Hi everyone,

I have a c5/6 disc bulge with some cord impingement and get migranes also. Have had ccortosone facet block injection before a year ago and am thinking about having more. I seem to get constant flare ups and have accupuncture weekly plus chiro every 2 weeks or so. Iam taking too many meds and am worried about the side effects. Take Celebrex 400mg daily, panadeine forte codeine 30mgs-60plus every couple of nights and often daily. I also take cafergot(ergotamine) for migranes and sleeping meds temazepam. I feel I almost need stronger meds but don't want to go there. Thought about neurontin. Does anyone recommend this? or have any feedback on my med situation -is it dangerous?

Mel

Hi Mel, I take neurontin now after injections and it's a great help for me. The injections didn't work for me and just the thought of how close to my spine the Doc was injecting scared me (he didn't use a scope). I can't help with the other question but always believed that anything in excess is bad.
Frank

Hi mel, Nothing that your taking looks excessive. Most chronic pain patients take several meds to deal with pain, spasm and it looks like migaines are a problem too. At the level of meds your on your problablly wouldn't have a problem with becoming dependent on the meds.

If you have read about the long acting meds like OxyContin or MScontin "'morphine" Duragesic patches and methadone when we take these meds for an extended period of time you do become physically dependent, It's not the same as addiction it just means you can't discontinue the meds without tapering down the dosage. Dependence on the meds is what we trade for pain relief. It's a personal decision and only you know how bad you hurt and what it takes to manage your pain.

Neurontin is actually an anti seizure med that many PM docs use to treat nerve pain, Like radiculaopothy from a bulging discs and pinched nerves.It's also used to treat shingles and other types of peripheral neuropothy. If you don't have pain in your arms, "radiculopothy' all Neurontin will do is act like a sedative.

The two Pm docs that have treated me with long acting opiates had two different philosophies. The first would prescribe many aditional adjunct meds insteead of prescribing a large dose of actual pain meds. When I switched docs, my new PM doc upped the pain meds 50% and I was able to discontinue 3 of the adjunct meds that the first doc prescribed, Neurontin was one I was able to discontinue with a proper amount of opiates. So you really have to decide if it's worth taking 5 meds to keep your opiate intake down or just go with opiates and forget all the other meds that aren't proven to help but are believed to help.

Neurontin is an adjunct med, celebrex, if your problem isn't inflamatory may be a med you could discontinue if the proper level of opaites were prescribed. Some docs will prescribe everything under the sun except opiates, Is this better than being dependent on opiates, I guess if it works it is, But if your still looking for adjunct meds to make up for using a very weak opiate like codeine then you need to decide how to pursue manageing your pain.

Personally I think fewer meds means fewer side effects. Being dependent on morphine is an easy trade when the alternative is being bed ridden. Are you seeing a PM doc or an ortho that is following the bulge in your discs. Surgeons aren't well known for being empethtic towards pain or prescribing pain meds to treat a chronic problems. Their job is to fix you and send you on your way, If you continue to have problems Pain management is an option. It's also an option to prevent very invasive surgery with very iffy outcomes.

It's really hard for anyone to judge what is excessive by mearly stating the number of mgs of a particular drug. If your taking what you think is excessive but it's not managing your pain, in what way is it excessive. When I think of excessive I think of being medicated beyond the point of being able to function. If the meds allow you to function better and restore some quality of life then I don't see any excess.

I take 600mgs of morphine a day to manage my failed fusion, L1-S1, It may sound excessive but what is strong medicine to one person may not begin to touch the pain of another.We are all different. If your pain isn't being managed than something needs to change. You won't know if an adjunct med will help until you try.But many folks take Neurontin in adittion to long acting opiate meds and muscle relaxers and anti Depressants. Then you have meds for the side effects of all the others like anti anxiety meds and meds for neausea. Some folks require a stimulant to counter the sedating effects of all the other meds.

When it comes to pain, nobody can say what is excessive for another person. It may sound like alot but if the meds improve my quality of life rather than limit me, my doc wouldn't consider what I take excesive and neither should another member on the forum. Good luck, David

Hi David,
I didn't actually mean she is taking an excessive amount, as I said "I can't help with the other question..." as you said, only she can tell what is excessive.
As far as the "neurontin" it was a PM that perscribed it to me for a bulging L5. Not only did it help with some of the pain in my lower back but I no longer have RLS.
Frank

[This message has been edited by mineman (edited 06-29-2002).]

Het Frank, I wasn't offended by anything you said. Excess could be the number of meds used or the the amount of a particular med. But since were all different nobody is really in a position to say someones dosage or med use is excessive. Usually the side effects of meds are the most dose limiting factor.

That coment about other forum memebers shouldn't suggest someones dose was excessive wasn't directed at you. I also agree the least you can get buy with is always best. Whether it's a dosage of one med or the number of total meds. Take care, David

I have c5/c6 herniation. It gives me a great deal of pain and muscle spasm in my neck, arms, and shoulders. I have numbness and shooting pains and aches too. I also get migraines and have nerve impingement in my legs.

I find neurontin helps with buring, throbbing, shotting, stabbing type pain and numbness. It complements other drugs. I found celebrex useless. Vioxx slighty better. I am off the anti-inflammatories. I can't find one that works and doesn't hurt my stomach.

