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Pro or No Meds....

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:25 AM in Pain Management
Does anyone know how to find a pain management dr that believes in medication? I just went to two one week apart that denied me a pain killer. The first said I have to be unconscious to be out of pain, the second said only morphine would help me and she was not about to prescribe strong medications. She ordered p.t. 3x a week and lidoderm patches. I got so upset I just left there without the scripts. I'd like to know before I go and waste my time with these dr's. I can't get any info online, at least I can't! I'm 63 yrs old and in so much pain, why don't they help me? Why punishment and 'looks'?


  • Hello, I just posted a question on the lower back forum with almost the same question. I am having a problem finding a pain management dr that will prescribe pain meds that will help. My ortho dr gave me pain meds, the pm dr gave me the lido patches too. Good you did not get the scripts they did nothing for me. I hope you find some help, have you talked to an orthopedic dr. maybe they could help you. I have an appointment tomorrow with my second PM, we will see what he will do. Take care.
  • :H What state do you both of you live in?
    I am very satisfied with mine and could ask him if he has any referrals?


  • Sorry to hear that you are having trouble being treated with pain medication... I understand your pain (pun intended). I had a situation that was similar, but I WAS able to find a PM doc that prescribed me pain meds after being denied by a different doctor.
    I have heard that in some places it is difficult to get narcotics to treat pain. Something you might try is to call these doctors ahead of time and ask if they prescribe pain meds to treat pain or if they only do procedures. The office mgr should be willing to give you this information. This could save you from going to a doctor and paying, only to be disappointed in the end.
    Good luck with your search!
  • How could there be a pain management doctor who doesn't "believe" in giving pain medication? That's like an obstretician who doesn't "believe" in delivery babies. Unless, there's more money in injections and other types of "procedures". I have never encountered this problem. I have seen several PMs. Actually, one, I read in his office notes, did not believe in the long term use of narcotics for the treatment of pain. If there were several other options that worked just as effectively, we'd all be cheering, "hurrah" but in the absence of those alternatives, we need drugs. Only once did I have a problem -- it was at an ER following a radio frequency ablation where I was given no post-op drugs (my choice -- I'm super sensitive to opioids. they tend to make me hyper and panicky feeling). the deal with the PM doc was that he would be in his office all day the following day and if my pain kicked up following the RFA, I could reach him at his office. Well, he never got my many messages and so, on Saturday, two days later I presented at the ER and was treated like a piece of poop drug seeker by the brand new litle girl who was the "ER doc". I won't continue (as much as I want to.) I do think the advise to ask if the docs do something other than procedures) is the way to go (so as not to be suspected as a drug seeker.) I'm trying to think why I have not encountered this. Have you gotten a referral? I always had a referral. I always had MRIs, EMGs, operative notes, etc. demonstrating that I do, indeed, have a problem that causes pain. I think I would go to my surgeon or my PCP and get a referral. Going the referral route will garner you more respect but, frankly, i think the vast majority of these PM docs want to do procedures because its good for their pocketbook. Take the time to find someone who has yours (not his or her) best interest at heart and do not settle for being a doctors personal ATM. Susan (with the bad attitude.)
  • live have a sign on the door "do not enter with narcotics" the first time I went there it shocked me. I tried thier injections and after over $5,000 and no relief I quit going.
    All the injections did for me was to make this diet controled Diabetic insulin dept.This was 9 months ago and Iam still on insulin, so if your diabetic please think about this before you get shots. I now go through just my regular PC fpr pain meds and don't have any problems because she knows the constant pain I am in.
    So, what Iam trying to get at is if you have a good relationship with your PC Doctor than in my opinion that can sometimes be your best bet.
    I wish you good luck on your road to being pain free.
  • sorry you suffering >:D< >:D< >:D< >:D<

    like others have said a referrel is good. plus having test results to back up your pain.

    we have 4 drs in my immediate area. 1 treats backs with injections and long acting meds. the other 3 only treatments. thats it.

    it all depends on where you live.

    if it wasn't for my pcp right now i would be down a creek without a paddle as my ortho dropped my pain control 8 wks post op fusion UGHH :jawdrop: :jawdrop:
    he will take care of me till my next surgery then im headed back to the pain guy i saw before. he only uses 4 meds that im not happy about but hey i have to do something. and if he can RX meds he can do more, he just doesn't. that has always confused me.

    i wish you the best of luck!!!
    what type of pain are you experiencing if you don't mind me asking ????

