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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19560
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I'm in so much pain after chemo and radiotherapy which finished

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I'm in so much pain after chemo and radiotherapy which finished 2years ago . I'm in pain 12months now and no doctor can tell me WHY . Had bone and CT scans
Hello from JustAnswer.
I am sorry that you are suffering so much from the pain.
Could you describe the pain in more detail?
Where is the pain located? Does the pain radiate?
What type of pain is it (sharp, dull, burning, etc.)?
Is there anything that you have found will worsen or ease the pain?
What type of chemo and radiotherapy was performed?
Customer: replied 3 years ago.

The pain is in my bones from my big toe to my cheek bone but not my hips elbows or shoulders . I'm in more pain at night . I'm like a 90 year old woman . The pain is sharp and consistent . I had breast cancer when I was 39 chemo and radiotherapy 34 radium. The pain wakes me at night and it takes me a lot to get out of bed . On morphine since May and it helps but now they r reducing it and I'm crippled but still trying to work . What do u think

Thank you for the additional information.

It is good that you have already had bone and CT scans, as these are the proper tests to exclude the possibility that the bone pain could be directly due to cancer, such as a metastasis to the bones.

Since there are no metastases, the other primary mechanisms by which chemotherapy can affect the bones is either by a direct toxic effect on the bone or on the nerves that serve the bones. There are also certain metabolic conditions that can contribute to bone pain, such as hyperparathyroidism or vitamin D deficiency. It is also possible that there could be inflammation contributing to the pain, although this is usually considered quickly when someone presents with musculoskeletal pain.

If the pain is due to a direct effect of the chemo on the bones or nerves, the usual approach is symptomatic relief. If you have not had blood tests to check for metabolic problems, it would be appropriate to do so. Inflammation is usually diagnosed based on the findings on exam, but there also are blood tests that are non-specific tests of inflammation.

From the perspective of management, if there are any metabolic problems, they should be separately managed. If there is inflammation, the usual treatment is with an non-steroidal anti-inflammatory medicine, although some people benefit from a short course of steroids. Otherwise, the usual approach is relief of the pain.

There are several options for relief of symptoms in addition to using opiates for pain control. It may help to use medicines that are used for many underlying causes of chronic pain, including certain anticonvulsants, such as gabapentin and pregabalin, and certain antidepressants, such as amitriptyline or duloxetine.

If I can provide any further information, please let me know.
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