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Time to switch pain meds?

LandryLLandry Posts: 6
edited 06/11/2012 - 8:46 AM in Lower Back Pain
I am currently taking 30mg oxycodone (IM) 5 times a day, and it seems as if I have built up a tolerance to the drug.
The first one I take, usually with in 30-45 minutes of waking up, works fine for about 1-2hrs. after about the 2hr mark I dont really notice any relief. So there goes number 2 for the day. It also helps, but only about 75% as much as the first (im estimating 75%). and about 1.5hr later no relief at all. After this, I get very little relief from the other 3 pills per day, sometimes I will up the dose a bit to 1.25 pill instead of just one. which will help but I end up running out of my meds early. I know I cant be the only person with this problem, and am not sure what I should ask for at this point.
Unfortunetly my job requires me to sit behind a desk for the better part of 10-12hr per day. The oxycodone will get me through most of the day, but after about 5:00pm Im just begging for the day to end. What should I ask my PM doc to do with me? I think he feels as if Im hopeless as my MRI results dont seem that severe. I read on another post about a standing MRI which I am very excited about talking to my doc because when I do lay down I get almost instant relief. So i think that a standing mri may show that I really do have pain. lol

Thanks everyone!



  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    a (CR) controlled release formulation.

    What (if I may ask)is your actual diagnosis?

    That seems (to me) to be a substaintial amount of medication sans a diagnosis.

    How long have you been taking this amount of OXY?


    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • The body can really build a tolerance to Oxycodone and Oxycontin. The three days prior to going through rapid detox from Oxycontin, the doc switched me to 30mg of Oxycodone every hour. I still went into withdrawls because my body chewed the medication up so fast.

    I am with Metalneck, I wonder why your doc hasn't considered putting you on extended release by now. It helps to even things out and keep you from having so many peaks and valleys of relief throughout the day.

    From what I've heard, the open or standing MRI's don't have as much resolution as the standard ones. However it never hurts to try everything you can to find out what's causing you such pain and discomfort.

    Keep us posted,

  • Well, the actual cause of pain has not been 100% determined. It seems as if it has to be from the disc itself as I have no pain or numbness in my legs or butt, only pain where my disc is. the only thing, aside from pain meds, that offers relief is decompression of the disc via traction or my inversion table. this will give me 100% relief but only for a few minutes, 15-20 at most.
    Here are my last two MRI results.

    Technique: Sagittal T1 weighted, T2 weighted sequences as well as axial T2 weighted sequence is performed.

    Findings: There are no prior MR examinations for camparison at this time. At the L5-S1 intervertebral disc space there is disc deydration. There is abroad based disc herniation lateralizing greater towards the left as compared to the right. The disc herniation displaces the S1 nerve root posteriorly. There is a slight flattening of the S1 nerve root. the right S1 nerver root is normal. There is no significant compression of the thecal sac. The neural foramina are normal bilaterally.
    At the L4-L5 intervertebral disc space there is also a broad based central disc herniation. There is also disc dehydration. There is a slight extradural indentation of the thecal sac at the L4-L5 intervertebral disc space. There are mild facet arthritic changes seen at this level. There is a mild foraminal stenosis bilaterally.
    1. Central disc herniation at the L4-L5 intervertebral disc space as above.
    2. A broad based moderately prominent disc herniation on the left side at teh L5-S1 intervertebral disc space.

    Most recent MRI opinion, Too long for me to type the entire findings right now.


    1. At teh L5-S1 interspace location there is a mild amount of disiccation and asymmetrical left sided bulge of the intervertebral disc. In the midst of this bulge, there is a bright linear signal that could represent equivalent of a radial tear through the annulus. No Protrusion per e is seen however.
    2. At the L4-L5 interspace mild generalized expansion is seen. There is a very shallow directly midline protrusion. Just behind this protrusion there is a bright signal in the annulus also suggestion the possiblility of a radial tear in the annulus. Again no significant impression on the thecal sac is seen but the findings here may also be cause for pain.

    Does this sound like something that surgery could help with?

    Thanks everyone!

  • BotzBotz Central FloridaPosts: 223
    Other then the meds what other procedures have you had? PT,Injections, Micro-Discectomy, Fusion?

