Going Back on Tramadol
Once upon a time, I was on a painkiller called tramadol, a slow-release medication for chronic pain prescribed by a pain clinic. Coincidentally, the restless legs syndrome symptoms I had disappeared — not that I knew it was RLS at the time. I forgot the existence of those nighttime adventures once I was on this painkiller for years.
It was only hindsight (and knowing now that I have severe RLS) that made me aware that it was RLS at all. I had no idea at the time that RLS could be so painful, or afflict places other than the legs. Tramadol was effective management for my RLS symptoms even though it was intended for something else entirely.
I didn't think my pain medicine was doing anything
Once upon a time, my doctor and I decided we would try and reduce some of my medications. I had this brilliant idea to go off of my painkiller because I thought it really wasn’t doing anything.
Turns out, it was. But with chronic pain, sometimes it is hard to tell, since painkillers do not do much for some people, and some of them do less than others. Tramadol was my only option because of my migraine disease, as other pain medications could cause rebound headaches.
Then the pandemic happened, and I couldn’t get back into the pain clinic. I realized then, Man, I really should go back on that medication that at least did something to manage my pain. I am back on a waiting list for tramadol, but with the pandemic, well, that is one long waitlist these days.
My RLS responded well to tramadol again
Once upon a time, my RLS went completely nuts again.
My neurologist did confirm the diagnosis once the RLS returned with a mighty roar. It has been hard to manage and control since then. And, of course, my pain has also been quite difficult to manage.
One day, my doctor realized the pain level I was in was compromising my mobility and put me on half the dosage of slow-release tramadol I was on in the past. We didn’t want to just jump right into the full dosage given how much time it had been since I had been on it.
Perhaps unsurprisingly, my RLS also responded well to the tramadol again, and I needed less of my RLS medication at night. Before this, I had been getting to the point of needing a higher dose of my RLS medication. Often, I needed more than the dosage I was on in order to manage it. I had been waiting to see my neurologist to get the dosage officially raised.
Doctors can be reluctant to prescribe opioids
It’s great that half the tramadol dosage actually halved my regular RLS medication dosage as well, meaning I will not have to increase the dosage of that medication. It was worrying me that I would, because it would have meant that I would have been on the way to augmentation faster than I should be.
Most doctors are reluctant to prescribe opioids for pain, let alone restless legs syndrome. My doctor only did it because of my pain levels and because I have been on it before — as well as the fact that I have a referral in for the pain clinic, but we both know there is a delay due to pandemic backlog, so it will take longer than it should.
However, I know for a fact that this much tramadol worked effectively for my RLS back in the day. I am not entirely sure why it isn’t now. That is a bit worrisome. It is the dosage one would get for chronic pain, so it should be quite effective for RLS, I would think — yet, not this go around.
Want to read the next installment of this story? Read more in Part 2 of this article by clicking here.
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