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Chronic back pain, treatment, medications, psychiatrist

gregalanggregalan Posts: 9
edited 06/11/2012 - 8:40 AM in Chronic Pain
I will appreciate any thoughts and experiences. Trying to keep it short. In 2003, herniated L4/L5, DDD stenosis at L3/L4, L5/S1, slight ddd at L2/L3. Recommended for fusion or pain management/therapy. Tried everything for three years(therapy, chiroprator, message therapy, numerous epidurals, aqua-therapy and so on) In 2005 started tramadol at 50mg 2x day and cymbalta. Worked part-time 2006/2007 (white collar, sit and drive a lot). Received partial disability. Coflex operation Jan. 2008 (two levels), overall good and worked part-time for one more year and went off prescription meds and used over the counter. In 2009, back full time, but severe spasms, fatique, more pain, more injections, back on tramadol and clonzepam for sleep. I have had sleep problems since 03 and tried everything for that also (I can fall asleep but I do not stay asleep). My most recent visit with my physiatrist (been seeing since 03)suggested that I may consider seeing a psychiatrist based on the long term chronic pain and problems such as fatique and insonmia. This statement hit me hard as I always felt that I have mental stability. I will appreciate any input.


  • to the University of Miami pain clinic for almost a year now, and as part of my treatment for intractable pain, I do see a Psychologist. My Psychologist specializes in pain Psychology and he deals with the depression, sexual issues, anxiety and sadness that living with chronic or intractable pain can bring to us.

    I was a bit skeptical at first when my PM Doc said that he was going to send me to a shrink, but after talking to her and knowing that she was on my side and that she was going to give me the tools that I needed to deal with the emotional side of chronic pain, I accepted her, and her treatment. As long as this Doctor is not there to tell you that "all of the pain is in your head" and that you need to have treatment for your "delusions" or something like that, then I would accept it as part of the team of people that are going to help you get through these difficult times and condition. Good luck to you and I hope that it goes well,

  • When I saw a psychiatrist after my accident, he told me that chronic pain causes a lot of psychiatric distress, such as anxiety and depression. My PM doctor was quite happy to hear that I was working with a specialist to deal with that side of the pain issue!

    Psychiatrists are better trained to deal with psychotropic meds such as cymbalta, xanax, and ambien (all of which I take). I say see the specialist who knows the most about the meds you're taking!

  • Gregalan,
    From experience even those without mental stability surmise that they have it, we should not be so reticent to deal with our issues that perceives in a lifetime 1 in 4 people will have some MH problems.

    For most the origin of the pain is not in your head, it is only illuminated by our thoughts and feeling, emotions and experience. Measuring pain itself is problematic if not impossible, what we evaluate are the presentation of pain behaviour or traits once the pain has endure the brain cycle, we are beginning to acknowledge the variation of the perception of pain for any individual in that for some the communication of higher end number on the pain scale are not always reflective of actually capability, something is going on.

    As with any relationship finding some common ground is always an issue initially and it takes time for a good working relationship to develop, I have been fortunate that those who I have seen and that is many over the years have never implied that the totality of my pain is in my head and no academic research suggest that statement itself has any rigour or validity.

    Our 4 week residential PM supported us in developing improved coping skills though the use of CBT and for those that needed it a half full lifestyle ethos. Left to survive in isolation it is easy to develop that all consuming dire outlook, improvement needs active support and specific encouragement, in enduring pain continuously we have sufficient inherent capacity to perform from a more suitable platform and positive stance, pain cannot be surmounted in isolation however skilled of tenacious your stance, it need constant attention.

    Psychological help is only one mandatory aspect of the multi faceted support we need to cope more effectively and reiterated in Melzack and Walls assertion that a “collective approach” is most effective in managing pain.

    Take care and good communication.


  • Thank you, everyone, for your comments, insights, and understanding.
  • FWIW I think every Chronic Pain patient should go to a shrink. Studies show almost 90% of chronic pain patients suffer from depression, and as a demographic we are 3x more likely to commit suicide than the rest of the populace. Chronic pain actually alters the brain, neuro-pathways change, etc. I resisted going to the shrink for a long time, I am ex-military and very self sufficient, I thought only weak people went to the shrink, I also thought only wimps took pain meds long term: How wrong I was! A shrink who specializes in chronic pain is just a part of treatment as far as I'm concerned. For me a very needed part of my treatment.
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