Paracetamol not giving releif. Help!

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If you have specifically a pain related to stomach,it could be due medicine induced gastritis due to long term usage.Diclofenac may not be a good idea for such pain.You may need gastritis related medicines like PPI for a few weeks.Itmay help you, seeing a gastroenterologist in your area for a clinical examination and appropriate management

Thank you for sharing your history. Your case is complex, and your reduced response to common pain medications is important to understand. 1. History of CNS Tuberculosis & Hydrocephalus Having had brain and spinal tuberculosis along with hydrocephalus can lead to long-term changes in the central nervous system. Even after treatment, some people develop: • Chronic neuropathic pain • Altered pain perception • Increased sensitivity to pain stimuli Neuropathic pain does not respond well to usual painkillers like paracetamol or diclofenac. 2. Very Prolonged Corticosteroid Use You were on steroids for 1.5 years, which can cause: • Hormonal imbalance (including adrenal suppression) • Changes in pain modulation pathways • Increased inflammation when steroids are stopped This can make your body less responsive to mild analgesics. 3. ATT (Anti-TB Treatment) for 3 Years Long-term ATT can sometimes affect: • Liver enzymes (altering drug metabolism) • Nerve pathways This again may influence how your body processes pain medications. 4. Why Paracetamol or Diclofenac Don’t Work Well for You Based on your history, your pain likely has a neuropathic component, and such pain typically does not respond to: • Paracetamol • Diclofenac • Single-dose emergency pain injections These drugs work for inflammatory or muscular pain, not nerve-related pain. 5. What Kind of Pain Relief Works Better For neuropathic or chronic central pain, the medications that help include: • Gabapentin or Pregabalin • Amitriptyline or Nortriptyline • Duloxetine These act directly on nerve pathways and are commonly prescribed in patients with post-TB neurological pain. For severe acute pain episodes, doctors may also need to use: • Stronger NSAIDs • Combination therapy • Antispasmodics for abdominal cramps • PPI + analgesic for acidity-related pain 6. What You Should Do It’s important to consult: • A neurologist, for persistent or neuropathic pain • A gastroenterologist, if acidity and abdominal pain are frequent You may need a tailored pain-management plan instead of random emergency injections.

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Your history changes the entire picture and this is not a simple “pain not relieved by paracetamol” issue. You have: Past Brain & Spine TB History of long-term ATT (3 years) History of steroids for 1.5 years Hydrocephalus Treatment completed 2 years ago This combination means your body has gone through major neurological, hormonal, and inflammatory changes. Because of this, your pain pathways may not respond normally to basic painkillers like paracetamol or diclofenac. Why your painkillers may not work 1. Central Sensitization After brain/spine TB, some patients develop a condition where the nervous system becomes hypersensitive, and mild pain feels stronger. Basic painkillers don’t work well here. 2. Steroid Withdrawal Effects Long-term steroids can alter cortisol levels. After stopping them, pain perception increases and NSAIDs become less effective. 3. Neuropathic Pain Component If your pain is nerve-related (very common after CNS TB), paracetamol and diclofenac will not help at all. Neuropathic pain needs specific medicines like: Gabapentin Pregabalin Amitriptyline / Nortriptyline Duloxetine 4. Gastritis or stomach issues from past ATT/steroids This can cause pain that does not respond to diclofenac and sometimes even worsens with NSAIDs. 5. Rebound pain / chronic pain syndrome The body becomes resistant to simple analgesics. What investigations you actually need To understand why your pain persists, you need: MRI Brain + Spine (if not done in last 1 year) Vitamin D + B12 levels (deficiency causes body-wide pain) Serum cortisol (morning sample) Complete blood count + CRP/ESR Renal & liver function tests Without these, treatment is just guesswork. What will help immediately You likely need a neuropathic pain regimen rather than simple painkillers. Your situation needs personalised management Your medical background is complicated, and the pain pattern clearly points to something deeper than “regular pain.” A proper review of your scans, history, and symptoms is essential before deciding the right medication. If you want, I can go through your history, reports, symptoms, and create a structured pain management plan for you. You can reach me directly on nine three two six zero two zero five three six on WhatsApp for a detailed personal consultation.

You should consult a neurologist in opd and discuss your problem in details....

Paracetamol isn't universal pain relief drug... Just say what type of pain... At which part of body...pain nature...

