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Old 07-25-2008, 12:14 PM   #1
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Help...looking for pain med suggestions

Hi Guys,

I've been suffering with chronic pain for six years. First it was just fibromyalgia but now I have some disk problems in my back. I'm having a real problem finding a med that I can tolerate well. I started out with Elavil (worked only for a while but had some nasty side effects), then went on Neurontin (worked ok for a while but made by BP go up forcing me to go on a BP med). It seems to have lost it's punch now. The latest try was Cymbalta. It worked great but made by BP shoot up to 160/110, and that's while already being on a BP med. That was the end of that one. I think I've tried every muscle relaxer out there and none have helped expect Soma, but I just can't function on it due to the drowsiness it causes. As far as all the OTC stuff..Advil, Tylenol,etc. it's like taking candy...no help at all. The one thing I take that helps a little is Tramadol, but my doc only gives me 30 pills a month which just doesn't cover much of the time. He says it's addictive so it's not good to take more. As far as any more powerful narcotics, forget it...none of my docs believe in using them for chronic pain. It's a shame since that's one class of meds I do seem to tolerate well.

My pain doc wants to try giving me an epidural steriod injection but I'm really afraid to do that. The last time I had a spinal injection it triggered a very bad, long-lasting fibro flare.

I've done a year of chiropractic treament, and 2 months of physical therapy. They actually made things worse.

I feel like I'm running out of options. I was just hoping that someone out there may have had success with any other non-narcotic pain reliever & perhaps I could suggest it to my doc at my next appointment. Thanks for any help.

Steve

 
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Old 07-25-2008, 12:43 PM   #2
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Re: Help...looking for pain med suggestions

I finally got to PM and I now have the Fentanyl patch as well as Percocet for breakthrough pain. They will work with me on getting my pain level to a level I can live with. They prescribe Long Acting as well as BT meds. Sounds like you need a new PM . Are there others in your area ? Do you need a referral from your primary doc ?

 
Old 07-25-2008, 04:32 PM   #3
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Re: Help...looking for pain med suggestions

Hi Steve!

are you under 40? it sounds like you are running into the age thing, they dont want to start people on stronger pills young, the idea is that by the time youre old (like me lol) nothing will work. that is nonsense of course.

You need a good pain management doctor, one who knows the difference between tolerance and addiction. Its a try and see kind of thing, most of us here went through quite a few doctors before finding one we were happy with.

Its always a good idea to try everything before narcotics, its good medical practice and you never know when something will at least help a little, later on you can add some things you learn now for better quality of life.

The elavil is more of an antidepressant muscle relaxer than an effective pain med, all it ever did for me is make me sleepy, lol. I think you need to try some different meds and see if something will work better for you.

Hopefully someone here can give you a name, otherwise you are on the right path, its just a long painful process, anything you can do to shorten it and get to a doctor that knows more modern ways is best, if there is a teaching hospital or one attached to a university in your area, their pain clinics are always a good place to try.

Good luck and welcome to the pain boards! We have 2 Steves now, but since it was my favorite brothers name and is now my oldest sons name, thats fine with me!

Your Friend, Fabby

 
Old 07-25-2008, 06:33 PM   #4
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Re: Help...looking for pain med suggestions

Hello all! This is my first post. I was put on opiates before I knew any better. I wish I had known about this wonderful group of people sooner. I am on 150 mg of Lyrica, low dose of Morphine,paxil and remeron for sleep. I use ativan when the burning pain is really bad or I have a flare. I can't say the Morphine helps my pain at all. The remeron really helps me sleep. I have just started taking supplements. I hate being on sooo many pills. I try to get exersize every day. On better days I have gone sailing, kayaking and biking. Has anyone tried Serzone for the burning pain. Wish you well Steve. This is rough stuff. Keep trying different meds. and alternative methods like yoga,meditation, message and accupunture.

 
Old 07-25-2008, 06:58 PM   #5
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Re: Help...looking for pain med suggestions

Quote:
Originally Posted by Fabrashamx View Post
You need a good pain management doctor, one who knows the difference between tolerance and addiction. Its a try and see kind of thing, most of us here went through quite a few doctors before finding one we were happy with.
I would agree. The phrase "pain management" means to "manage one's pain"....Not to under medicate our bill your insurance for expense injections that don't work.

Quote:
Its always a good idea to try everything before narcotics, its good medical practice and you never know when something will at least help a little, later on you can add some things you learn now for better quality of life.
I would agree....Regular narcotic supplementation is the last resort....Once all the alternative treatment options have been exhausted. Regular narcotics are for those who have been classified as "chronic." Chronic pain is defined as pain that lasts longer than 3 months. Some experts define it as lasting longer than 6 months. Chronic pain persists over time and is often resistant to medical treatments.

However, when narcotics are deemed necessary, your Doc needs to be understanding and compassionate......And use meds where and when applicable. IMO, it's inhuman for patients to suffer.....And should not have to todays day and time.

Good luck.

Ex

 
Old 07-26-2008, 06:43 AM   #6
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Re: Help...looking for pain med suggestions

Thanks for the responses everyone.

(Fabby...I'm a 45 year old family man. I don't think it's an age thing as far as the narcotics. My doc explicitly told me they should only be used for cancer, surgery, etc. When my disc herniation first started he did give me 10 or 20 Vicodens but I had to practically beg for them and then I got a lecture. He told me that he normally doesn't give them out but since he knows I'm responsible he would make a one time exception).

