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Old 01-17-2005, 03:28 PM   #1
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blueswimmer HB User
Tolerance question from chronic back pain sufferer

Hello all,

I've posted thsi question previously on the 'back pain' board, but didn't get as much feedback as I wanted, so I thought I'd try here. I've been through a lot of pain the past few years. I'm only 33 and feel like I've got a lifetime of back pain to deal with.

My question is about how I can reduce the extent to which my body builds a tolerance to pain meds. I have 3 herniated disks. Thankfully, my pain is not 24/7. It usually gets worse during the day and only gets to the 'medication' point usually late in the afternoon. But by evening, sometimes it is unbearable.

My doctor has prescribed percocet 5/325 as needed. At first, I was worried about taking narcotics, but I'm nearly past this internalized stigma. I felt guilting asking for strong pain meds, but my doctor was very supportive after he saw my MRI. When I take pain meds, I usually only take 1 percocet, sometimes with an Advil because I'd rather not have to take a second perc if an advil with the first perc will do it. But there have been times when I've needed 2 or 3 percs (total during the day, not all at once) but this is not the norm.

So.... how fast does a person typically build up a tolerance to percocets? My doctor said that he had no problems whatsoever prescribing the meds I need but he also said that if it got to the point of taking 5 or 6 percs a day, that he said we should talk about a long-acting med like oxycontin. I'm kinda scared of getting to that point because then it becomes "every day, all the time" rather than "as needed."

How quickly does tolerance develop at the level I'm taking them? Maybe I'm being overly concerned. I will say that taking percocet really helps the pain and let's me do "normal" things like cook, household chores, etc. Without it, I'm miserable and avoid life activities which I enjoy but are excruciatingly painful.

-blueswimmer

 
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Old 01-18-2005, 04:13 PM   #2
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Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
Re: Tolerance question from chronic back pain sufferer

Hey Blue, Nobody can really answer that as everyone is different, Your use is minimal, as long as yu keep it that ay, tolerance will buld slowly. If yo u can work and get by on one perc a day or 3, your doing well. There just isn't a way to say how much pain someone is in by any diagnostic test and how medication it takes to help. The thing to keep in mind is that if the meds start hindering you more than helpng it's time to reevaluate things. The LA meds may be the next step or maybe things will progress to the point of needing surgery.

Meds can mask a fixable problem to the point the problem can't be fixed so get several opinions and educate yourself as far as other methods of pain management. If the only method you ever use is opiates simply because it's a gaurenteed instant fix, it has a price. Nobody has crystal ball to see what that price may be, but your doing the right thing in taking an advil with the percs, why take 2 perks if 1 perk and one advil will help.

There are dozens on non opiate pain rlieving modalities to look into, PT, Chiro, Acupuncture, Tens, Epidural steroids injections,Self hypnosis, bio-feedback, guided imagry, TINS, TENS, nerve blocks, trigger point injections etc etc. If a non opiate method works, this wouldn't b an issue, but folks tend to swant instant relief, I did, I still did all that stuff, but if someone would have prescribed aI certainly would have taken pain meds my frst 7 years of pain management.

There are alllso mrore PM docs that won't prescribe opiates than will. Eventually your GP becomes uncomfortable with continued use, you will likely be cut off or referred to a surgeon or pain maagement.

Sounds kind of quick to condem yourself or let some doc condem you to alife of pain and medication. Some docs will start you on LA opiates without having tried another method to manage your pain. Those docs put themself at risk because they may have to justify their prescribng practices, and if you have never tried anything else, It's pretty hard to justify OxyContin as your only option because you needed more and more percs.
Good luck, Dave

 
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Old 01-18-2005, 05:29 PM   #3
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blueswimmer HB User
Re: Tolerance question from chronic back pain sufferer

Thanks Dave, I appreciate your insight. Just to add to what I wrote (I had tried to keep it short...), I have gone through multiple physical therapists (and still incorporate specific stretches and exercises into my daily routine) to help. I also tried the ESI's but they simply didn't help. My TENS unit helps a little bit, but can't always lug that thing around. But it does help on long drives.

My family practicitoner, who sent me through the physical therapists and the ESI's finally sent me to a pain doctor (after the x-rays and MRI's), who reviewed everything, including the MRI's and is very unwilling to consider surgery because of the thoracic region because of the adjacent nerves and organs. Both of these guys were comfortable with the percocets, but I really wanted the feedback on avoiding tolerance.

THanks again!

-blueswimmer

 
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Old 01-18-2005, 07:03 PM   #4
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Re: Tolerance question from chronic back pain sufferer

sorry to hear about thoracic as i have thoracic and cervical herniations.
i statred taking cymbalta which seems to work for both pain and associated depression. has helped me get my sleep back so far. are you in ny?


Quote:
Originally Posted by blueswimmer
Thanks Dave, I appreciate your insight. Just to add to what I wrote (I had tried to keep it short...), I have gone through multiple physical therapists (and still incorporate specific stretches and exercises into my daily routine) to help. I also tried the ESI's but they simply didn't help. My TENS unit helps a little bit, but can't always lug that thing around. But it does help on long drives.

My family practicitoner, who sent me through the physical therapists and the ESI's finally sent me to a pain doctor (after the x-rays and MRI's), who reviewed everything, including the MRI's and is very unwilling to consider surgery because of the thoracic region because of the adjacent nerves and organs. Both of these guys were comfortable with the percocets, but I really wanted the feedback on avoiding tolerance.

THanks again!

-blueswimmer

 
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Old 01-19-2005, 07:13 AM   #5
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blueswimmer HB User
Re: Tolerance question from chronic back pain sufferer

Hi Larry,

Nope, I'm not in NY. I'm in central Missouri. I'll have to look into cymbalta. Thanks for mentioning it.

-blueswimmer

 
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