Any insight?? Opiate tolerant? What comes after ESI's and trigger points? - Pain Management Message Board

skych · 10-06-2007, 09:03 AM

Hello everyone,
Feelbad do you have any input on any of these things? You have responded to me before and I have read some posts that you have made to others so I am wondering if you can help with some direction or encouragement????
Let me start with a breif history...

I was on workers comp for 3 years for an arm injury that resulted in 4 surgeries. My case for that just recently closed. I was seeing a PM for the last year of this case. Really good doc.

Unfortunatley just before the closeing of the WC case I was in a car accident. Although I hit the other car (sort of a T-bone thing) it was the other drivers fault and they were cited. I was going 50 MPH just before hitting her. I had only a split second to try and stop.

Anyway I now have bulging discs in my neck and compressed spinal nerves.
My GP and I and the attorney decided that I should return to the PM doc. I have since had one ESI from a crappy PM doc that I saw befpre returning to the PM that I had for WC.
The good PM from WC did 4 trigger points last Monday.
Well to make a long story short I am very opiate tolerant and I am not really getting the relief I feel I should from the percocet that I take. I can currently take 6 a day, but the problem is that on an occassion I get the spiked incidents where I just want to die or throw up.
At one point when on WC they switched me to Methadone. It really helped but I had a rough time tolerating the side effects. Not to mention the tapering process was pretty awful for me. No matter what you take at some point the day comes when it is time to try getting off them....YUCK! I do not want to take Methadone again. I just can't go there.

When I go back to see the PM doc next Thursday I will be addressing this issue with him. He is totally aware of the tolerance I have. I am soooooo not willing to take Methadone again. I am a student and can't function well enough on that stuff to do well in my class.
My question is what else is there to try?? I can't use vicodin because it is just to constipating and I have the same tolerance issue there.
Does anyone else in here have this tolerance issue? I do not abuse my meds, but I feel guilty for asking about stronger stuff.
I am also a recovering addict and alcoholic. I just celebrated 3 years a month or so ago. My doctors are all aware of this. I am completely honest about everything. My drug of choice was Methamphetamines.
Anyway..I am tired of this pain and for the most part it can be managed with the 5-6 percocets a day, but there is times ( about 3-4 times a week) that the pain just exceeds a 10 on that scale and I am not able to get it controled.
I hope that others here can share their experiences with me!! It is always nice to know your not alone and that others understand.

As far as the ESI and trigger points went. I was in a lot of pain right after the ESI and I only had a day with some relief. The trigger point I thought was helping but I am not really sure because my symptoms vary in their intensity from day to day. Not to mention I have always had the spikes of uncontrolable pain.
Anyone have any experience with this??

Please share your stories with me!!!

Chrissy

feelbad · 10-07-2007, 08:48 AM

Hi chrissy,i am familiar with your story.sorry for what you are having to deal with and trying to stay clean on top of it,thats a job in and of itself.honestly,for my c spine crap that keeps triggering the cycle of TPs to have to deal with,i have found that the more "outside' methods of controlling them are far more superior than anything i have actually 'taken'.while my oxycontin does help with the more structural/mechanical types of pain process,i cannot get rid of the horrid inflammation up there long enough to really "feel" any progress.the best things i have used are the lidocaine patches,really.the problem with having the inflammation is no matter how many TP injections you get,that will keep the stupid cycle going til the c spine issue thats causing the inflammation goes away.good luck with that right?when i have a particularly bad spot on any given day,i slap on the lido patch and it really does help to calm things down,in alot of cases,in that area,completely.very strange in how these patches actually work with TPs.it really does sound from what you stated that the TPs are a big issue for you too?

injections have their place but as you have found out,they just don't give you actual relief for more than a couple days if your lucky.i also recently discovered this stuff called biofreeze?wow.this has helped alot with the overall upper back and c spine crap.i don't know why or how it just does.unfortunetly you can only obtain it from a chiro.my hubby just happened to work with someone who was seeing one and saw him putting this stuff on his low back one day.he asked him about it and the guy,after my hubby told him about my many issues,actually gave him a couple packets of this gel stuff for me.nice guy.it really does help.i think if you really needed to you could probably find someplace online to obtain it thru.it really works well for my upper back and c spine mess.between this new stuff and my good old lido patches(i also use the lido ointment into the hairline?),this is what i am actually using to control that mess up there.nothing else internally taken really seemed to give me any real relief from that TP cycle of hell it keeps on creating.trying other topicals could also benefit you too.i also found out about the theracane when i went for my latest round of PT.its a cane with knobs on it that you can place over your shoulder from the front,put it over the wad of TP and just pull forward til it releases. it does work wonders for some.also the tennis ball in a sock thing up against a wall and pushing it into the tense areas works for me too.its amazing just how creative you can get when you are suffering isn't it?

this is about all i can think of off hand chrissy.if i think of something else,i will shout it out to you hon.but DO definetly try the lido patches on the TPs.this really is the only real relief i get,just using those on the hot spots.it helps keep the pain of the TP from radiating out to other areas too. good luck,keep me posted on how you are doing,K?marcia

acaptainn · 10-07-2007, 11:29 AM

Ditto the lidoderm ! it helps w/my b/t pain. Good idea on the biofreeze im gonna try that,thanks for the info FEEL

skych · 10-08-2007, 06:29 AM

Good Morning,

Thanks Marcia,

Well Darn it!! LOL. At least I know that others have had about the same experience with the trigger points. I am sure that the PM is trying his best to keep me from having any more surgeries.
I really do not want to try anymor trigger points. I have already been to the neuro who has said that there is nerve compression. He already told me that if an ESI did not work I should consider a foramiotomy. The thing is that the issues in the neck have been identified, but I really do believe that an MRI is in order for my thoracic region to make sure that there is not any issues going on further down.
As for the PM, he mentioned Facet Block injection. DOn't really know a lot about those, but I can say I am only really willing to try these things one time. They are painful.
The pain meds I am currently on work for the post part but there are times when if I could take more I would. Sometimes the pain just gets out of control.
I have a box of Lido patches and they helped me in the past for my elbow probs, but they are very expensive and I have only a discount card for prescriptions. I already am paying $118 bucks for the Cymbalta I take.. not to mention the other regular meds I need. OUCH!! big dent in the checking account every month just for prescriptions.

Well I appreciate your input. I will talk to the PM and let you know what happens.

Chrissy

feelbad · 10-08-2007, 08:54 AM

not actually having the ins thing really does suck.perhaps you could appeal to the manufacturers website and see if you could qualify for their free meds program,that is assuming that they actually work as well for your TPs as they can on mine.just a thought here for you,but like i mentioned above,they DO make a lido ointment.it is the very same 5% but unfortuently it really doesn't seem to work quite as well as the patches,but it could help some and i know it is much cheaper than the patches themselves.just see how the patches you do have actually work on the TPs and go from there.sorry i couldn't give you better info.marcia