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Hydrocodone not working as well as it did.

EmmyEEmmy Posts: 29
edited 06/11/2012 - 8:48 AM in Pain Medications
I have been dealing with pain in my thorasic spine for 3 years and have had 3 mri's, epidural shots, trigger point, nerve block and nothing helps.

I am now seeing a Pain Management Doctor and have been on hydro for almost a year and it isn't working like it used to and only lasts, maybe 2 hours. I talked to the doctor about it and he said the only thing they could do was take me off the hydro for about 8 weeks and then put me back on it,,Ekkkk. I cannot go 8 weeks in this kind of pain!!

Is there other pain meds that differ from hydrocodone that would relieve my pain, or are they all opiads so therefore none would work??


  • Have you tried muscle relaxers or a TENS unit at all?

    I use tizanidine for a muscle relaxer.

    I had the same problem with the vicodin and my primary doc moved me up to oxycodone after I built up a complete tolerance in 2months. Later on I started to go to a PM NP and she told me that oxycodone can really screw up you testosterone and many other things in your system which I found crazy. If they decide to move you to that ask lots of questions try to stay away from that at all costs.
  • It is normal for opiates to become less effective over time. That is called "tolerance" and is one of the less desirable qualities of them as a pain management medication.

    The question you need to ask your doctor is- is my pain increasing or am I becoming tolerant? And if I am becoming tolerant, why am I prohibited from increasing my dose to maintain adequate pain management?"

    Your doctor's answer to that question will tell you a lot about him/her as a pain management doctor, and whether that is the doctor you want to be with if the pain ever really gets bad.
  • I have tried a tens unit and it did nothing but make me uncomfortable. I tried one muscle relaxer, I think it was flexeril. Didn't do a thing.

    I have had physical therapy, Epidural injections, trigger point injection, ultra sound therapy etc.

    I was just shocked when he said I would just have to go without anything for 8 weeks while my body adjusted so the hydrocodone would work again.

    He said I could take no more than 3 7.5/500 per day, and I think if he would increase it to 4 a day I might be able to make that work.

    I was also thinking that he could put me on something else for awhile but he didn't seem to like that idea either. Pain Management Doctor's are hard to find so I don't think I would want to fire him.
  • I was on Hydrocodone when I was first injured and it handled my pain pretty well. However about 3 yrs later it was like drinking water - did nothing for my pain. This started to happen over time.

    I waited ( too long ! ) and when I finally asked my Dr. for something else I literally could not say a full sentence with out stopping for breath as the pain was so bad.

    I am now on the Fentanyl patch ( 75 mg every 48 hrs ) and take a break through med.

    It did take a while to get the right meds. for me. We tried several before we got the right mix.

    I totally disagree with the idea of going 8 weeks with out your pain med.

    I even asked my Dr. if some day I could return to Hydrocodone and he said "once your body has reached it's peak use of it, it will never work well for you again".

    Please keep us updated :)
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • How are you describing your pain to him? Are you telling him your pain levels?
  • I don't think that any doctor that handles a person's pain meds would stop them cold turkey - it's inhumane to believe that one can just stop and have to deal with the two+ weeks of hell that will come from stopping meds completely.

    I have to imagine that your doc is either going to taper you down (which isn't fun either pain-wise) or will make a substitution until it's time to go back on the hydros.

    Developing tolerance issues with pain meds is very common, and it's your doctor's responsibility to make sure that if he or she wants you off those meds, he helps you with either a taper-down schedule or a substitute to continue to handle the pain.

    You said he doesn't like the idea of substitution - so exactly what is his plan? Certainly he can't expect you to just stop for eight weeks...
  • I don't know, Cath, I've heard of the "med vacation" to break a tolerance cycle before. Tapering, maybe, but no replacement.

  • Someone asked if you are accurately describing your pain levels. Unless I'm missing something how can you know what your unmedicated pain levels are when you are still on the meds?

    I hate when I go to the doctor and he asks how I feel. If the meds are working the answer should be "great". But if I say that won't it look like everything is fine?

    I would double check about how to stop. But it is an interesting idea to stop and see how you feel.
  • She said they aren't working well but the doctor won't increase them.

    When I had that experience, one of the problems I found I had was that I was not describing my pain levels accurately. When I started using this:

    URL Removed

    and things got much easier. I was rating my pain much too low, so he was underestimating the effect it was having on my life.


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  • I went to the site that HBmom had a link for and that did help quite alot.

    I just hate when they ask me my pain level, #1 Am I just getting used to the pain and rating it lower than I would if I had never had the pain before, #2 I have good days and bad days so it depends on what day he asks.#3 how much are the meds covering up.

    Going by the link I would say I would rate my pain a strong 6. When I am getting ready for work it is maybe a 7 and that is when I take my first dose.

    I don't think I stress to my Doctor how badly it hurts and that the hydro's are not cutting it. They only help for maybe an hour or two. I need to be a little more clear to my Doctor.

    Is oxycontin or oxycodone different than Hydrocodone? Would it help pain if he took me off the Hydro's? What about percocet?
  • Since I have no pain when I am laying down, I go without a pain med for close to 10 hours. I can tell my level when I get up in the morning.

