Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

control of chronic pain

StarshineSStarshine Posts: 68
edited 06/11/2012 - 8:48 AM in Chronic Pain
Hello all,

I have been in chronic pain off and on since my c4-c6 fusion 3 years ago due to huge spurs flattening my spinal cord.

I have done the following treatments:

PT for one year with massage- temporary relief
accupuncture for 3 months 3 times a week- didn't work
heat and cold- temporary relief
facet injections etc.. didn't work
trigger point injections didn't work
accuscope didn't work
all kinds of vitamins and minerals-continued
theracane-use as needed some relief
prescribed meds- cymbalta, lyrica, savella with prn perc( the best for pain for me 5mg,) every kind of muscle relaxer

Some days nothing works and some days I feel okay. I try to keep active walking, classes etc.. but when i am active i hurt more and don't get the relief from therapies I use. Being inactive is unhealthy for both the mind and body so i am in a bind. I want to take the least amt. of meds as possible so i am trying to find a fine balance.

I jiggle my meds around to get the best possible combination. Sometimes i try more lyrica with less perc and a muscle relaxer or the opposite. My dr. understands that we have different needs at different times do to my activity level. I don't always take what is prescribed sometimes less sometimes more. I understand all my meds as well as my pathophys. If one communicates to your health care professional that u are educated in your condition it helps you to receive therapies which are needed. You are the one to communicate this and there is no reason NOT to ask for what you want. I don't play the game, I wouldn't go to a doctor who talks down to patients. I want to be respected as a pt as well as i respect him/her.

The reason I am writing the above is because I believe that others feel this way. I guess that there are ppl here that would look down upon this behavior (i have seen posts that say always to use what is prescribed cause doctor knows best) but I believe there are plenty of us who do take the control but don't just admit it.
I will say that I am a health care professional as well as all my family members (including a doc) so maybe i have another view, but I trust myself to control everything I do when possible which includes pain control, a strict diet to keep my weight down because i can't do heavy activity etc.. Guess i am a controlling person.

I don't need you all to tell me your regime. Just educate yourselves in your condition and take control. It's amazing how much better u will feel in both mind and body.

Hope all in chronic pain feel better!


  • Good post :D
    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.
  • I agree with Ms HD...this is a good post.

  • I agree with you Starshine!
    Only we know our pain, no one else does! Somtimes it takes more meds, sometimes less and only we know when it does.
    Cheers :H
    Patsy W
  • please be careful with your meds. taking more or less. more might be a problem. since we feel that we should be in charge of our pain, i don't know if you signed a pain contract. mine says i should only take as much as prescribed and if i feel i need more, i need to contact pain dr. i am a real believer in following dr's orders. they are the experts and know what is best. if you don't believe your dr is working on your best terms or if you don;t believe he knows best as an expert, get a new one. if my dr found out i was taking more without his knowledge, he would have a major problem with me. dr's look at taking more as abusing meds. taking less is not a problem since drs and especially mine work towards me taking less in the long run. i have reduced my dose of fenatyl lollipops from 700 micrograms to 500. it does not seem to be a problem.
    take care with meds
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I'm with Jon on this one. The person taking a medication is not the one who should be choosing the dosage. Especially for narcotic pain meds. But even for muscle relaxants and anti-depressants playing with your dosage is a big no-no. The only meds you control are the break-through drugs and even those should be used within the prescibed limits.

    If you think your dosage is wrong then call your doctor. He wants you to get adequate pain relief. But he can't help you if you treat yourself. If you feel less is good then let him know this as well so it can be noted in your records.

    I'm sure that there are many people who do play doctor with their meds. But this is poor pain management and as Jon points out can break a pain contract.
  • kris
    also this leads to problems that pain drs have with patients. patients self medicate and as a result pain patients who truly need treatment for chronic pain get short changed. this is why it is difficult to get meds and why drs or er's don't believe us. we have a hard enough time with the media saying pain meds are bad let alone dealing with our pain drs. all of this stuff makes it harder for the true pain patient. thanks for the supportive message. i am lucky because i have never had a hard time with dr's. i am out in front and do what they say to do.if we all did this i believe there would be less hastle. it is weird because even though i have no problems with pain dr and orhto, i still feel like i am going to the principal's office. i don't feel guilty and i don't cheat with my contract but i still have these feelings. anyone else deal with this when the visit pain dr?
    i don't know why but it is not as bad as it used to be.
    anyway enough babbling
    good luck all pain patients
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • As long as your prescription is written for that amount, go for it. If your prescription is written for a lesser amount, you need to talk to your doctor first.


    An oral agreement to let you set your own narcotic dosages is illegal. Every prescription must have a dosage, a date, and who it is prescribed to. That is who may legally take the medication, and how much they may take.

    Which is a good reason to have great communication with your doctor, as the OP describes, and make sure he prescribes enough to cover your pain.

