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Long Term Pain Management??

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Old 09-21-2011, 12:07 AM   #16
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Join Date: Feb 2011
Location: Qld, Australia
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inpain44 HB User
Re: Long Term Pain Management??

Thanks for that BrisNeck. Yeah I just noticed a pain management course at doctors office notice board coming up and was going to attend. It's an 8 week course and hopefully i can make it. Concerned i won't be able to be there for all sessions due to work committments though. I have been reading books on pain management and gained some benefit. I do need to do something more than medication as have been having a few bad weeks lately and difficult to handle.

I am now on 5mg Norspan (Buprenorphine) weekly patches which have really been very helpful in the last two months or so. They have worked much better for me than highest dose of Tramodol plus nurofen plus panadeine etc. On some days I am still taking Tramodol, but only 300mg extended release as opposed to the amount i was taking before plus nurofen plus panadeine. Am only going to take them until they run out and try the patches on their own again. Maybe need to go up to 10mg though I think, as 5mg patch for the first week or two was not enough on it's own - although some definite improvement. Since starting the Norspan patches I have been taking very little other medication. It is significantly stronger than Tramodol of course.

The last couple of weeks have been a struggle though. So maybe need to manage my days better and I find it hard to pace myself. I am a bit of a workaholic with everything, work work and work around the house etc. Obviously limited to what i can do sometimes, but when feeling good on the good days i overdo it bigtime and suffer severely for the next 2 weeks or more (not kidding - in agony for couple of weeks and can barely get out of bed - stupid i know). Trying to make up for lost time or something i guess. But doing things i have to do, not things i like to do, like sport or hobbies etc. I am always concerned about doing anything I don't need to that will cause me pain. A game of golf also increased my pain significantly for the week or so after. So have just stopped playing now.

It is something we have to live with and keep under control. I will definitely check out this pain management course. It seems like you got some good benefit from it. Thanks

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Old 09-21-2011, 12:55 AM   #17
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inpain44 HB User
Re: Long Term Pain Management??

Sorry for late reply, it has been very busy last few months and been back to see pain specialist and doctor many times. I have now started 5mg Norspan patches which have been helping much more than Tramodol etc. as noted in recent post. Also mentioned last few weeks have been a struggle and really think there is somethign else going on, so will get doctor to run some more tests again to see if anything shows up that hadn't before. I will ask to run the ANA test again.

MRI showed nothing abnormal except some deteriation of the disks i believe it said. I was front seat passenger in the car accident and was aware that we were about to hit a light pole, so braced myself (or i would likely have hit my head on the side of car or pole & not have survived). but being braced and very stiff i suffered severe lateral whiplash (side-on, not front). No bulging disks, so really not sure what causing the pain. Is mostly pain in neck and radiates into headache all day every day, some days better than others. On good days the meds help me forget i have pain, on bad days i would really rather be dead to be honest (not trying to be dramatic). i really don't enjoy life much because of it. also get pain in mid-back, sometimes lower back, not sure if related to neck or not, but also aches and pains all over body on top. Not been sleeping much lately which is not helping, sometimes from the pain, but also stress and other health issues i guess. Was becoming an insomniac again. Trying to get sleep again but is difficult.

On my bad days and can feel a migraine coming on, i have no choice but to go to chiropractor. i understand some people feel they do not help or can cause damage (my partner who is a masseuse included), but when i am bad like that he is the only thing that helps me. i walk out feeling much better usually great relief and migraine does not eventuate - if i can get in to see him in time that day that is.

not had MRI with contrast. what is that they use for contrast? probably some chemical i don't want in my body, i am guessing, that will likely affect my overall health anyway.

Not tried Gabapentin before first i have heard of it. BrisNeck also mentioned this one.

Sorry to hear you are in so much pain also. It is very debilitating and just makes life difficult in all areas. also because its not such an obvious & quantifiable issue, most people and doctors don't understand. if my doctor could spend a week with me and see how much pain i am in, and how much it affects my life they would not hesitate to prescribe whatever you needed to take the pain away. a different perspective would make all the difference, knowing that they would not want to suffer like that themselves, so why should anyone else...

some days i just can't take it and do not want to get out of bed. lucky i am able to work from home now and very flexible with hours and do not need to travel much anymore, or i would not be able to work on a consistent schedule at all - very erratic. although doing too many hours again, it is flexible so i suffer through the bad days and work hard on the good days or parts thereof for that i am grateful & consider myself fortunate.

Last edited by Administrator; 09-21-2011 at 08:58 PM.

Old 09-21-2011, 07:42 PM   #18
Join Date: Sep 2011
Location: Brisbane Qld Australia
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BrisNeck HB User
Re: Long Term Pain Management??

Just a few comments,

The 2 week course I did was paid for by my Health Fund, I took 2 weeks off work unpaid. 8 weeks is a long time.
Wesley also has a part time course spread over multiple weeks.
As far As I have been told, the Wesley pain management course is the only one in Qld.
They make sure you do think about activities so paceing is important. Feel good, do too much, spend the next few days in pain.
I have had too many side effects, so I am looking for a low dose, low side effect drug regimine. I think 2 x 3 Osteo Ease per day will be my mainstay once I am off the Duratram trip.
Doing exrecise & specific stretching has made my pain levels decrease to managable.
Things at home & work like getting monitor heights correct, buying back supports for desk chairs to correct poor posture, using correct lifting methods etc.
Building up strength to help the damaged area also helps to reduce pain.

Drugs are not the answer, they seem to cause more problems than they mask. You need a holistic answer.
The biggest problem I saw is that doctors tell people to bed rest, they lose muscle tone, and their life spirals out of control. you then see the doctor for stronger & stronger drugs.
It's the same story over & over again.

Old 09-21-2011, 11:27 PM   #19
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Re: Long Term Pain Management??

One thing to remember when your trying to work the med tolerance/dependency issues. Use 2 different meds for Long acting and breakthru. An example being a lot of folks who are on Oxycontin for long acting coverage also take oxycodone for breakthru pain, the problem with this is that these are the same meds and they work on the exact same pain centers in the brain. If you can use something like MSContin for long term and oxycodone for break thru, then you have two different meds which work on different pain centers in your brain, therefore lowering the rate at which you become tolerant and also lowering the rate at which you become dependent.

I, myself use the MScontin/Oxycodone mix and it works really well. I've been in pain management since I was 17, I'm now 42, so trust me *l* I've been through just about every pain med out there. I find that when I'm on say Oxycontin for LA and Percocet for breakthru, my tolerance goes up really fast...because I'm essentially feeding the same med to the same pain center in the brain. And common sense tells you the higher your tolerance goes the worse your dependency on the meds is going to be.


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