    I'm with you, I hate being asked what my level is, it seems such a subjective question.
  • Yes, percocet (which contains oxycodone instead of hydrocodone) is considered a bit stronger than hydrocodone-containing meds. However, a) it's usually not a good idea to request specific medications. And b) it doesn't work that way for everybody.

    Just accurately describe your pain and tell him the current meds are only lasting 2 hours. Hopefully that will get the point across :)

    I was describing pain as a 5 that was putting me to bed with a heating pad and wondering why they wouldn't give me stronger meds, until I started researching the rating scales and said "oooohhhh, now I get it!"
  • No, I won't be asking for a specific med but I will try harder to get my point across.

    I see you were hurt in a riding accident. Do you still ride??

    I have a 2 year old AQHA gelding that I am just starting on ground work and will start riding him in the sping. Western Pleasure Prospect.
  • If I don't have my meds it puts me in bed with a ice pack...Ice numbs it nicely.
  • I was able to ride some for a while after my accident, but I haven't been able to ride at all this year, and had to put my horse on the market. We still have one horse (my daughter's) and I hope to be riding again this summer after my surgery.

  • At my last PM appt, my doctor and I were talking about all the things we have tried (other than medication) and I realized that I always see him first thing in the morning (between 9 and 9:30) and that is always my best time of day so when I rate my pain level, it is always at the lowest rating I ever experience! My pain intensifies as the day goes on. Can't believe how long it took for that to sink into my thick head.
    We have gotten to know each other pretty well over the last 15 months and our goal has been to try and control my pain with the least amount of prescription drugs possible. He started last June (a year ago) with a facet joint injection. No relief. Then I did a trial SCS, and did feel somewhat better, so got the permanent implant. Developed new issues and did PT, added a muscle relaxer (Zanaflex), did trigger point injections and added a muscle stimulator most recently and got no relief from those. I have been on Hydrocodone up to 4 times/day for a long time, but nothing any stronger than that, along with an anti-inflammatory. Anyway, he is going to do an epidural injection next Friday and do it at a different level than I've had in the past and hopefully that will settle things down. He also "under-prescribed" (his word) a pain patch for me to see if I could tolerate it and get any relief, knowing that if I function ok and feel comfortable driving, working, etc, he can always gradually increase it. It has had an amazing effect, especially the first two days I wear it. It has just been one week and I cannot tell you how much better I have been. And for the first two out of three days of the patch, I have used so much less Hydrocodone and Zanaflex. It has made such a difference in the amount of rest I get, plus my ability to do things beyond just getting through my workday. I think once he finds the right strength, I may be able to stop the Hydrocodone completely or only use it on the rarest of occasion. Will probably continue with the Naprosyn (sp?) and Zanaflex.
    I hope your doctor will work with you the way mine has. I have 100% confidence in him and although I was leary of taking this next step, I am happy to do it to avoid additional surgery right now. It is inevitable, but I'd rather wait as long as possible since I've had two major surgeries in the last two years.
  • I think you need to think about a new Doctor. You are in pain, real pain and his idea is for you to be in more pain???? Makes no sense to me. And you say this Doc is a Pain Management, how long have you been going this Doc? Hope things work out and get better for you.
    C3-4-5 fusion 2005
    C-5-T-1 disk bulged
    L-4-5 bulge to the right, with Microdiscectomy, failed
    L5- Bi-Lateral bulge
    Pain in right foot -loss of feeling
    Left butt, hip and front thigh pain with bad shooting pain into inside ankle sometimes
  • I saw my pain management Doctor today and I don't know what has changed but he wrote me script for MS Contin and 5/325 hydrocodon for break through pain. 15 mgs MS Contin twice a day and the hydrocodon no more than once a day. I will take one in the morning and see how it goes.

    Anyone taking or taken MS Contin??
  • Glad to hear the doc is going to try some different IR and ER meds. Let us know how it goes.

    Congrats on your 2 year old and have fun training him. I have a 5 year old APHA gelding that I've been training and he is a sweetie. He's my daily therapy!

  • I'm glad you have something more for your pain. I took MS Contin for almost 2 years and it worked fairly well for me but required a few adjustments and increases along the way. I felt a little tired at first until I got adjusted to it. I hope it's helping you now. 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
  • The mscontin works pretty well but he either needs to increase the dosage of it or allow me more hydrocodone for break through pain. I am only on 15 mgs twice a day and that is just not enough, the pain is breaking through at about 4-5 hours. I am going to call his office on Monday. Is that appropriate? Never mind, this can't wait untill my next appointment.

    Yes, having a horse is my therapy as well, and this little guy is going to be fun. He learns so fast and nothing bothers him. The first time I put the saddle on him he didn't even flinch, that's the way he is with most new things.
    Your horse is American Paint, is he double registered AQHA or another breed? Do you show or just pleasure ride? No matter, as long as we are having fun and some distraction from the pain.
  • What was your dosage when you were on ms contin? Why did you stop taking it??
  • I started at 30mg day then went to 30mg twice a day. A couple of months later I went to 30mg 4x day and stayed on it for almost two years. Then at the end of January this year I told my Dr. I was still having pain and she said she would switch me to Oxycontin instead because she thought a different narcotic may help better. I have no meds for breakthrough pain. I hope you find the right dose for you. 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
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