✅ Your Background Matters You have a history of: Brain & spine tuberculosis Hydrocephalus Very long duration of treatment (ATT for 3 years, steroids for 1.5 years) Both prolonged TB and prolonged steroid use can cause long-term changes in pain pathways, gut function, and hormonal balance. So your current issue may be related, but we need to go step-by-step. ✅ Your Main Problem: Pain Medicines Not Working If paracetamol doesn’t work — that’s okay. Many people do not get pain relief from paracetamol alone. But if diclofenac injection or strong emergency pain meds also don’t help — this is unusual. This suggests one of the following possibilities: 🟠 1. Steroid-induced adrenal insufficiency (very common after long steroid use) You used steroids for 1.5 years, which is highly likely to suppress your adrenal glands. If your adrenal glands are weak, your body cannot handle stress or pain properly, and symptoms include: Severe or persistent pain Pain not responding to usual meds Fatigue, weakness Low BP or fluctuating BP Stomach pain, nausea, acidity Anxiety, irritability Poor stress tolerance This fits your description extremely well. A simple blood test confirms this: 🧪 Morning cortisol (8 AM) 🧪 ACTH level 🟠 2. Central sensitization Due to past brain TB, your pain-processing system may have become hypersensitive, causing: Pain that feels stronger than normal Pain not responding to basic meds Headache, abdominal pain, body pains, burning sensations 🟠 3. Acid reflux + visceral hypersensitivity If your stomach pain + acidity are not responding to pain injections, it could be due to: Hyperacidity Gastritis IBS-like sensitivity Slowed gut motility (common after TB and long steroid use) Pain meds don’t help this type of pain. You may need: Proton pump inhibitor (PPI) like Pantoprazole 40 mg Antacid syrup Levosulpiride or Domperidone (if slow gut) 🟠 4. Neuropathic pain TB affecting the spine or steroids can cause nerve pain, which does not improve with paracetamol or diclofenac. Neuropathic pain responds to: Gabapentin Pregabalin Amitriptyline Duloxetine Emergency pain injections won’t help neuropathic pain. 🟠 5. Vitamin deficiency Especially: Vit D deficiency Vit B12 deficiency Both cause pain that doesn’t respond to normal painkillers. 🟥 Serious red flags requiring evaluation If you have any of these, you must get checked: Frequent severe abdominal pain Pain unresponsive to injections Weakness, dizziness Fainting episodes Very low stamina Body pain, joint pain Anxiety and irritability Poor stress tolerance These are classic for adrenal insufficiency after long steroid use. 📌 What Tests You Need Please get these done: 🧪 8 AM Serum Cortisol 🧪 ACTH level 🧪 Electrolytes (Na, K) 🧪 Vitamin B12 🧪 Vitamin D (again) 🧪 Liver, kidney function 🧪 HbA1c (steroids can cause diabetes)

Good day to you ma'am I understand your concern and I am sure this must be distressing causing a hindrance in your day to day activities. I shall try to the best of my abilities to consult you Tuberculosis is a bacterial infection caused by mycobacterium tuberculosis. It usually present as a primary lung infection. However, in your case as it is involving multi organ system it is most likely secondary TB (miliary tuberculosis) Pain is a symptom which has a broad description with many causes and it is not enough on this history to understand it's origin I would like you to answer the following questions to rule out certain possibilities # How did the pain start? Did it come one day suddenly or has been for sometime and has increased day after day to intolerable levels finally? # Is your pain sharp as if pins and needles are being stabbed or very deep like someone has punched you in that area? # What is the location of your pain? Given your previous history I want you to understand knowing the root cause and coming up with an appropriate treatment plan for your case is beyond the scope of this Q/A forum.

I kindly urge you to book a one to one consultation with your family physician or any physician you are comfortable with so that an extensive workup (history, investigations) can be done followed by designing an appropriate treatment plan.

If you feel I can be of better service to you Feel free to book a one to one consultation via practo app. Note: I am sorry for not providing WhatsApp contact henceforth due to issues pertaining to Medico legal protection of both client and the doctor One time consultation fee = Rs 200 Follow up consultation= Rs 100 Hope this advice provides you the much needed insight Wishing you a speedy recovery

You can consult me directly on Practo, or reach out via WhatsApp: Eight Seven Six Two Seven Four Nine Nine Seven Four I’ll guide you step-by-step with easy-to-follow treatment plans. Early consultation helps avoid complications — feel free to connect. Only whatsapp message no calls

Ultracet p  tab or inj probably give u results. Tab nexpro RD40 ONE IN EMPTY STOMACH FOR ten days. Mucain gel 10ml without water nothing by mouth till 30min can be taken 3to4 times  for acidity.

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Avoid fried and spicy food Water intake more Do connect and consult

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Nerve problem