How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. P. Jyoti Your Own Question
Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
Type Your Medical Question Here...
Dr. P. Jyoti is online now
A new question is answered every 9 seconds

Dear DOC, I am on ms mono duo 90mg twice daily for severe pain

This answer was rated:

Dear DOC, I am on ms mono duo 90mg twice daily for severe pain _ two knee replacements one of which went horrible wrong. E.g. reflective pain syndromes. The main issue now is in Tony thorax regime and neck. With severe degenerative changes bone on bone,nerves punchline,bulging etc. Trying to sleep is dreadful with pain worsening until I'm usually awake from 4am. It tells like my upper back is constantly second by second being hit by a hammer. The 180 mg I take daily do not stymie the pain. I see my doc monthly and my pain specialist yearly. I need something substantially stronger. What can you suggest. I believe I am pretty close if not opiate intolerant,but my life as it is is pretty miserable. No let up,never any relief. Regards. Gordon Vail. :/. I was on fentynal patches, duragesic 50 mg. These were sort of ok but I could hardly stay awake whilst driving. No issues driving with oxycontin or nd mono- morphine sulphate. I need help.

Dr. P Jyoti :

I am Dr. P. Jyoti, MD. I promise to use my full experience and knowledge to provide answers specific to your question. Feel free to ask me anything.

Dr. P Jyoti :

hello would you like to chat on this?


I was trying to chat live with you on this.

As you realize, you are already under the care of your doctor and a pain management specialist, so a quick pain solution is not easy.

However, I can give you a number of suggestions that you should discuss with your doctor and pain management specialist.

Medicines: Drugs like Amitryptiline, Neurontin, Topiramate (Topamax), pregabalin (Lyrica), carbamazepine (Tegretol) can be combined with the analgesics. They have a synergistic effect and can help in intractable pain.

Narcotic Analgesics: you are already using them.

Lidocaine patch: these contain a local anesthetic that you can use in the most painful areas.

Tricyclic antidepressants: drugs like Amitryptiline are combined to give effective relief.

Steroid injections: corticosteroid injections are given at the nerve site to reduce the pain.

TENS: electrodes are placed on the skin over the painful areas and are used to relieve pain.

Peripheral Nerve Stimulation: in this, electrodes are inserted under the skin to relieve the pain.

Discuss these options with your doctor and pain management specialist. This will lead to an informed discussion and one or the other should work for you.

Hope this shows you the way forward - wish you good health and a quick recovery.

I hope my answer has helped you gain more knowledge and confidence about your problem and in knowing what to discuss with your doctor.

I hope my answer has satisfied you. Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!

Dr.P.Jyoti, MD.
Dr. P. Jyoti and 3 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

Dear Doctor, Thank yo or your quick response. I have tried Lyrics (150mg) with no perceptble benefit. It's also extremely expensive in Australia if used for pain.I have used cortisone with reasonable results from both my GO and pain specialist. Both doctors are compassionate and wonerfull beings. I have had three procedures on my neck 're last one was to electrocute three lots o nerve endings cotirisation-not sue about the spelling. Unfortunately cortisone injection to my lumber ended up with a pierced lung and an emergency trip to AndE in the early hours of the morning. Use TENS years ago. Not much cop. A am pretty excited about the lidocaine patches and will discuss this with my Pain Professor on the 28th of June- my next follow up. My lung collapse was interesting s it was so deflated they doctors went through the left chest muscle between the heart and chest muscle to get it up again. Regards XXXXX XXXXX off to fill up a hot water bottle to give a bit of relieve as I've USD my second 'MS MONO DUO_morpine sulphate for he day. Thanks again.


Glad to have been able to help to some extent.

I do hope it works out well for you.

If the question has been answered to your satisfaction, please rate my service.

Rating system is the row of faces below - click on a happy face to give a good rating. Thank you.

Remember also to come back here if you have any other questions, I and other experts on the site are always ready to help you.

You can always request for me directly or begin your question with "for Dr. P. Jyoti", I will be very happy to be requested.

Thank you - Dr. P. Jyoti