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Questions about pain management

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Old 05-13-2006, 05:07 AM   #1
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Questions about pain management

I was sent to a pain management clinic over a year ago, this placed scared me,I signed there contracts.I have failed back surgery syndrome x2, neuritis ,
a demyelinating disease of unknown origin.All they wanted to do was nerve blocks at the lumbar region,didn't help at all,I stopped going.Now my team of DRs want me to go back.My question is will they switch my current meds?I take baclofen,zanaflex and quinine for severe spasms and spacticity and I'm getting results.My pain is consistantly at an 8.Its just not at the lumbar area.I have neuritis in the arms also.(what is neuritis),plus a host of symptoms from the demyelinating process.Is worth going back to PM,do I have the right to say don't change these meds.This is all very confusing for me.Any insight would be helpful.

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Old 05-13-2006, 08:01 AM   #2
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Re: Questions about pain management

could you possibly see a different PM doc at a different pain clinic?? The best thing to do would be to find out just what PM docs are availiable to you per your insurance,and then just call them up and ask them what there particular pain treatment philosophy they just do procedures only/do they use other modalities including meds?You can also discuss this with your doc.

i am wondering though,you stated that you are getting good relief from your current combination of meds yet your pain is running at an 8?the thing is,the meds that you have stated here are realistically only treating your spasticity and not any of your actual pain processes.have you ever tried any of the anti siezure type meds like neurontin or one of the others?these work really well on neuropathic type pain syndromes.even trying some sort of narcotic along with it would possibly help you.

you really do need the expertise of a good pain doc who can help you come up with the right combination of many possible meds that will actually address the pain along with your spasticity.

I suffer with two of the most horrid neuropathic pain syndromes known to man,central pain syndrome and RSD i also have some really incredible spasticity in both legs due to the spinal cord damage I suffered.My PM treats all of my issues with both meds and other modalities like the injections and other stuff,I also started using the TENs unit last summer and wouldn't part with it for anything now.this really helps with the deep bone ache flares I have in my RSD doesn't really do much for the overall burning in there but it helps tons with the bone ache crap.

I really do think that for what you have described,you really DO need a good PM who uses all kinds of different things to try and help you to control your pain issues.they just really know so much more than any other type of docs about pain and the best ways to treat some of the more bizarre types of neuropathic pain like I have.You just need to find the right doc.i do wish you lots of luck here and hope you can get to one of the good ones who really wants to help you.

as far a neuritis,i am thinking it is just another form of a neuropathic pain syndrome.anything with "itis" at the end means inflammation,and the neuro in front means neuropathic in nature.Have you had any type of a spinal cord injury in the past or some other issue in the c spine area?this area is usually where this type of pain would stem from.also,do you know what is actually causing the spasticity in your legs?or is this all somehow related to the demyelenating condition you have?have you had any sort of testing done?if so,what tests and did they actually find anything?

I do hope they can at least figure out what is causing this condition.have you ever gotten any sort of a second opinion on this dx?
please keep us posted,Marcia
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

Old 05-13-2006, 10:12 AM   #3
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Re: Questions about pain management

I agree with Marcia. You need to find a better PM as a whole to treat your pain. Some PM clinics do nothing but push inneffective injections that can cause damage over time. A pain level of 8 really isn't acceptable (at least to me) but a good PM will assess the situation and prescribe the appropriate medication and modalities such as therapy for example. It's difficult to find a good PM and something that often takes years to find but once you do you'll see how you suffered for no reason.

I am not sure which part of the state you live in (I live in OH as well) but I know where I live there are only a handful of doctors who actually assist by prescribing the appropriate medication, the rest like to do injections. I was fortunate to find a great PM but it did take me several years to finally track him down.
In the entire state there are only a few hundred PM's, 1 for every 2,000 people in pain according to a recent study. It's quite sad. Ohio is also very strict when it comes to prescribing, they are well known for shutting down many non PM type doctors for over prescribing so you'll want to be sure you see a true PM which is generally an anethesiologist.

Old 05-13-2006, 01:43 PM   #4
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Re: Questions about pain management


I have been to 4 neurosurgeons and 3 neurologist 1 electromuscular and 1 neuromuscular DRs.I have not yet had 2 drs agree on a dx except for chronic lumbar radiculopathy.I have had this for 12 years it relapses and remits.
I have had 2 stardard EMG/NCS and one deep muscle EMG/NCS.Shows slow conductivity rt sural sensory nerve.Rt ankle has no feeling , no reflex..
I have had MRI lumbar,Mylogram ,no nerve impingment,all implants intact,
MRI --thoracic,4 minimal disk herniation,no impingement,
MRI --c-spine,mild stenosis,unknown cause,possible demyelination
MRI-- brain,cortical atrophy,demyelination

I realize my meds are for spasticity,(I have to use leg braces because of it)I have it in legs and arms.I have tried lyrica,neuronton,elevail and several others had allergic reactions.I do have hydro's but don't touch the pain
I have had no trauma to the spinal cord and they have no clue what is causing the spasticity.Meds control it,but wear off quickly.
I am seeing my electomuscular DR in 2 weeks,she is the one DR that knows the central nervous system is out of whack,she scheduled all the MRI's a year ago.I am having trouble with my c-spine.When I bend my neck down I get an electical shock down my neck and it shocks the crap out of my right foot and it hurts.She intially sent me to the PM.Family Doc says possible pinched nerve.A few months ago , after a hot shower I blacked out from the heat and hit my neck on side of tub.It has given me problems ever since.I disreguared it,the symptoms I have ,have been here for so long I really didn't give the electrical shocks much attention.
I live 50 miles south of Toledo.
I have kinda put off PM until I get the cast of my hand.I broke it 2 weeks ago.Don't want to look like a walking disaster.Already taking enough razzing from other DRs.I hit my hand with a hammer while pounding a stake in for a tree.
I will call on Monday it'll take a month or so to get in.


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