  • As Starshine said, if you have an excellent relationship with your doctor, and your doctor GIVES YOU PERMISSION to take ONE extra if you absolutely need to because your normal dose isn't helping, then there is no problem. My doctor has given me permission to take an extra IR med if I absolutely need to, and I tell her if I have at our next appointment.

    If you DO NOT HAVE their PERMISSION, then you should always call and ask before taking an extra. If you don't then you are breaking your contract if you have one.

    And if it happens quite often that you need to, and you are always running out at the end of the month, then you should be discussing this with your doctor, as obviously the dose, or the med, is not working for you. It is my opinion that if this is happening, you are abusing your meds. If it's happening frequently, then call your doctor each and every time. This is something that needs to be discussed by the two of you.

    This is something that is between you and your doctor, and it should be an open an honest relationship on both sides. If your meds aren't working for you, tell them. If they won't up your dose, there might be a reason why. If they are simply not treating your pain, find a doctor who will.

    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • everyone is right on what they are saying don't take more then your pm doctor tells you to take if they tell you can then you can i hope you find a med that will work for you to control your pain
  • For the ppl who responded here and to all others who have chronic pain and a pain contract go to the topic
    "bioethics of Pain Contracts" and listen to the docs short lectures. You will be surprised that pain contracts aren't what u think they are.
    Thanks for listening!
  • Go to that topic where? Here? I don't see such a topic on Spine Health.

    Do you mean do a google search?

  • I found some at the Center for Bioethics, are they what you're discussing?

    These are opinion pieces, not factual pieces. I have only listened to the first one, but it seemed pretty clear cut to me- they are a way to make it clear between the doctor and patient the requirements and restrictions that will exist in the relationship.

    And, of course, a lot of talk about how doctors can be arrested and charged as drug dealers if they do not abide by the rules of "the game," as you call it, a.k.a. the law pertaining to prescription of controlled substances, and that this is a tool physicians use to help communicate with patients.
  • If a doctor has a pt who signs a contract and dies from an overdose the doc is not responsible- no contract he will be investigated.
    yes, they are opinions- and from highly respected docs.
    Tools to communicate no!! your mouths are a tool, your empathy is a tool, your CARING is one too etc..- the agreement is a tool to protect the doc from legal troubles and to hopefully help the pt to understand the importance of taking controlled substances as prescribed. Some ppl don't need to have that contract if they have a good relationship with their doc. And that is my opinion.
    Thanks for the opportunity to voice it.
  • Starshine said:
    Some ppl don't need to have that contract if they have a good relationship with their doc. And that is my opinion.
    ------------ snip-------------

    I couldn't agree more! When I went for a second opinion a while back (Ortho spine vs Neuro) to see if my diagnosis and resolution options were on track, the very FIRST thing they did was try to force me to sign a contract! I refused.

    If after examining me and maybe if I seemed shaky or flaky, okay he might think the contract covers him and his practice, but to label me right out of the box - sorry the hair goes up and I leave. Now in this case, I did get the exam and second opinion. The doctor asked why I wouldn't/didn't sign it as all his patients are required by (him) before he treats them. I told him that I am a person that is responsible, and is an adult. I will not sign a contract as though I am a drugie.

    I left at that point thanking the doctor for confirming virtually everything my NS advised me of. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Did you listen to all of those audios, Starshine?

    The first one I listened to said that although the contracts are an ATTEMPT to avoid responsibility, they do not actually- the doctor is STILL responsible if a patient ODs.

    And as we've seen many times, if a patient overuses meds without a contract, doctors can and do drop them.

    So the contract only writes out what people should be doing. It does not actually keep doctors from getting arrested, nor does it remove responsibility from patients.
  • yes i listened to all- remember they are opinions- u said so yourself so keep on listening- u only listened to the first. If a pt od's and the doc keeps proper documentation then he or she has nothing to worry about. Documentation saves all!!

    Someone please save me from this thread- i feel like i am being bullied. Happy, just relax- are u having a bad pain day?
  • Starshine,

    Hopefully you don't feel like I'm bullying as I am just giving my feelings of "contracts" and my experiences. As for HB, I don't see her doing it either. She as I see is a very analytical and thorough person, so she is just being frank on what she is seeing from that site. Sorry HB, not trying to put words in your mouth. I'm glad you posted the site, as it was another perspective to add to our 'knowledge' base. :) *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • nope- no bullying just in the news so much it's in my head. Sometimes it's not what you say, it is how u say it. Email and posts sometimes have tones- that's why it is important to read and reread the posts that one writes. But sometimes when u reread others posts, you add to the message in your head. Do u know what i mean? Okay i'm finished posting for awhile - my pain is relieved thanks to the boards- thanks all for listening!
  • You're 100% correct. It is hard sometimes to "see" the emotion meant in a post. I think we've all been there Starshine. I guess that observation could be deemed right on. I hope you continue to post. :) Feel better. *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • No, I'm not having a bad day at all. Just posting my opinion on the topic, which was that the audios did not drastically change my views on pain contracts, and I was surprised because I expected them to say something different.

