Body pain due to stress for more than 4 years - #10805
I have been diagnosed with major depressive disorder. I have it since 6 years. I have extreme anger issues too. And I have body ache since 4 years. The psychiatrist has prescribed me nortriptyline, duloxetine, oxcarbazepine, and trifluoperazine. I sometimes feel sensations like it's burning, itching, electric current, or Like I have a cut on my body. The pain is on and off. The pain also gets worse with stres. Nothing helps except medicines and PMR. I want to know if it's chronic pain or central sensitisation.
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Hello dear Please be aware As per my clinical experience it seems central sensitisation It will require comprehensive evaluation Kindly follow below instructions Mri / ct scan ECG Doppler electrometry Dopamine,ggt and serotonin evaluation Kindly share these results with neurologist for better clarification and avoid medicines for anxiety Regards
You are a dentist so how are you able to answer my questions related to psychiatry?
Thank you for your help.
There’s no injury. Initially the pain was random. Like I have pain for no clear reason except it now responds to stress only. Now its not random. But since the doctor has prescribed me duloxetine and oxcarbazepine the pain has increased. How much sure are you with your diagnosis? And why?
Hello dear Thanks for kind response. See the medications you are taking act in central nervous system. They have action on dopamine/ serotonin or bradyki nin which in turn are endimorphic or in simple way pain affecting hormones. Hence the pain seems directly linked with central nervous system. Simple pain goes easily with voveron xr gel or diclofenac gel. Hence, i request you to please get tests done for ggt, dopamine and bradykinin and share reports with orthopedetian or experienced neurosurgeon for better clarification Regards
I am also pretty sure that I have central sensitisation. But whenever I try to ask my psychiatrist he doesn’t use the word “central sensitisation” or “nerve hypersensitivity” hence I sometimes have that 1% of doubt. Maybe he’s protecting me by not using the label.
Hello dear Thanks for the response. Dentistry is not related to just dental procedures only Something we have to tackle medical emergencies also like hyperthyroidism and epileptic seizures There can be chances of a medically compromised patient having dental problems requiring emergency medications Hence we are trained to encounter these medical conditions and hence,are aware of the associated problems and related medications. Therefore accordingly to my experience,I have tried to diagnose your problem and associated procedures. Hope it is clear from my end Thanks
Your nervous system has become hypersensitive to pain. Pain is real, not imagined, but the signal amplification happens in the CNS, not at the site of injury. Often coexists with depression, anxiety, PTSD, and emotional dysregulation (anger).
Talk to your psychiatrist or pain specialist about central sensitization. Ask if your diagnosis includes fibromyalgia or somatoform pain disorder. If not done yet, a pain clinic referral or clinical psychologist consult can help tailor your therapy more precisely.
There’s no injury. Initially the pain was random. Like I have pain for no clear reason except it now responds to stress only. Now its not random. But since the doctor has prescribed me duloxetine and oxcarbazepine the pain has increased. How much sure are you with your diagnosis and why?
Dear Anwesha, whatever maybe the reason, your pain is genuine and it must be very difficult for you to go through that pain. As discussed earlier, if everything is ruled out and if medications are not helping to the extent that you need, therapy is the best option. Among therapies, CBT for pain and somatoform disorders can be helpful for you. Kindly consult a qualified Clinical psychologist for initiation of therapy. Regards.
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