Restless Legs Syndrome (RLS) Discussion Board

I have a question for those of you who are currently prescribed strong opiates fir non-painful RLS symptoms...

Have you encountered a situation where you needed a strong opiate for pain (broken bones, surgery) in addition to treatment of RLS? If so, how was this pain addressed and was it effective? Did you have problems with needing to change your RLS related dose following a possible increase in opiate dose for pain?

I am currently prescribed tramadol ER 300 once per day. At times I utilize kratom for breakthrough symptoms when I can't sleep. The possibility of needing/using a stronger opiate was brought up by my doctor. I have a history of kidney stones and I am worried that if I was already using a strong opiate for RLS, that i may run into issues with pain control should I happen to need it. I also am worried that if an increase in opiate was needed for short-term pain, that it would effect the dosage needed for RLS symptoms once the temporary pain had subsided...

Thanks for sharing any info or experience you may have.

For my non painful (but so distressing RLS/WED 24/7 symptoms that it should come under the umbrella of pain) I use the following for treatment.
Ropinerole
Maxitram Slow Release 100mg x twice daily (this is tramadol)
Cocodamol 30/500 x 3 times daily (sometimes 4).

My daughter in law who is a senior prescribing nurse within the pallative care sector said kindly that she wouldn't like to be trying to cover serious pain management should I ever need it.

My life is all about control of RLS symptoms, never mind other issues that I am dealing with. If my RLS is not under control my life style is beyond hell. I get by not too badly, with my above mentioned medications I still have breakthrough which I try to walk off.

With regard to my RLS symptoms and treatment I have no option but to deal with the present...... any future different pain management will have to be a consideration if and when it happens. Just my own point of view.

I use methadone - have for at least 7 years, I think. I do occasionally take pramipexole part of the time, but because I am physically dependent, I still take a small amount of methadone even when I use the pramipexole.

I haven't needed any surgery or had any terrible pain. I have had a couple broken bones and some dental issues. I found that NSAIDS worked acceptably well. One time I was prescribed tramadol and I did use it. It was effective, relatively speaking, and I didn't have any issues with my symptoms.

Deb, one of our members, had major surgery - I think she was on methadone at the time. I don't recall her saying anything about any issues.

I have had surgery for kidney stones and the most difficulty I had was convincing the doctor that I was not an addict. Apparently it was the hospital's policy that they not treat pain unless there was a family member present who vouch for me. The fact that I was taking fentanyl for a condition that most doctors perceive as something benign probably triggered some inhibitions. I believe it was morphine that was administered at the ER. There were no problems, short or long-term.

I take Methadone, and as Ann stated I have had several joint replacement surgeries. My hip doctor had me take Narco. That worked fine. I usually take less Methadone because the opioid covers my RLS PLM. When I had my shoulder done, it was the worst pain of all of my surgeries. He was a different doctor. He thought that my Methadone would cover some of the pain. I have found that is not the case. I didn't know how bad it was going to be going into it. I had the Narco, but it wasn't enough. I had to use my husband's Oxycodone too. I alternated them. I do have a limit with opioids, side affects. Luckily it wasn't severe for too long. I did have to get more Narco from my primary doc though, since the pain lasted so many more days longer than the other surgeries.
Hope this helps.

SnOMan
I had knee surgery (ACL reconstruction and meniscus repair) while taking 9-12 mg hydromorph contin for RLS/WED. I was presecribed oxycodone on top of the HM. I believe it was less than I would otherwise have been prescribed because I had the identical surgery done on the other knee pre-WED/RLS and was prescribed both a long-acting version (oxycontin) and a short-acting version of oxycodone. This time, just the short acting.

It was fine; I didn't even need all the oxy, possibly because of the HM. (I rneeded it all last time but that may also have been because they had to go back in after a week and fix something - the worse pain was after that, as I recall)

My WED coverage stayed the same, I didn't need to increase or decrease the HM.