Medication as a possible cure
14 June 2014 - 10:45am
I put this under a new topic since I have been to see a new (orthopaedic) doctor on the small island of Koh Samui, Thailand where I am living. Without telling him about my previous diagnosis or treatment (see thread Injection into palm of hand, below) he also diagnosed Carpal Tunnel Syndrome and he has prescribed the following medication:-
(TGABAPEN) Gabapentin 300 mg (15) 1 tablet before bedtime
(TETORI1) ECTORICOXIB 60 mg (15) 1 tablet before breakfast
(TOMERPRAZ) Omerprazole 20 mg (15) 1 tablet before breakfast
I really hate to take large amounts of medication unless there is a real possibility that this can be a cure. I appreciate any advice. Thank You.
Gabapentin is a drug originally developed for use in epilepsy but which has been found to be effective in pain arising from nerve disease. Though it makes sense to try it out in CTS there are in fact two controlled trials which did not show it to be any more effective than placebo.
Ectoricoxib is a non-steroidal anti-inflammatory drug, the same group, ultimately, as ibuprofen and aspirin. There is only one worthwhile trial of anti-inflammatory drugs of this type in CTS that I know of and theat too showed no superiority over placebo. Notwithstanding the lack of evidence many textbooks recommend treating CTS with NSAID's so this is a fairly standard thing to try. They do have a nonspecific analgesic effect so if you have pain with CTS they may alleviate that to some extent. I do not think there is much evidence to suggest that they treat the underlying problem.
Omeprazole, I suspect, is just being given to try and protect you from the side-effects of Ectoricoxib - primarily intended to reduce the risk of bleeding from the stomach.
Not telling the new guy about the previous injection is being a bit unfair on him - it's a pretty important piece of information. As it stands he is not giving you anything particularly non-standard, but at the same time these medications are not categorically known to have any effect on CTS. JB