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Old 01-03-2013, 06:08 AM   #1
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acute pain

I have ongoing problems with neck pain. The oxyneo(40mg) I take deals with general chronic pain well enough, but I get episodes of very intense pain feeling like a migraine in my neck (& shooting to my head as well). My 5mg oxycodone breakthrough meds don't even touch this. Do I need to have my general meds increased to deal with this, or can I take something much stronger for these special occasions?

 
Old 01-03-2013, 12:28 PM   #2
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Re: acute pain

Hello Bnrdog,
That is something that you really need to discuss with your primary care doctor or pain management doctor. In Canada , things are a bit different than they are here in the States, but there are a few things to consider before you approach whichever doctor. How often are you having these new pains/headaches? Are they only since your surgery or did you have them previously?How long ago was your surgery? Have you had any testing or xrays done to rule this in or out in relation to your neck problems or surgery? If not, you may want to start there..It is possible, that during the surgery a nerve may have been in contact with one of the instruments, or been moved around a bit and it is inflammed. If that is the case, pain medications are not going to be helpful in reducing that type of pain.A better option would be something like lyrica or neurontin (gabapentin)works to treat nerve pain much more effectively than opiates do.
As far as the breakthrough meds go, how often are you taking them? Breakthrough meds only work when they are taken correctly- which means only taking them when you are having a flare up in pain that you can not control by any other modality. If you are taking them for example this way, bottle says -take 1 tab every 4-6 hours, and you do, then they will only become part of your regularly taken long acting meds- if you are taking them only when you have a flare up, and not on a regular, daily basis, then they should help to reduce the extra pain.

 
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Old 01-03-2013, 07:31 PM   #3
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Re: acute pain

Hi bnrdog, My wife has cervi headaches from multiple disc bulges ,stenosis and reverse lordosis. She gets a trememendous amountof relief frm the preventative side. She has an Occipital block and a rounnd of botox done every 10-12 weeks, She can tell when it's time for the injections. There is no one way to deal with pain and preveting major flairs may be even more effective than simply rtreating them with more meds when something else may provide more lasting relief. She also takes nemanda, between the two , Injections and nemada she was able to reduce her over all opiate intake by 2/3rds and hasn't had an increase in opiate in 4 years. all you can do is talk to your doc about the pain, severity, frequency etc and let the doc be the doc. There is nothing wrong with asking about adjunct therapies and meds and you might be surprised by how effective they can be.
Good luck, Dave

 
Old 01-04-2013, 06:43 AM   #4
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Re: acute pain

Definitely ask about any other therapies which may be helpful, and discuss with your doctor that your breakthrough pain med hasn't been cutting it (differentiate regular pain vs. this new/separate pain). It depends on the person how high of a dose they need for breakthrough. I actually take a pretty high dose in relation to my daily dose (although a different med), but I don't require it very often (I get 14 doses every 28 days).

If this is something new, it would be more worthwhile / appropriate to start from the beginning with a diagnosis, etc, than adding in more/stronger meds. Definitely possible this could be something separate. For some reason occipital neuralgia jumps out at me...you heard of that? Just a guess of course though.

Try to keep a log of these episodes so you can accurately discuss the frequency and severity. It may even be helpful to jot down any potential triggers (stress, lack of sleep, exercise, certain foods, etc) in case it is migraine or similar. Best wishes.
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