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Pain management advice

asignor908aasignor908 Posts: 339
edited 06/11/2012 - 8:46 AM in Back Surgery and Neck Surgery
I had my ACDF on August 3rd and I also need back surgery on the lower back due to extreme chronic pain in lower back, legs, hip, and feet with nueropathy. I have a PM and NS. While they do give me meds I am never pain free or even close to it. All meds are short acting the NS ha me on oxycontin 10mg 3x a day and the PM doc has had me on percocet 5/325 4x a day. The PM doesn't seem to like to give enough pain meds to do the job and seems to love the epidurals which I have had one so far with minor sucress. I will see him for the first time since my surgery on Weds. and I have no idea what he will do for me since the NS has gave mt oxys, but I am still in alot of pain and it does not last for the full day. They are afraid to prescibe because of these drug addicts is my only guess. I have had to go to the ER once since surgery because the pain got so out of control.I guess I feel feaarful of trying to push my PM for more or better meds, any advice on how to deal with my PM to get the help I desperately need would be appreciated.


  • I would just talk to your pm, and tell him/her that the meds just aren't strong enough? Usually they will help you out to make you comfortable. I need to do the same too!
  • Just be honest with him about how you feel and what your concerns are about inadequate pain relief.

  • I will try to tell him what my needs are, I guess I just feel intimidated and fearful because the PM seems to have all the power when you're in pain.
    AL S
  • jlrfryejjlrfrye ohioPosts: 1,110
    I also had a pain management Dr. that would not control
    my pain and gave me way too many injections, as his nurse said I have had way too many for any one person.Red flag in my mind. I found a new pain management and they changed my pain meds from vicodin to oxycodone 4x a day. It helped with some pain relief but in my opinion not enough. After my posterior surgery I was honest with the doctor. I told him that my pain was at an unacceptable level. With that said my dosage and strength were both upped. And now we are in discussion of switching to a long acting medication, which kadian has been mentioned. The only way you are going to get help in your pain relief is to tell them what you are doing is not helping. With you remaining quiet they are assuming that all is well.
    Explain that your pain is severe enough to land you in the er. Hopefully the doctor will listen and you will get the relief you need. Good luck
  • Hello,
    Managing pain according to Melzack and Wall is about a “multifaceted approach” and medication is only one aspect of the management process, many here live with unacceptable pain levels and the notion that continuing taking medication to an extent that it does give sufficient coverage is unsustainable in the long term. It may for some be possible to mask the pain from medication and we all know finding that balance between appropriate levels and functioning is always a constant challenge.

    The epidurals are only attempting to mask the pain and not give retrospective improvement, we all differ and the success of these blocks does vary with each individuals. They are sometimes used as an interim strategy and on the basis that you suggest invasive surgery is appropriate in your opinion, why these shots are being used and what is the short term objective ?. CP is sometimes managed in incremental treatments and follows a defined pattern of progression, each aspect fully implement and evaluated before the next stage is used, most non-invasive treatments are used before the introduction of more rigorous methods. Although I have had three epidurals, my understanding that this in itself would supply some evidence to an underlying facet of my failed fusion proved unfounded, any small relief lasted 6 months between shots. We all expected our medication to be sufficient to make our quality of life feasible, when it does not do what we expected, it is a shock.

    Our Pm practitioners were always reluctant to give patients more and more medication, that strategy in itself may create more problems that it solves in the longer term. Managing pain takes skill, knowledge and perpetual tenacity; it requires a lifestyle change in reaction to those imposed restrictions. Perhaps you could keep a journal that relates to activity levels and pain as a consequence and use that as evidence to support your cause, times, dates mood, ect.

    The idea that Susan used small changes, brought some additional relief may help you and review what else you could do or adapt to try and improve that underlying pain. If you seek a more suitable strategy then only you can decide if what is being currently provided is adequate for you and present your evidence in the terms they understand.

    Take care and good luck.


  • Are you taking anything for the nerve pain? When I do, my pain is reduced slightly. I'm at a point in this journey that any improvement is welcomed.

    You are still early in your recovery, but I am now seeing a Pain Psychologist, who works with my PM doc.
    I'm open to ALL options to help decrease pain.

    Good luck,

  • Yes I take oxcarbazepine 300 mg 3 x a day. Before I took that given to me by a nuerologist I literally thought I would go insane from the nueropathy. I tried gabapentin or nuerotin first and even in high does all it did was make me sleepy.
    AL S
  • SpineAZSpineAZ WiscPosts: 1,084
    I'm on a good combination of Long Acting pain medication and well as pain medications for break through pain not controlled by the LA. I have both cervical and lumbar issues and my PM has me on MS Contin, Norco, Soma and Neurontin. This combination has worked okay. Allows me to be functional at a decent level. Some days all I can do is lay on the couch or bed but generally this combo works. All 4 come in generic and with my insurance generics are $10 per month so all of this for $40. I had previously tried Opana ER but even with a co-pay card it's about $75/mo on my pharmaceutical insurance plan so I had to revert back to MS Contin.

    The first PM doctor I had was good but only had me on Norco and Flexeril. And I grew too tolerant to Flexeril so it did nothing for me. My PCP suggested a change to my current PM and their approach is much more comprehensive and thus they added the LA medications. I also just had ESI #2 on my neck. I've had a ton in the past but we're trying them again.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Saw my PM and told him my meds were not cutting it so he gave me dylaudid (i know spelling is off) 2 mg 3 x a day. Said he would on keep me on it for 3 months and idf pain didn't get better he'd take me off of everything. I don't get it and it seemed like kind of a threat. I'm not sure what to do at this point, may have to look for a new PM as I hate feeling pushed around.So if it's up to him I'll be on percocet 5/325 4 x a day and dylaudid 2 mg 4 x a day which is not that much neds. It is just so depressing but I'm trying not to over react. I'm gonna try to get some rest now.
    AL S
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