I hate feeling like I have to beg for medication. It makes me feel like some type of drug abuser when I'm not. I'm willing to try anything whether it's a narcotic or not. The fact is I wouldn't even want to take narcotics on a regular basis. All I asked him for was for some stronger pain meds to get me through the bad flares. It's just frustrating to me how these docs are so willing to hand out some of these non-narcotic meds like candy. My pain doc put me on 120mg of Cymbalta per day. Thank goodness I was already taking my BP regularly at home. One 30mg pill sent my BP to 160/110! I can't imagine what would have happened if I had taken the whole 120mg! My regular doc was horrified...he said 120mg is way too big a dose of Cymbalta to start. I'm so frustrated that doctors can be so nonchalant about prescribing meds with such potentially serious side effects (without even warning me about them) but if I ask for a few Vicodins I'm lectured about how dangerous they are!

I don't know how I would go about finding another pain doc. I'm in an HMO so I just can't go to any doc I want. My neuro already told me he will not refer any of his patients to pain docs who prescribe narcotics for chronic pain. The only solution would be to find all new docs but what am I supposed to do..call up a doctor and tell him I'm looking for a doc who gives narcotics to chronic pain patients? I would immediately be labeled a drug seeker.

It would just be easier if I could find some pain relief without narcotics. If anyone else has any ideas of where I can go from here, please let me know. Thanks.

 
Old 07-26-2008, 07:17 AM   #7
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Re: Help...looking for pain med suggestions

Steve,

Welcome to the boards! I'm sorry you are having such a hard time finding a good pain management fit. I know how frustrating it can be when you have docs who just do not "get it" when it comes to prescribing opiates/opioids as part of a PM regimine. I think many here can tell you that we have all been through the same at one time or another.

It's obvious by what you wrote, that your current doc does not have up to date knowledge of how narcotics are being used today. As recently as 5-7 years ago, the entire medical community thought pretty much as your doc does.....that these meds were reserved strictly for cancer patients and other end of life situations. There were numerous studies done and it was determined by the AMA (and this was all published) that opiates/opioids are also beneficial as part of a pain management regimine for patients with chronic, intractable pain. I think your doc(s) must have missed this or ignored it.

My best suggestion is to do a little research. If you do a search under pain management including the area that you live in, you should come up with a pretty good list of possibilities. Then, having an HMO, you can check with your insurance company to see how many of them participate with your plan. If you ask your current PCP for a referral, and he refuses, then you do have recourse. (I used to work in the HMO industry) Your insurance company can advise you of your options.

Many of us actually travel a bit of a distance to see our PM docs. As much as it can seem like an inconvenience, it is worth the additional time and effort to get the best care possible. I'm not saying you will find a list of "pill mills" or anything like that, just a list of providers who have one specialty....Pain Management. Most of them use all modalities to treat chronic pain.

Again, I know it sounds like a lot of work, but if you are in pain, and it is affecting your quality of life, it is so worth it. I hope this helps a bit. Of course, it is your decision. I just thought I'd give you some ideas. Do with them as you like. Whatever you decide, I wish you the best. Take care and post often. This is a great group of people and there is support and wisdom here that can't be beat. Hang in there, CMP/MM

 
Old 07-26-2008, 07:39 AM   #8
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Re: Help...looking for pain med suggestions

When my lower back pain got to the stage of being classed as chronic, my GP reffered me to a pain specialist that I was told about by another cp'er. He is a anaesthesiologist and very well known Dr in my area. He first put me on SR Tramadol 100mg twice a day to start with then 200mg. Along with a SR anti-inflammatory and I was on an anti-depressant. Also backlophen a muscle relaxant which I couldn't take, and paracetamol for bt pain. I stayed on that mix roughly for the next 4 years.
Later on he started on injections every 5 weeks, which went on for about 12 months until I just couldn't take them any longer. They just weren't worth the agony for the result. During that time I found another doctor who put me on to a psychotherapy class that lasted a couple of months. He was the only Dr up to then to give me 1 script of 20 Endone. But he moved and I was back to the first PM. Most recently I found a Muscler Skeletal Specialist who also happened to be a GP. So along with my local GP I use the MSS to prescribe now the Durogesic patch (Fentanyl) that I am on now. That was after a number of different options along with epidural injections and another patch Norspan I think.
So you can see that a lot of us have been through a round about way of finding the right doctor for us and have tried all sorts of different med's.
I wish you luck with finding the right combination of med's for you and hope you can find a caring doctor with the willingness to try different options.
Allan
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25-Nov-2010: ALIF fusion L5-S1. 9 years of Chronic lower back pain. Nearly 18 months of pain across my upper pelvis, through my butt and down my left leg into my foot. Sciatica relieved by surgery.

 
Old 07-26-2008, 06:10 PM   #9
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Re: Help...looking for pain med suggestions

Steve, boy I can really relate to your frustrations. I don't believe that Tramadol is addictive like regular narcotics are potentially addictive. Some people disagree with me. I take 300-400mg of tramadol a day, and I have NEVER felt high or craved it. It works quite well for me many days. I don't think that 30 per month will give you much relief. I really think you should consider trying to find a new doctor. If he is stingy even on the tramadol, I doubt he will be willing to give you what you need to find reasonable relief from your pain.

Some people have good results from epidural steroid injections. I had 2 but unfortunately they didn't help me. I wouldn't totally rule it out, but it should not be done in place of good pain management.

I agree with the others that you deserve much more in the way of medical care than you are getting now. If you go to your PCP and ask for a referral, you can frame like your pain isn't being adequately addressed, and you believe that you have a right to appropriate medical treatment for someone with chronic pain.

Regarding the Soma, I have been on it 3x/day for several months now, and the drowsiness has abated somewhat for me. Most of the time I don't get the wave of drowsiness that I used to get about 30 minutes after I took it. It still happens sometimes, but for me the benefits outweigh the negatives.

Good luck

 
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