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Different Meds for Night Time

jegspineynjjjegspineynj Posts: 4
edited 06/11/2012 - 8:44 AM in Pain Medications
Hey All-

This is my first post, I've been lurking for quite some time now and thought it was the right time to take the plunge. Just a little bit about my situation. I hurt my back In September 09, unknown cause. Just woke up one morning and couldn't get out of bed. Thankfully, I had just bought an insurance plan. I went to a first Ortho Consult. Quick X-Ray's done which came up negative. My PCP had put me on Vicodin 7.5/750 every 6-8 hours and physical therapy. Needless to say it was barely helping my pain. I called repeatedly and was told that my doctor only prescribed Vicodin so I should find a Pain Management Dr. I found my first PM doctor and set up an appointment with him. He continued 7.5/750 Vicodin and sent me for my MRI. When he saw the results he upped me to 10/325 (Norco). Saw him for a follow up where he suggested Transforaminal Epidural. However, due to my injury happening so close to the purchase of my insurance policy, an investigation was opened to determine whether I had a pre-existing condition. I did not feel comfortable having a procedure I didn't even know if it would be paid for. He gave me 90 5/325 Percocet and said if I wasn't ready for an Epidural by the end of the script that I would not be able to come back for another appointment. I started seeing PCP for pain management. My doc would only give me 60 10/325 Percocet at a time, which meant I had to go every 10 days to see him. Met with a Second Pain Management doctor who basically called me a drug seeker and drug addict. Back to the Primary Care Physician. My mother who is a nurse forced the doc to put me on around the clock OxyContin to reduce the amount of APAP I was taking. My PCP discontinued 10/325 every 4-6 and put me on 20mg OC every 12 hrs. Again, clearly under medicated I sought out to find a new PM doctor who would work with me until my insurance issue got cleared up.

I found a doc who was willing to work with me and switched from OC 20 to Opana 20mg 1-2 every 12 with 10mg Percocet up to 4x a day for break-thru pain. I couldn't afford the Opana anymore so he switched me to MSCONTIN 30mg 1-2 every 8 hours. All the while I was extremely conservative with the meds, just took enough to take pain away. Never ran out early, stored as many as I could for the "bad days".

On Feb 24 2010 after filing a claim with the State Board of Insurance my condition was deemed not pre-existing. So I had my first epidural. Now I find that the pain is very different. It's not as constant and it is definitely easier to deal with in the morning. However, the night time seems to be the absolute worst. I can't seem to get the right amount of relief. I'm also on Flexiril and Xanax to help relax. I was wondering if anyone else has this problem and if their doctors give them something different or stronger for PM pain relief? At this point I only take 4 MSCONTIN 30mgs One at 8am, one at 4pm, two at 11 , 4 Percocet 10mg(1pm, 5pm, 9pm, 12am), 3 Flexiril, and 2 .25 xanax. Yet I am not able to get the relief I need to sleep. I'm awake till all hours of the night.

Going for my second Transforaminal Epidural today. The last one left me really sore for two days, and then I was A LOT better for 2 months. Now the pain is different, it used to be bad in the AM now I can deal with just an Aleve from 7-12, but at night I can't get the pills down fast enough.

Thanks for any info you guys might have.



  • I am kind of having the same issues with meds as you. I am on Norco 6 per day and it is not helping much with the pain. For me the night seems to be the worse also. I finally have a chance to stop moving and there's not as many outside distractions.

    I'm glad you are getting some relief from the injections. Hopefully they will continue to help you!

    Sorry I can't provide any answers, just wanted to say your not alone. I am contacting my PCP again today to see if I can get somemore help. One thought is have you talked to your Doc about meds to help with nerve pain? I am currently taking Gabapentin, I haven't noticed a difference yet but a lot of people seem to have success with it.

    Good luck!

    PS: Glad you posted I was a lurker also till recently. It's nice to find people in the same situations.
  • I hope the TF ESI injection helps your pain. Have you tried physiotherapy yet? I usually try to walk around the block just to make me tired and it helps the pain also icing and heat. I take serax as a sleeping pill and it puts me out for a few hours and relaxes the pain also. Do you have nerve pain sciatica? I take Cymbalta now for nerve pain and it helps with the other pain pills I take. I was also on amitriptyline and lyrica also that helped somewhat. Best wishes. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • dilaurodilauro ConnecticutPosts: 9,846
    You mentioned that one doctor who saw your MRI quickly gave you a stronger pain medication.
    What were the results of your MRI? Is it Cervical, Thoracic or Lumbar related?

