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Old 07-18-2012, 08:01 PM   #1
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Help w/med use

I have crps type 2 and was given a low dose of morphine extended release. I have been reading that morphine isn't the best med for neuropathic pain which makes sense because it seems my pain has gotten worse since. Has anybody had experience with this issue? Any advise would be awesome. Thank you.

 
Old 07-18-2012, 08:19 PM   #2
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Re: Help w/ med use

Has your pain got worse since starting the morphine as your first long acting med, or since switching from something else to it? I haven't heard that any pain med is better/worse for certain types of pain. Everyone responds differently to different meds though. Also, if you were just started on the morphine, they likely were conservative in the dose, so there should be room for improvement. If it doesn't help, definitely speak up...there are other options. I personally do not find morphine helpful, but others do great on it. Best wishes.
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Old 07-18-2012, 08:45 PM   #3
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Re: Help w/ med use

Yeah he kept my norco as bt and started me on 15mgx2 a day. I'm not saying it made things worse, im just having more flares than usual. I told the doc today it isnt doing much but he kept me on it.

I've been reading too that someone like me who was taking some form of opiate, should be started on 30mg. He is a real good doc, probably starting low & going slow. But honestly I don't find the morphine to be doing anything. I'm not looking for full relief or euphoria, but i need to ask him to up the dose next month or switch the med.

This was my 2nd apt and I went and bought nerve stimulating gloves, signed up for PT, and have been doing mirror therapy. Balancing my non narcotics with my narcotics and brought in my days worth of extra pills to my apt. (my apt was 14 days after, got meds for 15.) I brought in my medical marijuana card. So I'm building a good trust with my doc and I'm very by the book. So I see a good relationship in the future and I'll never ask for a specific drug. I will tell him what works/doesnt work and hope for the best.

I've just heard ppl on the boards, including you Kate, that morphine just doesn't appeal, respectively, and I think I may be one. I feel very fortunate to even have a pm doctor, and a good one at that. I'm still a newbie and will probably be asking for advice a lot.

 
Old 07-19-2012, 02:45 AM   #4
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Re: Help w/ med use

A lot of times people who first start going to a pain management doctor, the pain sometimes get worst or things just don't seem like they are improving. The reason why is that your body has to find what works best for itself. So alot of times they doctors are trying to find the right med or med combo to work for you. The first couple months you may find that it's not relieving your pain but that is exactly why you tell the doctor at your next visit that the morphine isn't working. They may up the dosage or they may change it all together. I agree with Kate, some people will stand by morphine and I know some people that say morphine doesn't do anything for them. It depends on what works best for your body. I really hope things get better for you. Just be honest with your doctor and tell him that this is not working. I am sure he will help! Let is know what happens at the next appointment. Good luck! Muah!
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Old 07-19-2012, 03:40 AM   #5
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Re: Help w/ med use

Narcotics are medicines that hit certain receptors in the brain that make us just not "care" as much about our pain. It effects the endorphins...

That is why it is a universal pain medication...

The specific nerve pain medications are Neurontin, Lyrica, and Cymbalta. These actually target nerve pain.

And then there are muscle relaxers like Flexeril, Robaxin, Skelaxin to name a few.

With pain management...it's important to work with your PM on what type of pain you have, and many of us end up on more than one medication to help with the different types of pain.

So, you are right in that morphine is not specifically meant to target neuropathic pain.

I am blessed that my 3rd fusion took care of most of my nerve pain but I used to be on Cymbalta for quite a few years.

I am on morphine sulfate ER (extended release) for the last few years as I lost my insurance through my divorce and couldn't afford the Oxycontin anymore (as they lost their patent and only have brand name now)

I find that the MScontin works well to help "dull" the pain a bit. And then I use Flexeril once or twice a day to help with muscle spasms as the MSContin doesn't touch that pain.

Also keep in mind that medication is just one small piece of the puzzle...

There is exercise, PT, aqua therapy, TENS unit, yoga/stretching, massage, acupuncture, injections, etc.

Just to name some other modalities to help our bodies. Unless we have something that can easily be fixed by surgery...we have to approach chronic pain with a comprehensive pain program that includes as many things as possible.

This way, each thing puts a tiny dent in our pain level and it all adds up to getting us to a 5 or so.

I live with a 5-7 on the pain scale for years depending on the day/activity.

So...if you haven't already...I would think your Dr. would be adding a nerve pain medication to address that issue along with your Morphine...

Good luck..