    HANG IN THERE there are so many people that can relate to your problems.
  • Stockbroker, Good day! :H

    I have seen different experiences regarding pain meds. Assuming we all had the same problem and all looked the same but went to 5 different Pain Managements Dr's for seeking help, I strongly believe that not everyone would get the same meds or amounts. One of my examples was my first Dr. only prescribed enough meds for 2 weeks with one refill, if you called the pharmacy for early refill you got dumped by the Dr.
    My current PM Dr. first gave me 240 Norco, 180 Soma, and 240 Motrin. I was blown away about the differences. When I read the prescription and saw the amount I ask the Dr. if this was correct. He told me bluntly, you are in pain, I have the images and your physical to prove it, now try to relax for the first time. He said "I not afraid to write prescriptions", and after a while we will decrease your dosage and get you on a recovery plan and fix your back. My previous “Mr. 50 count” DR said he doesn’t like to mess with the DEA and records. I think it's like anything else, some Dr's are just more conservative than others and they prescribe however think is appropriate, regardless of our preference.
  • Hi Bobby,
    I just saw your post and I appreciate your offered help. I live in Maryland. I just found another dr and am having another ESI tomorrow. I am going to a neuroradiologist. My Ortho dr gave me the pain meds I needed to help with the pain.
    Thanks again, Stacey
  • dilaurodilauro ConnecticutPosts: 9,740
    doctors sure has its twist here. There are a number of people that just talk about their disappointments and they there are so many out there that are totally satisfied.

    I fit into the category of being totally satisfied. My Pain Management doctor for the past two years has been able to help me manage and control the pain I have associated with multiple spinal problems.

    I have also read the bad stories and there are some common denominators in most of them:

    1. Person has bad pain but doesnt get any pain meds, but the patient doesnt provide the clinical symptoms of having that much pain.
    2. Doctor prescribes PT for the patient, but the patient doesnt want to do it

    One thing for sure, you have to work with your doctors in order to reach a place in which you will get what is needed and you will do what is asked. I know that if I was to refuse PT when my doctor ordered it, it would be ok the first time, but if I did it again, I only demonstrated that I did not want to be in compliance.. Once that happens, you will have a tough time establishing a solid relationship with a doctor.

    Pain is very subjective. One person's 3 is another's 7.
    And remember IF it reaches over 8, you should be getting off the computer and getting yourself into the hospital.
    Pain Management doctors that are experienced can tell when a patient is in pain and how much pain they are in. They can also distinguished between someone who just wants pain medications vs someone who needs it.

    Bottom line here, it is so important to estalbish a trusting and solid relationship with your Pain Management doctor. People will find out that managing and controlling pain is not just done using Pain medications.
    Its a 'blend' of medications and treatments. It could be nerve medications, sleep aids, some form of PT or Aqua Therapy. But I do not believe that just pain medications by themselves will do what people are looking for.
    And that is to reduce their pain levels so that they can continue to function the best they can
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I ran the whole gammut. First the diagnostics; then the PT; then the mild forms of NSAIDS and an epidural injection or 2, milder pain meds along with anti-depressants and neurontin - and more epidurals, stronger pain meds with epidurals, surgery, more epidurals, stronger pain meds, radiofrequency ablation, more epidurals..... Finally, now I am on two long acting, 3-4 breakthrough (sometimes more, depending on my activity), muscle relaxers (only when I KNOW fer sure I won't be driving) and a sleep aid. That's my pain management regimen. I have been going to the same PM for the past 3 years. I have never refused a treatment option (I was always positive it would work, then deflated when it failed) and have never demanded anything (well, except for that one time I commented: "You are supposed to be a pain management clinic, how come my pain isn't being better managed?" but I was having a bad (very bad) pain day and they knew it - so didn't take that comment for more than it was intended: venting because of the frustration of it all).

    To all those searching for a pain management doc: I hope you have much success. My doc is a peach. She was referred to me by my GP and I have never been dissatisfied with HER; only the inability to be pain free for more than an hour every now and then.

  • I love last line in your tag, "But this may all be because I am depressed..". =))

    That just makes me want to scream when they think that if I were not depressed I wouldn't be in so much pain! Hello!! I wasn't depressed when my pain started. Well maybe a little but who isn't?
  • It seems just from reading posts that the people that are satisfied with thier PM are getting pain meds. I agree that you must be open to all forms of therapy but what about in the interium should they just let you suffer? Is there not a patient bill of rights? Didn't the congress just pass a new bill concerning just these things? What about affordable health care? The price of epidurals,PT,psych councelling,massage,aqua etc..compared to a RX of narcotics. It seems to me that in many cases they are putting the cart before the horse,medicate then treat not vice versa.The meds can be triated down once the pain is under some sort of control. Just my HAO....Mike
  • The reason I am satisfied with my PM is not solely because she has give me prescriptions for pain medication. It's because she truly seems concerned with me, has made suggestions on what treatment plan to follow, etc. But, MOSTLY, it's because she LISTENS to me. She BELIEVES me. She doesn't pooh pooh my complaints of pain and tell me it's in my head. Or, it's because I'm overweight. Or, that I can't be feeling THAT badly. She believed me when I told her my pain level was at a 9. She has worked with me each (and every) month.

