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Treatment for NEUROPATHIC PAIN and unable to sleep.

Resolved Question:

I have neuropathic pain; right now I am enrolled in the VA medial services, but my next appointment is August 24 and the medication they gave me has no run out and I am worried I am not going to make it until the 24th the pain is there and I haven't slept since my meds ran out. I have tried calling my VA and told them my story but without seeing a provider first I cannot do anything, emergency rooms are too expensive, and well I am out of questions of what to do next.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 27 Doctors Online

Thank you for posting your query at
I understand your concern and will try my best to help you.
You mentioned neuropathic pain. Can you mention what are the symptoms that you're experiencing, like the site of pain and the severity?
Also what medication were you on previously?
Neuropathic pain has a lot of causes like diabetes, multiple sclerosis, peripheral neuropathy, alcoholism, facial nerve problems, back problems ( e.t.c )
It is more important to address the primary issue first.
Kindly provide me with some more history,and then i can guide you further,

Patient replied :

my body is in pain, tingling all over if I touch anywhere on my body I feel pain and at night it causes immense RLS (restless leg syndrome) where I cant help but twitch or having to constantly move my legs. I wounded pretty bad in Afghanistan I suffered two broken legs from an IED (road side bomb) and severe TBI (traumatic brain inury)in November of 2010 and my symptoms starting happening from there. I have been mainly using Gabapentin on Tramadol to control the pain...I have been using that for 2 years old patientnow with great relief but with the Veteran Affairs and how they work, they give you a 3 week supply when you have an appointment on the 4th week and its so frustrating because I will be in horrible pain for a week. It is a constant 5, but if I move around the pain can go into 6 without proper medications.

Hello. Thank you for the follow up.
I understand your concern.
Since Tramadol has worked well for you, it is advisable to keep using the same drug. But both tramadol and gabapentin are prescription drugs and for the matter, any first line management medicine such as SSRIs or Tri-cyclic anti-depressants that are also used off-label for chronic neuropathic pain, are all prescription drugs. To avail them, you need to go to a doctor.
The other available OTC drugs such as acetaminophen or ibuprofen does work, with limited success. Hence if there is no other way for you to get your medicines till your next appointment you can try OTC
Tab. Ibuprofen 400 mg, can be taken after every 6 hours depedning on the severity of the pain for 5-7 days after food along with Tab. Ranitidine 150 mg twice daily 1-0-1.
Sometimes alternatively in such cases physical therapy is helpful. So you can get in touch with a local physiotherapist for the same.
Hope this is helpful,

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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