 
Old 07-19-2012, 07:52 AM   #6
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Re: Help w/ med use

Y'all are awesome. Yeah I take lyrica, norco, ms, and lidoderm patches. And OTC I take ibuprofen (my doc wants me to stop that, I have gerd and a haital hernia.) California poppy and icy hot. I am enrolled in PT and have those gloves. So im fighting this with plenty of ammo.

And I'm fine with taking a few months to find out what is right for me. I just think since I have a progressive syndrome, it is, well, progressing. The only surgery I can have is a fusion and that's out of the question. Im fine with "masking" the pain with meds because it really does make things better for me.

I appreciate the info and I hope everyone is doing alright. Thank you.

 
Old 07-19-2012, 07:22 PM   #7
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Re: Help w/ med use

i would not refer to any of my medication that i take as "masking" the pain- and i have tried everything i can find to help my severe pain-i am willing to do anything an everything to relieve the vicious pain i deal with-and the only thing that realy helps is medication-the narcotic pain meds; i am not ashamed to say this as they have allowed me to live a more productive life. so if your meds are helping tell your doctor andd if they are not share that with him too, remember our doctors are not mind readers so i hope are comfortable talking about what your daily life is like with compared to without any meds-best wishes
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Old 07-19-2012, 07:54 PM   #8
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Re: Help w/ med use

I was just under the assumption "masking" means the process by which a stimulus (In my case, pain) is obscured by the presence of another almost simultaneous stimulus(endorphins from morphine like medication.) In my opinion, of course, if one has pain that has failed all treatment except medication, that is a perfect "mask" for the pain one would be encountering. That's all I meant. I hope everyone has a good weekend.

 
Old 07-20-2012, 07:44 AM   #9
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Re: Help w/ med use

I just wanted to clarify that when I was talking about opiates and just having them make us not care as much anymore...

I was only comparing it specifically to nerve pain medication..

Opiates work for universal pain in our brains and create artificial endorphins.....they do not work specifically for nerve pain.

So this is why I brought up asking LC if they were on nerve pain medication in ADDITION to the opiates..

Obviously I think opiates have a place in our chronic pain care as I am on them myself. Both long acting and breakthrough. So I absolutely think they are warranted.

I was just trying to brainstorm and see what LC was already taking as I know with CRPS...nerve pain is one of the main types of pain and I wasn't sure if they were already taking a nerve pain medication as well.

So I just wanted to make sure I clarify as I'm not the best at written word and didn't want to come across the wrong way.

LC...perhaps raising your dosage of Lyrica or trying another type of nerve pain medication?

Have you tried a TENS unit or is a SCS unit something your Dr. talks about using?

 
Old 07-20-2012, 09:54 AM   #10
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Re: Help w/ med use

I really do think my lyrica needs to be increased. 50mgX3 a day is the bare minimum. And medical professionals argue crps is more of an inflammatory disease over neuropathic. I just found that out. And my doc doesn't want me taking NSAIDs due to my stomach troubles.

He is one of those PMs that try all approaches. Yeah he prescribes but he also brought up the nerve gloves which I bought. Suggested PT which I've signed up for. Biofeedback which may come later. Tens, nerve blocks and spinal cord stimulators are all in my future. I've only seen him twice and we covered a lot of ground.

There are, of course, questions that can only be adequately answere by chronic pain patients...sometimes you all give the best advice. I've learned a whole heap in the 2 months I've been on the boards. Thank u very much.

 
Old 07-20-2012, 01:46 PM   #11
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Re: Help w/ med use

Quote:
Originally Posted by lake county View Post
I really do think my lyrica needs to be increased. 50mgX3 a day is the bare minimum. And medical professionals argue crps is more of an inflammatory disease over neuropathic. I just found that out. And my doc doesn't want me taking NSAIDs due to my stomach troubles.

He is one of those PMs that try all approaches. Yeah he prescribes but he also brought up the nerve gloves which I bought. Suggested PT which I've signed up for. Biofeedback which may come later. Tens, nerve blocks and spinal cord stimulators are all in my future. I've only seen him twice and we covered a lot of ground.

There are, of course, questions that can only be adequately answere by chronic pain patients...sometimes you all give the best advice. I've learned a whole heap in the 2 months I've been on the boards. Thank u very much.
That is great that that the doctor is trying other methods for your pain. I am a pain patient but not familiar with CRPS. I am sure for different diagnoses it's different treatments. Even the meds that I take (very strong meds) may not be the best thing for nerve pain. Not saying it won't, I am just not familiar with nerve pain so I couldn't tell you what would work. Sounds like your doc is trying to help though so that is a great thing. Sometimes you land docs who aren't trying to listen or help. Good luck to you and I hope the next time I hear from you you're telling me how great you are feeling. God Bless. Muah!
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