Neurontin has side effects: weight gain, edema, memory loss, teeth problems and others. I take a low dose - 600. Some take really high doses. It helps me. I would love to get off it and not mix up words, but it helps too much.

My main drug is MS Contin - morphine. I am on it all the time. I helps with headaches, neck pain and everything. I also need valium and other muscle relaxers and the neurontin.

Botox really helped my neck spasms. My neck was almost frozen at the time.

Not recommending any of this. Just thought it might help as we both have c5/c6 problems. I don't have cord impingement. That sounds painful. It helped me to hear other stories when I was starting out looking for pain relief. All these drugs really scared me. Now it seems so normal. The only think I take every days is Nuerontin and MS contin. Valium is almost every day.

There was some new information about Neurontin and bone loss. The study was limited to epilepics in some small country. I am staying on my small dose after talking to several doctors about it.


[This message has been edited by jane2 (edited 06-30-2002).]

Hi Nineman, David and Jane,

Thankyou for your responses and feedback. I really appreciate your info David on all the drugs, effects etc, it helped me to understand the whole process. You make a good point about everyone having different thresholds and maybe I feel my intake is excessive because the meds are not appropriate any more or the mix doesn't work. Wow these interactions get complicated and it's so hard to know whether to change drugs or get chiro, injections, operation etc.
Jane, it is interesting what you said re celebrex, I also found vioxx better and recently have decided celebex doesn't help much at all also. I may try neurontin and am booked in next week for more facet blocks c5/6. Will let you know what I decide as I'm sure to have heaps of questions.

Mel

I had trigger shots for a long time and then Botox really finished off the job on my neck spasms. It cured me for months. I am still better than I was. The shot was actually in the shoulders.

Accupuncture calmed things down a bit. I still needs lots of drugss. I really takes time to get it right. What worked at one point may not later. I would give the neurontin a try.

Hi Jane,

That is interesting re: the botox. Is it done very often and can u ask for it? Did you have it in the facet joints c5/6? I am wondering whether it may be more effective for me than the facet cortosone blocks. Interested to find out more, thanks. How is your neck going? Have you looked into disc replacement, My neuro mentioned it to me as a possibility where they use a prosthetic disc. But it is still a new procedure and they haven't done many studies on it's effectiveness. Just thought I'd see if you'd heard of it.

Mel

The herniation is c5/c6, mostly c5. The nerve is irritated (radiculopathy) and was causing major spasms. All my discs are bad in the neck and the neck bends the wrong way.

I went to a headache clinic and the hurt my neck doing PT. Lying down was torture. Anything that touched my neck made me want to scream. I felt like my neck had shrunk 2 sizes. The ligaments and tendons would not stretch. I had huge spasms. It worked on that.

The Botox is expensive. It lasted for 3 months. It allowed me to move my neck and stretch and get some normal movement back. My neck is still better than it was after the PT. I can still move it. It is not a total cure. I still have nerve pain too and my shoulders still hut and pain radiates to my arms. It really saved my life. I might do it again for the shoulder spasms I am having. That is from the neck too. The nerve gets the muscles going.

Botox has to be done by someone good. Facet shots are a good test. Can the doctor find the spot where you pain is? They have to know how much to use too. It is mostly for spasms and myofacial type pain. The kind of pain strong muscle relaxers help. Same stuff the facet shots work on.

For the rest of the pain, I take drugs. MS Contin has been a God send for migraines. My are not cervical, strangely enough. Most medications gave me more headaches. The long-acting ones really helped break the cycle of daily migraines for me. I am on the MS Contin (morphine) all day. It really helps with all the pain.

Make sure you get to a good pain doctor. You have cord impingement. You must be in awful pain. These alternative treatments like accupuncture and shots can help some and don't work for others. Worth trying some of them, but it is no replacment for decent pain control.

The longer your pain is undertreated the more the pain sets in. You body undergoes chemical changes if you are in pain for a long time. If you have spasms, a good muscle relaxer can prevent further damage.

I haven't looked into disc replacement. I am scared of it. Not sure thay have it down yet. You should talk to David about surgeries. I know many times surgery makes people worse. I think they are getting better at it. I have heard some success stories too recently. I don't want to scare you. Your neck is worse than mine becuase of the cord impingement. Surgery may be necessary, but it is not something I would jump into.

Disc replacement sounds scary. I think it is very new. I don't know much about it. I haven't heard of anyone who has done it. I'd like to see how this disc hold up 10 years later. Seems like it might give us all hope for the future.

My neck isn't bad enough for surgery. Whatever is pinching the nerves in my legs is. We don't know what is causing that problem yet. They thought it was my lumbar discs, but they are fine.

[This message has been edited by jane2 (edited 07-03-2002).]

[This message has been edited by jane2 (edited 07-03-2002).]

Hi Jane,

Thanks for the info. I just had more facet blocks done c5/6 yesterday. I am feeling numb and pain free so lets hope it lasts. My neuro also suggested a nerve block shot c1/2 as I have some problems there also(headaches)and have had lots after the facet blocks. Have you had this? I am also seeing a surgeon re the disc replacement so I will let you know what I find out. Sounds like botox may work for me too so I will search for someone good. I wonder if you could get it c1/2 for headaches. Hope your feeling ok.
Mel