Pain management for TMJ pain?

******1 · 04-08-2004, 02:13 PM

Hi, I was wondering if anyone else here was currently in Pain Management (PM) for TMJ? I have been taking Vicopropfen (7.5/200mg) for about 8-months now which was prescribed by my GP and allowed up to 8-a day which I most always need as my TMJ pain is quite severe! I have seen several dentists and one TMJ Specialist who said he could not treat me until I got my pain under control and recently, at the request of my Insurance company, my GP refered me into PM. (Also, I feel he might no longer feel comfortable prescribing my medication)

Today was my first PM apt and after filling out all the forms and talking to the doctors aide (I never even got to see the doctor!), she said that the amount of Vicopropfen I had been taking was too high and was equal to what a cancer patient might be taking and that she didn't think I could continue...then she said they would not even take me a patient until I had an MRI to "prove" that my TMJ pain was valid! Even though I had all my documentation and xrays from a previous apt with a TMJ dentist! The doctor even refused to refill my empty bottle of Vicopropfen after my GP had said to take it with me and that they would take care care of me! When I became distressed about this and asked what I was to do (I didn't want to be in pain NOR go through WDs!!)...she said I could go to the detox center at the hospital for more advice! ( how uncaring and insensitive!!!)

Needless to say, I was very surprised at such treatment but agreed to have the MRI done, took a urine test and told them that I would just call my GP for my usual refill, which I did when I got home and they said that was fine and they would continue until I had the MRI and we would take it from there.

What I am wondering is for those who are in PM due to their TMJ pain, is this standard treatment for a first apt? What kind of pain meds do they usually prescribe for this sort of pain and should I seek out another PM facility if they are not willing to give me something equal to the pain relief I am accustomed to? Any info or advice would be appreciated!
Thanks!
******1

tchair · 04-09-2004, 07:55 AM

******1,
Let's see, the doctor was lacking the time or inclination to see you. A major decision was made to cut off your medications without warning, seeing the doctor or any input from you. You were given patently false information about your dosage which reveals their lack of knowlege not to mention scare tactics. You now are aware that they are "uncaring and insensitive". The very idea that you can "prove" or disprove pain through an MRI is nonsense.
You can return to them and expect more of the same treatment, or as the vetrans say - take control yourself - and seek another doctor. Your TMJ specialist may or may not have been aware of the sort of PM he was sending you to. It is up to you to look again (and again if necessary) to find proper treatment. If you must explain to the specialist simply tell him what you told us - that they changed your treatment to no treatment without any consultation with the doctor, prior notification, or plan of any sort to treat your pain in any manner.
There are good pain management centers where you are treated with respect, no asssumptions are made about you and their goals are reduction of pain and improvement of quality of life. They may find your current medications are not appropriate. They may ask for phsycological screening, a narcotics contract and compliance testing. They may use trial and error in finding the best treatment. But a good doctor will taper you off of current medications if and when other treatments are effective, not tell you to take a hike.

******1 · 04-09-2004, 12:44 PM

Thank you tchair!

I know all of this...I do my research, educate myself on my condition and am involved with several online Pain management forums...I know that this is not the sort of behavior that I should accept! I find myself so 'vulnrable" though when my expectations are high and then to be let down so suddenly again and again...I am just tired of the "runaround" and even though I am in abit of a funk today, I will pull myself out of it and continue on with my search!

Thanks so much for your post though and I will be sure to tell my GP who refered me there exactly what you said...I did touch on this when I went to his office yesterday after the upsetting PM experience, but need to talk with him again to clarify it! I'll keep you posted what my next move is...
Take care!
******1

dan44 · 04-13-2004, 12:41 PM

I am new here. I also suffer from tmj. What did your xrays show? Let us know if you have had your mri too. I haven't had one yet. Curious to see what they actually show.
They treated you rather badly. I would ask for an explanation. Sometimes I think they base there opinions on someone without even talking to them.
I am treated at a pm facility. I haven't been treated like that knock on wood. They seem to think my pain is valid and haven't acted like I am a drug seeker yet.
Did your doctor call and talk to them? He would be the right person to tell them about you.
Thanks for any info.
Dan44

******1 · 04-14-2004, 11:18 AM

Hello all, well I am in a state of confusion this morning and I thought I would stop by here first and see if I could get some advice! This week is Spring Break for us and I've just been being lazy and not doing anything towards my current "situation"...dumb me!

I had not heard anything from the pain mangement clinic and figured they probably were not going to even call me back...until this morning when I got a call (left on my machine) from them with the date of my scheduled MRI! It is scheduled for tomorrow (Thursday) at noon!

The way I had left things with my GP was to just go ahead and have the MRI and see what the PM clinic has to offer me...my GP said not to worry and that he would continue to fill my pain medication for as long as needed, but to give this place a chance. I have alot of concerns though...I am afraid the MRI will show that nothing is wrong with my TMJ and that we would have better luck if I got the Xrays from my last dentist apt showing clear damage to the tmj and arthritis (sp?) beginning in my left side! I also feel that I should make an apt and go into talk more with my GP and let him know my fears and maybe he can answer some of my questions.(TODAY!)

The part I am most confused about is that IF my GP is willing to keep me on the pain medication for as long as needed...I am wondering if I shouldn't be looking for another TMJ Specialist or dentist to try to treat the problem rather than PM where I take the chance of getting the same sort of treatment I did this frist time! The problem here is that it was at my Insurance companies request that I was refered into PM...they began hasseling my GP and saying that they wouldn't continue to cover my medication from him...should I call my Ins.co and try to explain the situation to them? I honestly don't know what I should be doing, but I feel that I am being treated very unfairly and the upset this is causing me does not help one bit!! Any advice????
Thanks,
******1