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Hi I am on holiday here in Orlando USA and have run out of

 
Dr. Arun Phophalia's Avatar
  • Answered by:Dr. Arun Phophalia
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Hi I am on holiday here in Orlando USA and have run out of some of my regular medications one of which is my pain relief as I have lower chronic back pain with associated sciatic pain radiating on both sides! I have been to a pharmacist for advice and also to a clinic where a doctor did not look at or examine me because my pain relief is Co-Codamol, essentially acetaphenamin and codiene combined! I already understand that this drug is classified a narcotic in the states but it is also a prescription only drug at home in the UK also. Have you any advice in getting a prescription or something alternative which will help relieve my pain for example?

 

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Person's Gender: Female
Person's Age: 24

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All stated in question....

Submitted: 308 days and 23 hours ago.
Category: Health
Value: $79
Status: CLOSED
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Expert:  Dr. Arun Phophalia replied 308 days and 23 hours ago.

Greetings Emma .

You can visit one of the centers run by the Health Resources and Services Administration, they offer affordable quality healthcare to people without insurance.

You can find a health center near you by clicking here :

http://www.hrsa.gov

http://www.needymeds.org/free_clinics.taf

http://findahealthcenter.hrsa.gov/Search_HCC_byAddr.aspx


Unfortunately we cannot prescribe here. This is a question answer site. Doctors cannot prescribe online as it is not legal. A personal office visit is required and physical examination is necessary to issue a script. Canadian and Asian online pharmacies can send the medications but these can be substandard and regulatory authorities can stop them.

I understand that this may not be the answer you are looking for. But it would be unfair to you and unprofessional of me were I to provide you with anything less than truthful and honest information. I hope you understand.

A best over the counter prescription for the pain is alternate Ibuprofen and acetaminophen (paracetamol); every 4 hourly. This is quite efficacious on pain relief. The helpful herbs for chronic pain are;

1) Willow bark
2)
Devil's Claw
3)
Feverfew
4)
St. John's wort
5) Valerian
6)
Boswellia
7)
Curcumin
8) Ginger extract


Supplements and alternative integrative therapy protocols for pain relief are;

 

1) Evening primrose oil

2) Acetyl-l-carnitine

3) Alpha-lipoic acid

4) Benfotiamine (Milgamma), 100 mg, is a lipid-soluble vitamin B1 analogue

5) Vitamin E

6) Acupuncture

7) Yoga

8) Prolotherapy.

 

Following measures are beneficial for lower chronic back pain with associated sciatic pain radiating on both sides;

 

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

 

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

 

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

 

3) Local analgesic gels or sprays / ointment

 

4) Hot fomentation

 

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

 

6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

 

7) Lumbosacral corset or support or brace

 

8) If obese or over weight, reduce weight for long term benefit.

 

You can start the following exercises;

 

1) Straight leg raising: Lie on the bed with your back and remain in a relaxed position. Slowly raise one of your legs upward and keep it as straight as possible. Count up to ten, and slowly bring down the leg. Do the same with the other leg. Repeat this exercise ten times.

 

2) Curl ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl-up lifting the head and shoulders from the bed / couch. Hold for ten seconds, then slowly lower to starting position. As strength builds, aim to complete one sets of ten curls. The exercise should be done twice a day (both the sets).

 

This is a slide show for the exercises (you can pick up your own set, which suits you);

 

http://www.mayoclinic.com/health/back-pain/LB00001_D

 

Please feel free for your follow up questions.

 

I would be happy to assist you further, if you need any more information.

 

Please remember to only rate my answer when you are 100% satisfied. Please note you are rating my help and not the site or the solution only my help. If you feel the need to rate negatively, please stop and reply to me via the Reply To Expert or Continue Conversation button with the issue you have. I will be happy to continue further and do everything I can to provide you with the service you seek.Dr. Arun Phophalia41087.6967367708

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Expert:  Dr. Arun Phophalia replied 308 days and 23 hours ago.

Hello Emma,

You gave me a negative rating, "helped a little." I would be glad to answer your further queries, if you specify them, so you are satisfied with the answer.

It is privilege assisting you.Dr. Arun Phophalia41087.7172701389

Customer replied 308 days and 23 hours ago.

As I am a nurse u have tried all the above alternative treatments and have ongoing physiotherapy for my back' although your answer is very informative I really do not understand why physicians I have seen will not prescribe to me! I have, in consultation with my gp at home set up this pain management reigeme following WHO guidelines and although I can understand and accept the classification of my medication I do no see what difference a 5 day supply of medication will make to anyone except to Alleviate my pain.

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Expert:  Dr. Arun Phophalia replied 308 days and 23 hours ago.

Emma,

The other way to obtain the short term prescription for the Co-Codamol is going to urgent care clinic or emergency room (especially when you show your GP's prescription). They are required to provide you with treatment and that may include short term use of a medication that can help with your pain. Unfortunately this cannot be prescribed online, as we discussed. As a matter of fact no prescription drug can be written without personally seeing a patient. Otherwise there can be criminal proceeding. I can understand your frustration and appreciate your medical issues. I am sorry about it.Dr. Arun Phophalia41087.7286019676

Customer replied 308 days and 22 hours ago.

I apologise for my frustration and rudeness, I am aware of the legality in prescribing and do not expect nor did I assume I could get a prescription online! Thank you for your advice, I will try returning to a clinic hopefully with more success this time!

Accepted Answer

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Expert:  Dr. Arun Phophalia replied 308 days and 22 hours ago.

You are very welcome, Emma.

Best wishes and kindest regards,

Dr. Arun

Expert TypeDoctor (MD)
Category: Health
Pos. Feedback: 98.7 %
Accepts: 15618
Answered: 6/27/2012

Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine

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