    I saw a rheumatologist back when my problems first started rearing that ugly head. HE said I needed to lose about 40 pounds and my back would not hurt as much. He also said my neck and back pain were because of connective tissue disease. What he would NOT do, however, is perform simple xrays to rule out anything else. His opinion was gold, and with him being a god and everything, I should not question him. Besides, he told me matter of factly, connective tissue does not show up on an xray. So, after being treated by this SoB for a couple years, I went to my GP who was appalled at this medical god's treatment and referred me to a PM. ANd it's been great ever since. We did tests, epidurals, massage, physical therapy, all the while, we were trying different types of medication to see what worked for me. Some people can be treated quite affectively with minimal medication (God love them!)and for others, it takes a bit more than that, but less than narcotics.

    I have lost that 40 pounds. 46 to be exact. Funny thing, my degenerative discs and herniations and bulges and pain are all still there... I have also been telling myself "I do not hurt" "This pain is not real" but I don't seem to be listening - it's still there!

    I do believe people have a RIGHT to be heard and believed and treated. I don't think a doctor should arbitrarily write prescriptions for heavy duty pain meds without some kind of proof there is a medical reason why a person is hurting (if that were the case, everyone would be on pain meds, just about!) But, I do believe they should at least do the proper tests as quickly as possible.

    I am sure if you go in with a broken bone, gunshot wound or some other wound, they'd treat your symptoms then and there. And work their way back ward.

    And, I believe our new president will be doing something about affordable health care. Didn't he say that in his debates? I know if I were president, I'd be sure everyone is able to have health care. Some how. That should be an American right (up there with voting, owning guns, etc).

    Take care peoples!

    (If I have managed to offend anyone with this post, I am truly sorry... I've been a bit pushed to my limits this week and it's only Wednesday! If I have offended, please just ignore me.... !)
  • Yeah - it would be great if I were able to take a "happy pill" and my pain would all go away. I'd but stock in the company making those pills, let me tell ya!
  • dilaurodilauro ConnecticutPosts: 9,740
    the situation with Pain Management doctors that dont seem to be wanting to help you versus those that will not help you for specific reasons.
    This is not singled out to any one person, but in general.
    Yes, patient have rights, just as doctors do. There have been revisions in the pain scale and these charts are made available in almost all medical institutes.
    There are many patients who need the care of pain management doctors and do receive this care. There are also many patients who believe they should be getting some treatment, but based on clinical examinations and other tests, the doctor does not feel certain medications are warranted. So doctors are also a bit gun-shy due to the recent press releases of doctors being put in jail for dispensing narcotics. Nothing is black and white and when it comes to spinal situations it is even more difficult.

    When you have a fever, a thermometer is used to determine how high that fever is. With back/neck/thoracic pain or any chronic pain, there isn't a simple device that will measure the pain that you are in. Maybe if there was, there would be less problems that people seem to have with pain management doctors.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • THAT was what I meant to say, rather than all that rambling, non-sensical stuff I wrote. :D
  • I just wanted to say that I agree with all the different opinions. I think we can have as many different opinions as we have different doctors. They all seem to have their way of treating their patients. We as the patient have to decide if this is the doctor we can work with, as well the doctor has to decide if they can work with us as a patient too.
    I found out today that my doctor for my ESI is going to be my neuroradiologist. My procedure went very well, I don't remember a thing and that was best for me. I got so upset and nervous last time that I think I caused more pain by being tense and rigid. This time the nurse gave me some meds in my IV and off to sleep I went. It was only twilight but did the trick. Only I am having a lot of pain tonight, just like the last time. But this time my ortho dr gave me medicine that will help my pain.
    Trial and error, but don't ever give up, there is a doctor out there that will help you no matter what, just don't get too frustrated and take control of your future. That is what I decided after seeing the second PM and he did not give sedatives for the ESI either. I knew that there are doctors out there that can give sedatives if that is what will help me get through. I found him about 2 hours later and had the procedure today.
    Thanks for all the advise on this site, your info is invaluable and your courage to keep going is commendable. Keep writing and inspiring others to know the are not along in the fight for less pain.
  • The only thing for me is my co-pay is $50 to see a PM so, I need to know what they do and do not do. I have been told differnt things by differnt Dr's that my head is still spinning. I did not want meds just wanted to get rid of this pain and get fixed well, that did not happen and I am still trying to find the cure. I still say regarding this issue that you need to call and ask questions before making and paying your c0-pays. I think that the PM Dr's that just do the injections and RF and do not give meds something is wrong their. My reg pm Dr. did a RF on my neck and I was crying in pain in recovery and the nurse said after me asking for something your Dr. does not give his PT's meds. I thought I would die. I ended up at ER which cost me $150 co-pay and just so happend to have a Dr. that has had RF's done I had to have a CT of my head to make sure I did not have a bleed. I really like this Dr. but if I need meds I know already he does not give them so I go to another one for that.
  • Hi, Stacey,
    Where in Md. do you live? I am in Md. also and have a pm who prescribes meds. He is in Baltimore. Let me know if you want more info.
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