Managing pain

Pain relief is very individual. Explore some ways you can manage the pain of living with chronic UTI.

How do you manage pain when you have a chronic UTI?

You should always discuss options with your specialist or GP. We make no recommendations about controlled, prescribed pain relief as prescription and management of these should be under the appropriate care of a qualified practitioner. However, non-prescription paracetamol, ibuprofen or aspirin can be purchased over the counter in your local pharmacy. Always check with your pharmacist if taking other medications to ensure there are no drug interactions and follow the dosage instructions on the back of the pack.

Azo, a urinary painkiller may also help. Azo is available on prescription or over the counter in America or via Amazon elsewhere.  It contains the active ingredient Phenazopyridine Hydrochloride. It is specifically targeted to help with the symptoms of urinary tract infections such as pain, frequency or burning on urination. Ask a doctor before use if you have

• kidney disease
• allergies to foods, preservatives or dyes
• had a hypersensitive reaction to Phenazopyridine Hydrochloride

Do not use if you have Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency unless approved by your physician.

When using Azo, a stomach upset may occur, taking this product with or after meals may reduce this. Your urine will become reddish-orange in color. This is not harmful, but care should be taken to avoid staining clothing or other items.

Another option are allergy/antihistamine tablets containing either Cetirizine, Loratadine, Promethazine and Ranitidine. They work on the H1 and H2 pain receptors in the bladder and can help reduce inflammation and pain. All are available in pharmacy without prescription. Stronger anti-histamines can be prescribed via your GP or specialist – discuss which is appropriate to manage bladder pain and whether there are any medication interactions.  Some antihistamines can cause drowsiness so may need to be taken in the evening before bed.

Amitriptyline or Nortriptyline are other options often prescribed to those with bladder pain. These are anti-depressants which have been found to help with nerve pain in the body including the bladder, aid sleep and can be prescribed by a consultant or your doctor. They should always be taken at night as drowsiness is a side effect. Discuss with your GP or specialist if you plan to increase or decrease the dosage of an antidepressant as side effects are common and should be managed appropriately. Your pharmacist can also provide advice around the day to day use of these medications.

Always discuss any other medication taken for other medical conditions with your GP or consultant as certain medications do have significant interactions with types of antidepressants. This particularly applies if you are already prescribed anti-depressants to manage issues such as anxiety.

If you are struggling with chronic pain; your GP can refer you to a pain management clinic or better still a pelvic pain centre where you can talk to a counsellor and receive clinical support and appropriate medication to manage your pain.

Pelvic pain clinics in the UK

The UK has a dozen NHS pelvic pain clinics with multi-disciplinary teams (pain management consultants, physios and counsellors).

• Birmingham – University Hospitals, Multidisciplinary Team for male and female pelvic pain (dedicated pelvic pain clinic).
• Birmingham Women’s Hospital – a female pelvic pain clinic including clinical psychology.
• Birmingham – Sandwell & West Birmingham Hospitals – Pelvic floor physiotherapist who also works in their pain service.
• Bristol – University Hospital, Gynaecology, Physiotherapy, Pelvic Pain:  female and male
• Edinburgh – Royal Infirmary,  Gynaecologist, Pain specialist, Psychologist (Multi-disciplinary team)
• Leicester Royal Infirmary – Gynaecologist,  Pain specialist, Psychologist, Physiotherapist (Multi-disciplinary team)
• London – Bart’s and the London, Whitechapel:   Gynaecologist led pelvic pain clinic
• London, St Mary’s, Paddington (Pain specialist)
• London- University College Hospitals, Pain Management Centre (Multi-disciplinary team)
• Manchester, Wythenshawe Hospital, Pain specialist
• Manchester, St Mary’s, Gynaecology
• Middlesborough – James Cook University Hospital, Pain specialist
• Oxford – John Radcliffe Hospital, gynaecologist, physiotherapist, Pelvic Pain clinic and adolescent pelvic pain clinic

If you are seeking a referral, research the services offered as these may change.