Amitriptyline for back pain. Has it worked for you?

Thump has a prolapsed lower disc and was prescribed amitriptyline.
He was taking it as and when he felt he needed it but it wasn't really doing much.

Consultant physio said to take it every night to calm the nerve pain down and that seems to be working - he's sleeping well and looking a lot better for it.

I have it every day for neuropathic pain, along with clonazepam and Pregabalin.

So... Hard to say if it works by itself for me.

In unison with the other 2, for neuropathic pain, it does help.

Occasional 10mg Amitryp taker here, to help me sleep - A nurse friend said to take it about 8pm ready for the night ahead. I find if I take it any later in the night it knocks me out for most of the following day too.

I was taking 10mg partnered with Naproxen for severe knee pain. They seemed to work together but not on their own.

My GP said to double the dose when I couldn't sleep but you have to be very careful. In higher doses like 50mg it's used as a lazy antidepressant as it can knock you out. You can't be depressed if you're asleep is the thinking 🤦

Was prescribed it years ago for neck / shoulder pain, which was actually a muscle spasm following a car accident (rear ended). Took it for few nights and it certainly helped.

Apparently it's also used as a muscle relaxant in small doses, hence the above. Woke up in the morning and felt sluggish. Definitely hung on me into the early afternoon which put me off taking it more often.

Has anyone had success with is when taken as needed?

Yes. For back pain. Suffered with sciatica for years. Frequent back spasms. Definitely helped me sleep, and rather than being tired and sore every morning, I was sleeping better and more mobile. However, it used to cause me to get really hot, and occasionally I would be woozy in the morning so I wouldn't drive just in case. Had a double nerve root block a few years ago now and that allowed me to stop taking all the pills I used to.

I take 25mg at night for nerve pain relief following years of sciatica.

I had surgery in 2015 to sort the three herniated discs that was causing the sciatica but the residual nerve damage still lingers. I have a numb right foot and toes, sometimes I’ll get what feels like tight hamstrings if I over do things. It’s just nerve pain rather than muscles.

Been on it for 8 years now, sometimes 25mg isn’t enough, but when I’m working night shifts I can’t take it at the usual bed time, so I take it the morning before bed. When I come off nights and take another that night it knocks me sideways the following day. But if I don’t take it I’m in lots of pain the following day, which then takes 3-4 days to get back on top of the pain.

It works for me, and as above I tend to take it around 8 or 9 in the evening so it’s working when I want to sleep.

10mg for pain on left shoulder/arm (trapped nerve) which flares up every so often (every 18 months so far).

Yes, calms down the pain and takes about 8 weeks for it to subside so can stop taking it.

Takes about 1 week for the amitriptyline to take effect for me.

Not me, but my other half... and in their case... yes... when so many other things did not. Has lots of other effects as well (not necessarily "side" effects, some are are other reasons to prescribe), so read up on it, for sure.

Amitrip. is usually taken every day. Be aware lots of these drugs give you a fuzzy head. I've had Ami, Pregablin, and gabapentin for on-going neuro pain, but the side effects, fuzzy head, not being able to concentrate and many others, I just packed it in (broke my spine 7 years ago)

The side effects were worse than the pain.

I was on it for pain management and lasted about 3 months on it and never got up to my actual dosage as It just ****ed me up. Had to go back to the hospital and tell them if I take what they suggested I'd never get out of bed. Got swapped to Nortriptyline which I was on for over 10 years before coming off that.

mrs took it daily for about a year or two for upper back/neck pain with issues not dissimilar to you described.  She found it made a big difference.  She stopped as symptoms had subsided and she probably went 6 months without taking it at all.  Symptoms came back but she now takes it a bit less often.  The first night helps but its really the second and third night in a row before she's feeling lasting benefit (first night you get to sleep but wake up sore, but three days in a row she'll be good for all the following day).  She takes it between 8-9pm and so if she is going to need to drive after 9 or is drinking etc she will miss a night.  She can miss one night without going back to the start but two nights in a row and she's back to building up the tolerance again.  She's been using it like this for another year or so and not had to up the dose*.