    My initial reaction to your post was that you are on a lot of various pain medications and have seen a number of different doctors.

    That alone can raise a red flag. Doctors and Pharmacies know that you see multiple medical professionals asking for pain medication. That does send a negative message and will leave the doctors with a question as to what you are doing.

    Besides medications, what treatments have you had?
    Again not knowing what your medical problem is, its hard to say if Physical/Aqua Therapy should be considered along with the many other conservative

    Medications alone, will not eliminate your pain.
    Going from one medication level to another is just going to help you manage your pain. Its not going
    to fix your situation.

    Nighttime is almost always difficult for many spine patients. Its a combination of finding a comfortable sleep environment and the fatigue of going through the day.

    I would discuss your condition with the doctor who
    read your MRI's and see what action plans that they would suggest. Any doctor who reads a MRI image will not only prescribe pain medications, but they will also prescribe multiple other treatments.
    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
  • Thanks for the responses all.

    Charry- I've had some physical therapy. I do my stretches just about every day and I also walk and try to keep as active as possible. I do have nerve pain, I was on Lyrica for two weeks, hated the side effects so I got rid of that.

    dilauro- Yes once the doctor saw my MRI and it was clear that I wasn't just another "24 year old drug seeker" they began increasing my medication. My short description of what has been going on really took four months between September and December. I wasn't going to different doctors at the same time asking for pain meds, it was the natural evolution of my diagnosis.
    I have had Physical Therapy and I had my first ESI in April. My issues are in the Lumbar area of my spine. I have anterior and posterior annular tear, herniation, and two broad based disc bulges.
  • Hoping that you find your 2nd injection a relief.

    I have gotten them many times and found them very benefitial. It is common to be sore following an injection. Ice will be your best firend and I have found that if you ice each hour for 15-20 minutes round the clock for the first 24 hours, it is very helpful.

    It is also recommended that you lay low for the first 3 days, resting and keeping activities minimal. It seems to help the steroids stay in the injected area for greatest pain relief.

    It was also explained to me that the injections are designed to be a 3 part seguence. Initially targeted at the location of the most intense pain. After that pain has been relieved, you may have additional pain is different spots that the most intense pain initially kept you from noticing.

    You may want to try Lyrica's "cousin" medication ~ neurontin. I take mine at bedtime, about 20-30 minutes before I plan to fall asleep, as it makes me very sleepy.

    You could also try adding advil/tylenol pm or benedryl at bedtime to help you sleep.

    Is it possible to also utilize heat via heating pad at bedtime. Before my surgery this really helped.

    Do you have assess to a swimming pool? Being in the pool and taking that stress off of your spinal cord and other joints may help you to get some relief/sleep also.

    There is also a resting position that was frequently recommended by a poster, "Gwennie", that helps decompress the spine. My PT suggested I do it several times a day and since then I rarely have the deep, deep aching I used to have each evening. If you want more info about this resting postion, let me know and I'll help.

    Wishing you the best of luck! Please let us know how your injections went today!
  • What is the resting position that Gwennie suggests? Where I am right now any PT things I try to do just irritate the heck out of my back and legs.
  • Lay on your back either on the sofa or on the floor. Have your hips bent at 90 degrees, your knees bent at 90 degrees and your legs resting on pillows if you are on the sofa, or your calves resting on the seats of the sofa if you are on the floor. Extend your arms out straight with your palms up. hold your head in midline.

    Rest, with deep cleansing breaths for 10-15 minutes.

    I will often combine this resting, decompression position with ice.

    My PT suggessted I schedule this into my day 2-3 times.

    Believe it or not, when I do this, I no longer experience that deep, deep aching in my legs. If I forget and a couple of days go by, that aweful aching returns....

    I hope this helps. PM me if you need more info.
  • Thanks I will give that a try...any help with the aching will be a relief
  • Hey everyone,

    Again thanks for the help. I do have a swimming pool. We just opened it last week. I've been trying to get into it as much as possible.

    I will definitely try the couch thing. I actually had been doing something similar. I do have a heating pad that I use at night. I'm just worried because I go back to work in two weeks, and usually when I do too much during the day it keeps me up at night.

    My PM doc switched me from Flexiril to Robaxin. He said that should help to knock me out at night. So we'll see how that works. I was supposed to have upper levels today, but my doc wanted to repeat the first levels and then in four weeks move up to do the upper levels. He also said we might try to do Facet Injections in the future. Other than that everything is the same.

    Thanks again guys!
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