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Old 10-08-2007, 11:40 AM   #1
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AlanVA HB User
Which med for back pain

Was wondering if anyone had an opinion of which pain med is a good choice (I know that's subjective) for back pain issues?

I have a torn disc (and some related issues) in lower back from 2.5 years ago which a surgeon who has handled me since the injury says that I am not a good candidate for surgery and instead has basically provided me pain killers (he is also a pain mgt doc). I've had MRIs done that show the damage, physical therapy for months, almost 12 months under a chiro's care for that spinal decompression therapy which helped some but wasn't quite the "cure" the chiro made it out to be.

Anyway, when I see the surgeon he will prescribe usually 80 vicodins with the directions of 1 or 2 every 4 hours as needed for pain but since the end of the first year, I don't have anywhere near the need for that level and I might do more of a schedule of 1 or 2 every couple of days as needed based on activity level and actual pain which seems to be good and bad days for me.

He will give me the above script and tell me to come back in two months and sometimes I return at the two month mark, and other times it might be 4 to 5 months before I return for a refill.

He will discuss my situation and basically repeat that if I really want surgery he would cut me open to work on my disc but again, given that I can move and function without much of an impact on daily life and then having to be out of action for 3 months after the surgery, he doesn't think my odds are better than 50/50 for being pain free afterwards.

Most of my day is spent at a desk behind a computer and so long as I remember to get up and stretch every so often, I do ok most days. My biggest pain comes if I have to either stand still or else wait in a line for more than a few minutes after which time, my left foot does that numb/pain thing and the pain quickly works its way up my leg and into my back (and hits about an 8 on the 1-10 scale rather quickly) and then can only be relieved if I sit or lay down for several minutes.

If I know I am going to be somewhere that will require a lot of standing or waiting in line (or walking sometimes) I will take one or two of the vicodins as a way to get some relief prior to the pain setting in - which does help to a degree. I still have the pain but it usually takes the edge off.

Some days I have some pain issues sitting at my desk and I will take one of the pills and/or after 2.5 years I've sort of gotten use to being in pain and will just tolerate the pain until I can sit down and rest.

I don't like taking the full amount of the vicodins due to the constipation issues as well as don't want to get into a physical dependence on them which I think I have had to a degree earlier in the treatment.

I've tried skelaxin as a muscle relaxer but never noticed any effect on that and on the last visit, asked the doctor for valium to use as a muscle relaxer which he agreed with along with the vicodins to take as needed - at least that is the understanding I think between us even though he wrote the script for twice a day as needed.

Something else that I think helped for a while which he gave me after I did a little research and asked for was a script for Amitriptyline as a low dose antidepressant taken at bed time. Shortly after starting, I did feel better on the day to day issues but usually this drug wiped me out during the mornings until I could get a few cups of coffee and wake up some.

I stopped taking the amitriptyline back around the first of the year when I was dx with diabetes and the primary doc felt the side-effects or risks with the amitriptyline outweighed any benefit from them.

So, after all of this rambling does hydroco/apap 7.5-750 with the as needed valium seem like a decent pain mgt solution or should I try something else?

I have an appt with a doctor at Georgetown Univ next month to see if there are any newer / less invasive procedures available for my torn disc rather than the traditional surgery that will replace the disc and put me out of action for 2-4 months.

I can't run or walk for long distances but I can do some exercise on an elliptical for 30-45 minutes most days before the foot and leg pain set in. If I try to jog, that usually will cause back pain within a couple of minutes of trying.

For a while, I was taking one vicodin about an hour before exercising which was helping me most of the days but again I didn't always like the constipation issues that came from daily use. With the diabetes, I need to do some type of physical activity usually every day to try and keep pace with the blood sugar issues since exercise helps reduce the glucose levels.

Thanks,
A.

 
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