15 minutes of beginning the therapy.
Now the interesting aspect of interferential is it has for most people what is called " carryover pain relief" or often called "residual pain relief". What this practically means is if your pain prohibits you from sleeping then you should begin a treatment at home about 30-40 minutes prior to bedtime, obtain relief, and hopefully the carryover pain relief will be sufficient for you to sleep most of night and break the pain cycle you are on.
The carryover effect is not understood completely as there is little research being done that looks at what chemical processes are going on as a result of varying polarities of the stimulus and how it is inhibiting the pain pulses.
You will not have to deal with certain drug reactions like tachycardia, stomach irritation, anxiety reactions etc.
Here's a video that may help but no matter what try interferential before you continue on this antidepressant drug pathway.
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While most people know that pain signals go up the spinal cord to reach the brain, they may not be aware that there are signals coming down the spinal cord that can increase or reduce pain transmission. By increasing levels of chemicals (norepinephrine and serotonin) at nerve endings, antidepressants appear to strengthen the system that inhibits pain transmission.
Some antidepressants may be useful in chronic pain because they effectively reduce anxiety and improve sleep without the risks of habit-forming medications. Some people with chronic pain are depressed, and treating the depression may also help reduce the perception of pain.
The optimal role for antidepressants in chronic pain is still being defined as research progresses. These qualities seem clear, however.