Pain Meds and the possibility of further injury - Pain Management Message Board

db7363 · 06-07-2004, 06:44 PM

Hello everyone, I've been reading this board for a while but have not previously posted. I am looking for some advice on the use of pain medication. I was in a car accident a couple years ago and suffered a shattered ankle. I was in an exterior fixator for several months. I also have had back pain since the accident. The CT shows I have spondylosthesis and three buldging disc in my lower back. I just found out that I also have 2 herniated disc in my neck which has been causing pain throughout my upper body, arms, and hands. I currently am taking vicodin for pain. Prior to seeing the neurosurgeon, I was taking 800 motrin. It took the neurosurgeon sending a letter to my PCP before I was able to get vicodin. I am careful and don't do things that I have been instructed not to do. The pain seems to be getting worse. I currently use my pain as a guage on how much I can do. I'm afraid that if I get stronger pain meds, I may overdo it and make my injuries worse. Can I get your perspective on this?

Thanks
db

tyler7 · 06-07-2004, 07:25 PM

Hi DB-

Welcome to the board. It sounds like you're the victim of (like far too many others) an major opiophobic doctor, meaning your PCP of course. You obviously have a lot going on and I'm guessing you're in obvious, significant pain everyday and you had to pull teeth just to get Vicodin? And it sounds to me like this is most likely a chronic problem, especially if you say it's getting worse. Vicodin is not the optimal med to be treating chronic pain with. Judging by your PCP's actions thus far, I'm sure he wouldn't have ever recommended/referred you to a Pain Management doctor (PM doc - and a specialty doc that MANY here on the board are under the care of), but has even your Neurosurgeon ever mentioned this? It seems like at least it wouldn't be an unreasonable thing to look into. I of course don't know many of the details of your unique situation, but you could very possibly best be on a long-acting opiate pain med such as MSContin, OxyContin, Methadone, etc, and maybe even using a short-acting med (the Vicodin is an example) for what's called "breakthrough pain" (BT meds), the acute attacks of pain you have a couple times of day that punch through the relief of even the stronger long-acting meds.

It's very good to hear that you're following all of your doctor's instructions carefully. As far as possibly "overdoing it" with your body if you had stronger meds (thus covering your pain, allowing you to think in the moment that you're more physically able to do something than you might really not be), one of the things you'll find about treating chronic pain is, a doc's goal is never providing you with 100% pain relief; it's simply not realistic. I mean, you COULD achieve that, but you'd need to be constantly upping your dosage to do so (due to the tolerancy issue). No, even with stronger long-acting pain meds like the ones I mentioned above, if you can attain a pain level of around a 3 or so, your doc would probably be very satisfied with that, as should you be. And that's being generous. There are plenty of folks on this site who even taking all the powerful opiates they do, they're still happy to reach a 4 to 5 level (when they're used to dealing with an 8 or 9 everyday). There are many different people here, each with their own unique story. I'm sure at least a few will be by to offer some perspective as well. Take care.

db7363 · 06-08-2004, 06:57 PM

Tyler, Thanks for your input. After reading some of the post on this board, I talked to my counselor about seeing an PM doc. I've had one appt already and have another one later this month. My appt with him was one of the few I've had where I felt he understood where I was at and what I was going through. Again, thanks for your help.
db