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Facet joint pain and narcotic pain medication

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:30 AM in Chronic Pain
Hello everyone,
I was injured at work in September of 2008. I have had much pain in my lower back right side and upper buttocks. I also have a ton of sciatic pain from my buttocks down my leg to my knee. My hip and groin are also very painful.
The doctors I was seeing after the injury were presribing Norco for the pain. It was very helpful. After a few months I had to swith to percocet 10/325 two three times a day. This was very effective for my pain. My workers comp. doctor finally got me into a pain magagment doctor. He thinks I have a lumbar facet join problem. He's saying my percocet will not help for this injury. I'm really concerned because he's not gonna fill this medicine which I know works. As anyone had a facet join problem and been told that narcotic medications do not help for this injury?
Any help would be awesome and sorry about the length of this post!!!


  • Get a facet block from your PM doctor! Yes, facet pain can be wickedly severe and there isn't a great diagnostic test other than relief from the facet block. Usually facet pain doesn't radiate alot, so it sounds from your description like something else is going on too. However, if you have a problem with a disc, there is a higher likelihood of eventually developing facet joint issues too.
  • I'm sorry about your injury and I was wondering if the doctor ordered an MRI for you. Maybe you can talk to your PM doctor about him offering you an alternative treatment/medicine for your pain. They should have you try a nerve pain medication like Neurontin, Lyrica, or Cymbalta for your sciatica, and anti inflammatory meds like Naproxen or Motrin. A combination of meds are more effective than just one when you're dealing with mechanical back pain and sciatica. You can also try using heating pads and ice packs, and it doesn't hurt to ask for a tens unit.

    I didn't know I had problems with my facet joints until I had my fusion, and the surgeon had to clean up a bunch of debris from all the arthritis. Some people have had facet joint injections where steriods are used to reduce pain and inflammation. When that doesn't work, then a procedure called facet rhizotomy is performed to deaden to nerves so that the pain signals don't reach the brain.

    Well, I hope things work out and you get the relief you need. Take care and welcome to SH :H
  • Yes I had a MRI and it came back normal. I've also tried many differnt types of anti=inflamitory drugs. They all seem to give me stomach pain and major headaches. I've had to stop using them. I hade a facet join block done yesterday as a matter of fact. I felt great for about two hours then the pain began to return. My pain in the hip and groin didn't improve at all after the ijections. I also got a major headache after the injection. I guess its just a cowinsidence.
  • did the doctor just tell you it came back normal? If you didn't see the MRI report (it's usually a one or two page report), you need to get a copy. I was told that my first two MRI's were normal wear and tear showing and that bulging discs weren't a problem. After getting copies of the reports, there was more mentioned that eventually led to my getting myelogram and discogram done, which showed a big disc tear and a chunk of disc missing. Just wanted to mention that. You may have everything and it's still an average MRI report. Also, MRI's don't always show everything.

    Good luck. To me your symptoms sound like you have a disc problem that's hitting nerves. If you have facet joint problems, the vertebra could be slipping when you move, but looked great on the still MRI laying down.

    I would push for more tests...there's CT scan, mylegram, discogram, nerve studies, and flex xrays (where you bend this and that way while they take pictures) How did you injure yourself? Was it from lifting? or did you fall? Sometimes the way you were injured can help with some other suggestions.
  • i have recently been told that i have {along with other back problems} facet joint hypertrophy or facet joint syndrome as it is sometimes called .i take oxycontin and oxynorm and along with my acticare and rest it does help with the pain.
  • I Have Severe Pain on my Low Back Only when I Lie Down or when I get up from Laying down. Wierd but that's when I mostly feel my Pain. I researched all my Symptoms and have always believed I had facet joint problems. The Drs. were not sure what was wrong with me Because my Pain came first only when I got up from laying down. They did not understand (Rare). This Site has helped me so much. You hafto be your own advocate. Don't give up. Be calm when you go in your Drs. office and explain in detail the Pain your in. I would Request an Mri to see if anything serious is going on. Your Dr. is Right the Pain Pill you want won't help the problem but it will help you with the Pain. I tried Relafin a Prescription Anti Inflammatory Med and that helped me a bit. I also asked for Pain meds for my Pain to take only As Needed. Don't be afraid to ask your Dr. for Pain meds if you are in Serious Pain. But again this will only help for a little while. Remember they can be addictive and they will only work for a little while. An Anti Inflmmatory may help better but again they too can cause other problems if you take too much. Glucosomine with Chondroitin is a more Natural Approach and this will help Get to the Root of the Problem. It is a bit Pricey but it helps if you take regularly and over Time. Ask your Dr. if it will be Right for you. It's in the Vitamin & Joint Section of many Stores. I hope you Feel Better and you find what helps best for you. *All this is just my Opinion, I am not a Dr. or Expert just someone who too is in Pain...
  • Sorry that the pain doc has different opinion than you with regards to meds, but he probably have more things up his sleeves than just pain meds. You should ask him what is his plans, and if each one doesn't work, what's next? In the meantime, can you take tramadol or something else? Especially if he refuses to prescribe percocet.

    Even though your MRI may not 'show' your problem, I hope your pain doc still believes that you are in pain.

    I had spondylolsis on the facet joints, two years later I had spondylolisthesis, then I went for TLIF and they did a facetectomy in the procedure.
  • once again the anti narcotic police raises it's ugly head
    drs and the public are brainwashed about narcotics. a lot of drs even pain drs will not prescribe them no matter what. if a narcotic is effective, discuss with your doctor and if he still balks, say thanks, walk out and find a new pain dr. sometimes it is trial and error with paindrs. take along all results of all tests you have had, mri, cat scan, nerve tests, discography etc and show them to back up your claims. if you have not had them try to get as many as you can. if dr still won't give you pain meds, then he is a jerk and you will have to find another one. i say jerk because everyone has the right to be treated for pain. if he does not give out narcotics, he is not using the full gammit of meds aviiable. it is up to you to find someone who is more sympathetic. clinics i found are less probable to give out pain meds. i have a private pain dr who is not with a group. i have had no problem with him. sometimes we have to travel long distances to find a good pain dr. i did and had to drive 200 miles at one time. remember takke all test you have to back up your claims and take more if you can. the more the merrier as far as test results go
    good luck
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
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