Hello, I am obviously new to this. I have never posted on this site, I have read quite a few, but never done any myself. I really think this might help me. So here it goes. About 6 months ago I was diagnosed with cervical spine disease. I have been fighting this horrible pain for over two years, but the doctors didn't think to give me an MRI until 7 months ago. I was having non stop horrendous headaches. So I didn't realize that my neck was hurting, or I thought it was a side effect from the headaches. Well everything I have read about cervical spine disease says the pain of course is in the neck, but that it could radiate down the shoulder, arm and into the hand. Well I have that some, but nothing I have read says anything about it causing headaches. So are my headaches a side effect of the csd, or is there something else wrong? I am not sure. However I have really crappy insurance, and my Primary care doc wants me to go to the Pain clinic. Well they will only pay for 50 percent of that, and only after I take chronic pain classes. Which last like 3 months long. What can they tell me about chronic pain that I don't already feel? lol. Well anyway, so now my doctor is going to send me to an Orthopedic specialist. I go next week. So I am hoping that helps. I have been on Neurontin for about 5 or 6 months, and I haven't noticed any help for that. And I am taking Norco also. I take the 10/325. The doctor told me not to take more than 5 per day. But there are most days when I have to take 2 at a time just to get some relief. Then like 3 hours later it is unbearable again. I have read that other people are on more Norco than I am. I know there is a risk of dependency or addiction. I don't feel I am addicted at all. The only time I take it is when I am in a lot of pain. And then it just doesn't seem to work that well. My doc will not put me on anything stronger. And now I have to have xrays for both of my hips, because we believe I have arthritis in them. So I feel helpless a lot, because I know there are many days I take more of the pain meds than what is prescribed, but it is not for any kind of "high" because I don't get it from the meds. I just want to have this pain under control. I really hope that the specialist can help me next week. Well I guess I have been rambling on enough. Thanks for listening/reading
Ok, so there are other reasons that your Dr. told you not to take more than 5 Norco a day. Yes you can develop a Dependence on the Narcotics, your body does get used to it, and if you were to stop you would detox and go through withdrawals, nothing can be done about that, it's a side effect of Chronic Pain treatment. It's only addiction if you run out of meds early and get more wherever you can, if you take more than your supposed to, etc. The main reason is that Norco 10/325 is 10mgs of Hydrocodone and 325mgs of Tylenol. 5 Norco's a day is 1625mgs of Tylenol. The max safe daily allowance for Tylenol is 2000mgs, after that you risk serious kidney and liver damage.
GP's rarely RX stronger meds than Vicodin or sometimes Percocet. They are not trained in Pain Management. A PM Doc is trained to handle all aspects of pain with various modalities, procedures, therapies and medications. They are also trained in weeding out the drug seekers and addicts. The Ortho your going to see will most likely not RX you meds either, most Dr.'s leave the heavy duty pain meds up to the Pain Management Docs.
The classes they want you to take will not be about "pain", they talk about utilizing all modalities and therapies to manage your pain, not just meds. They'll talk about lifestyle changes you can make to alleviate some of your pain, they'll go over their rules and regulations and probably the Pain Management Contract you will have to sign. This is also another tool to weed out drug seekers.
PM docs and Pain Management is a whole different world then that of the family doctor. You'll be given a contract that spells out exactly what you can and cannot do in regards to your treatment of your pain. It will outline what is expected of you, i.e. keeping your meds stored safely, being at your appointments, taking your meds as prescribed and only as prescribed. It will also say that you are subject to pill counts and urine tests at any time. You say your Dr. doesn't mind you taking more pills than he prescribed for a day. That is not allowed in Pain Management, that would get you dismissed from the clinic and a big red flag placed in your records which would then make it very difficult to get in with any other PM Doc.
Yes, Cervical Spine Disease can cause Headaches. They are called Cervicogenic Headaches. These are caused by referred neck pain which is pain that moves away from where it originated, your neck, and radiates up into your head.
The Neurontin your taking is for Nerve Pain, there are a few other Nerve Pain meds such as Lyrica, Neurveen and Cymbalta.
The reason your Norco wears off so quickly is because it is a short acting med that has a half life of 3.5 hours, which means 3 hours or so after you take it, it has already peeked and is on it's way down. Your also building up a tolerance to the med, which is normal when you've taken something for a long while. You would most likely be better suited to a Long Acting med such as Morphine, Oxycontin, Opana, etc. these are slow release 12 hour meds. With them you don't have the peaks and valleys that you have with the Short Acting meds. They build up in your blood plasma level and offer a constant level of pain control. This is the next logical step in your Pain Management Plan, which is why your Dr. want you to go to a Pain Management Clinic.
Okay, so I've "typed" your ear off. Hope you can find the help and support that you need here, there are many really great people on this site that are always willing to help.
One last thing, if you post your threads on the Pain Management Board, you'll probably get more responses.
The Following User Says Thank You to katlin09 For This Useful Post:
Thank you so much for all of that information. I really don't know of anyone else who is going through this. So I don't know what to expect, or how to deal with it. I am so new to all of this. And I wanted to say right away, that no my doctor is not ok with me taking more pain meds than what he rx'd. But there are some days that I do, like when it is raining, holy crap them are rough days. So then the next day, I take a little less to make up for it. I am not a drug seeker, or trying to go from doc to doc getting meds...I have heard of a lot of people doing that. I just want to manage my pain. Thank you for letting me know about the headaches associated with my cerv. spine disease. Just about everything I was reading was talking about the pains in the neck, or the arm, but nothing about the head. So hahaha, I was thinking it was all in my head. No I am just joking, I was wondering I guess if there was something different going on with my headaches. But after reading what you wrote about the referred neck pain going into my head, it does make a lot of sense.
I will gladly do whatever the pain management docs want me to do. I don't have a problem with signing a contract or the random drug testing. I understand why they do that. My biggest dillema is coming up with the money to see the pm doctors. Because I have crappy insurance, they will only pay for 50% of clinic visits. And I only work about 34 hours a week, and my husband is only part time also, so he has no insurance, I have insurance through where I work, but it is only offered for me not my family.
But my husband is looking dilligently for a better job, but this economy is so rough. I am not sure where you are from, but I am from Michigan...we have one of the worst jobless rates in the US. So it is rough. But hey, we are happy to have jobs at least...things could sure be a whole lot worse.
Thank you for letting me know about the postings I do going onto the pain management boards. I will do that. Your reply was very helpful. thank you so much
No problem, if I can use the last 25 years in Pain Management to help others going through it, then maybe some of it was worth it. I'm in North Carolina and our job market isn't much better. There are more jobs available, but where there used to be 5 or 10 people applying for a job, now there are 50 to a 100, not fun!
If there are any major teaching hospitals in your area, you might check and see what there Financial Assistance programs are. Many times they will give folks without insurance cut rates and sometimes if income is low, only charge a co-payment. If they have a pain clinic, that might be a solution, may be worth checking in to.
I get Cluster Migraines that last anywhere from 6 to 13 days at a time, and I take preventive meds for them as well as onset meds. I'm not sure if preventive meds work on referred pain headaches, but it might also be worth it to ask your Dr. I know living with a headache all the time can just about drive you crazy.
Anytime you have a Q, don't hesitate to ask. The folks around here are very nice and very helpful. We all have a little different story and have had different treatments, so usually someone can come up with an answer to a Question.