I don't think you can "take as needed" as even if you wait until you go to bed to decide that you will be having a very long lie the next day, and the relief is not instant so if you wait for the pain its not going to help, but using it to break the cycle of pain and poor sleep definitely works.

*I got the feeling that because she's not had to up the dose the GP thinks it's not worth actually tackling the underlying problem.

Yeah, just came off them after a trapped nerve / bulging disc issue, they helped me get through the night a bit better, take 12 hours before you want to wake up is the advice, i was also on naproxen so can't say if they did the job 100%, but it worked.

10mg is the basic starter, struggle a bit, they'll say take 20mg, give it a few days to get in the system, will feel like forever if you are like i was, struggling to sleep and waking up just moving your head in the night.

Thanks all, that's some useful insight, I appreciate it works differently for different people.

Mines prescribed as needed as in I don't have to take it every day, but if I do it's one hour before bed.

The first dose last night produced some exctopics about 20mins after taking it which lasted about 2-3mins, GP said this can be normal.
Leaflet says don't take with heart blocks but today GP said my RBBB is compatible.
Felt a bit of a fuzzy head today but that may just be fatigue.

For me that single dose eased the peripheral oversensitized nerves but not the core of the pain, I still worke up in severe pain when turning over in bed, just with no warning signs and then 10/10 white hot pain.

I might try tonight & over the weekend and review on Monday.

Not keen to take long term but would like some sleep assistance right now.

I need to initiate some core work.

Hopefully it'll improve with proper dosing, worth looking at a mattress and pillow to assist long term?

Don't go upping the dose too quickly and see if you can manage on a low dose - takes a while to work. Higher doses are not fun ! I've also tried duloxetine which helped, but again there were unpleasant side effects. I just occasionally take OTC co-codamol these days at bed time.

I used to get 'brain zaps' with one ! Give it a try for a few months.

10mg a night here for nerve issues from dodgy discs. It was explained to me that it would only work over a long period of time with a constant dose; which is very different information compared to your ‘as needed’ advice.
I sleep very well and the pain is definitely subdued to what it was at its peak but I don’t know if I could stop taking it or not. I have no qualms taking something long term so I’ll just keep going.
I don’t get a fuzzy head and if I’m up early for a long drive or something then it doesn’t seem to stop me waking up properly.
I did have to jump through several hoops when I had a medical for a minibus license; many statements needed to reassure the system that the sleepy antidepressant didn’t actually make me too sleepy!

Similar here, 20mg Ami a day, been so for maybe a year. For sciatica & coccydynia, from L5-L4-S1 disc bulges and a fissure. The only side effect I saw at first was taking too near bed time kept me awake a while. Usually take it 7 to 8pm, no side effect these days.
Does it work, dunno! I missed a week when I went on holiday & forgot to pack a strip of the stuff. Can't say I noticed, or anything negative restarting.

More of my situation on the recent sciaticatrackworld thread.

50mg here. Have to take it about half 7, struggle to stay awake past 10. Definitely helps with my sleep, but feel a bit foggy for a lot of the morning

it’s present most of the day but the bit I hate is turning over / twisting in bed

Top tip I've learned in the past few weeks - hold your knee as you turn over in bed so that your legs and upper body move together and your back doesnt twist. Ie - if you're lying on your right side put your right hand under your right knee as you roll left and pull your legs with you as you go. You will invariably steal the covers as you do this.

More comfortable for making that actually manoeuvre but also tended to wake up in better shape and have a better behaved back the next day too

I've been prescribed it for ulnar nerve pain in both arms. It does nothing apart from making me feel half asleep for about 18hrs.

Pretty much the same when I was on pregabalin. Stopped taking that too for the same reason.

Took the second dose last night, no weird palpitations and slept like a log with no pain when turning, brain was a bit foggy first thing this morning but coffee shifted that. I'm going to keep it going all weekend and reassess on Monday. 🤞🏻