    I went down the same path with sitting at a desk for 9 hrs a day. I was taking 30 mg Oxycodone every 4 hrs. for the last year or so. Sitting all day at my desk and spending the evenings on the couch. What a life. I have been thru all types of treatments. I saw a 2nd opinion Neurosurgeon that wanted to see if I could get any relief from an ESI to determine if redoing my fusion could possibly relieve my pain.

    Well I can tell you that this time the ESI did in fact relieve all of my pain. It has been over a month now pain free. I'm so amazed after all this time and many injections one actually worked!

  • I also agree that your doctor should add in an ER medication to give you better pain control, and also keep the oxycodone for breakthrough pain. I did take that combination long ago for my chronic low back pain and sciatica. My problems started off very similar as yours- the central disc herniation at L4-5 and lateral disc herniation at L5-S1. I had to have surgery to decompress the sciatic nerve and the procedure is called a microdiscectomy. My doctor did say that it would alleviate the leg pains only but NOT the back. If you are considering surgery, I recommend that you do the research because back surgery is a complex and serious matter. Take care
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    That certainly is not what I would consider normal MRI findings. Are your doctors actually saying that the findings of herniation displacing the S1 nerve root is NOT on of your pain generators??

    Have you consulted with a orthopedic surgeon or neurologist that specializes in spinal surgery as of yet?

    They will be able to answer your question of:

    "Does this sound like something that surgery could help with?"

    Best Wishes,


    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • Thus far I have had cortizone injections at both levels, L5-S1 and L4-L5; a nerve block, facet joint block and a discogram done. None of the procedures gave me any relief, and the discogram came back negative. The 3 doctors that I have seen, all seem to thing the pain is coming from the disc, just not sure exactly why. They have all 3 said that if the disc is pushing on the nerve root enough to cause pain then I should have significant pain/numbness in my legs. But I have never had any pain other than directly around my disc.
    Over the past few months, the pain only seems to get a little worse every month. Im to the point now that I go to work, come home and do nothing else. I usually dont have enough pain meds to last me past about 6pm so I just go home and lay down.
    I havent really put much thought into it until now, but I think that maybe I am depressed. I dont want to do anything, usually I hate to even talk to people. I have no life anymore other than work and there I usually find myself watching the clock to see if its time to take my meds yet. I dont get near as much done anymore and find myself pushing nearly everything back. I really hate where Im at in my life right now. I feel like I am pretty useless at most things. I have become nothing more than someone who deposits a check into the bank account. Not very good at being a husband or dad right now.

    Sorry for the long rant......
    Thanks for all your commnents everyone.

  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    self diagnosed one issue .... depression secondary to chronic pain. Have you considered seeking some assistance with this issue?.

    A significant number of us that struggle with chronic pain ... regardless of if we know the exact cause - are pre or post surgical suffer from anxiety and or depression.

    One treatment for chronic pain is anti-depressants and or other nerve medications.

    You may not think that you are being a very good husband or father but you are the only husband and father that your family has. There are many times that my kids are the fuel for me to keep attempting to chug along inspite of the obstacles that are placed in front of me. I can very much relate to how you are feeling - you are not alone.

    Please consider going to any and every length to treat all and any symptoms and conditions that present themselves. That may include the need to add to your team of professionals that you seek help from.

    Are these 3 doctors you mention pain management guys or surgeons? Have you tried the physical therapy, T.E.N.S., accupuncture, massage, or aqua therapy modalites yet?

    Although it doesn't help my surgical structure, my medications, or progression of my physical conditions - I see a mental health professional weekly.

    Consider expanding your treatment options?

    Warmest Regards,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • I have 2 compressed discs - L3/L4 and L4/L5. They bulge on a regular basis and the pain is constant. I have been to 3 chiropractors and tried many different therapies and treatments, including spinal decompression.

    None of these seemed to have any lasting pain relief, until I discovered Class 4 Cold Laser Therapy. Within 4 treatments my pain was reduced by 75 percent!

    I am now 2 months into treatment and my back feels almost like I never had an injury at all.

    It is a relatively new treatment, so there may not be a doctor in your area with this laser. There are only 2 near me here in FL.

    The laser is manufactured by a company called Avicenna, and their website is: Contact OP via PM for website

    My Doctors website is here: Contact OP via PM for website

    He has several very informative video's on his site.

    Your condition sounds pretty severe, but it has worked for a lot of his patients with major problems.

    This is the best thing I have found for pain relief and I just wanted to let everyone know.

    URL's Removed

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