  • HB/Starshine,

    I have to agree. I haven't listened to *all* of them, but my personal opinion of "pain contracts" has not changed. I still won't sign one, and will stay with my NS and GP for my meds. My GP; I think more so, as she has more of my overall health status? I know she doesn't *know* spine issues as well as a Neuro, but she has all the reports (bringing her more), tests etc.

    What I LOVE with her too (rare in South FL), she "listens" and too blocks time that you can "see" her and not be rotated at mac speed for a *cough* exam! :) Starshine, I know you stated that you *are* a medical professional (what type please?), which is great, as much of the medical mumbo-jumbo makes sense to you, but a lot of us aren't. We get self educated on a lot of our own medical issues. From what I've seen on here, and "Discovery Health" and other medical help programs and web sites "we" the patient have to educate ourselves and LEARN these terms and what they me concerning US.

    I do appreciate, and agree with your comments of us being "knowledgeable" about *our* medical issues to be more direct with our doctors. I try to abide by that philosophy. I just wanted to say "Thank you" for these threads, as they opened "communication" lines with some of us. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Hi everyone,

    Back with more questions? I have an appt with a neurosurgeon Thurs. morning. I really don't even know what to begin to tell him or ask? I have so much pain under the cervical fusion (entire neck) which I suppose would be the T spine? and I also have pain in my lower back where I have scoliosis. When I went to the 'pain' doctor, she gave me an injection in my lower back for a long time flare of sciatica. Wow, even she apologized for the pain it caused. She said that the areas were tight and close? I was in so much pain, I didn't ask what she meant. :''(

    After the injections tho, the flare subsided. Now I am having a problem with pins and needles in that leg, some numbness, etc. Cry. I don't know whether to ask him about the C spine, the T holding it, or the scoliosis?

    What would YOU do? I am in constant pain with not only my back but have migraines caused from the same accident. I also think the neck issues are making my headaches worse? I appreciate any input before I go to see this new doctor. I've heard great things about him. In fact, yesterday he operated on a friend who needed three vertebrae in her L spine fused--she put this off for years, but they are saying everything went perfectly. But obviously I don't want any surgery if it can be avoided.

    Thank you so much,

  • Well, the doctor I saw today who comes so well recommended, ordered a CT myelogram of the cervical spine and the lumbar spine with (can't read the rest?) anyway the current dx is Cervical and Lumbar Stenosis. He said it was very probable that I would need to have an area in my lumbar fused (there is a 40+ degree curved scoliosis. He is also concerned about the first T disk that supports my current neck fusion. :-(

    BUT he also is checking the highest area beneath the skull because he thinks that's what's causing these daily headache and migraines. He said he didn't even want to talk about surgery for I can't swallow well after two frontal surgeries as it is. I don't even want to talk about ANY surgeries. But I should find out on the 23rd. I go for the CT myelogram the 22nd.

    He gave me an injection deep into my hip...didn't hurt as when the pain doctor did it, but sore now. That will be fine tho. Does a myelogram hurt? what about an extended one which will show the c-spine, l-spine and top of t?
    My back is such a mess...I came home and cried. I don't want to tell anyone (hubby went with me and knows) but I don't like to be fussed over, etc. concerned elderly relatives who will constantly call and question, sounds bad but I guess I don't share my pain well-- which is why this forum is so wonderful. I can write and listen to you -- I appreciate you much. Esp. you, Brenda :-)

    Now what?? txxx, Abbey
  • Howdy Abbey,

    Looks like to me the jury is still out, hence the Myelogram. So far I haven't had one, so I am sure someone will chime in on what the deal is with them, and what this sort of test reveals. Have you used the search box on the top of the web page to see what it is?

    Once they have all their testing done, hopefully a game plan will then begin to form! Try not worry too much until all the tests are in, and you have a full briefing with your surgeon. If it helps, I've ended up in tears after leaving my NS's office! *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Abbey, you probably will also get more response if you start a new thread about your issues :) If people weren't interested in this thread, they aren't likely to open it to see new posts!

  • Actually, it's really very good that he's ordered a myelogram. They will be able to see, through injection of radiopaque dye, exactly how it is flowing around the nerve roots, and if there is any area where the flow is slowed or even cut off. The docs will be able to pinpoint exactly which areas are having the worst problem and need to be addressed, either surgically, or if the situation isn't found to be very bad, through injections in the specific areas to reduce inflammation.

    I think your doctor sounds like a thorough fellow, and that's what you want if the word "surgery" is even mentioned. Try not to worry, hon, until you know that you have something specific to worry about.

    Take care!
  • >:D<

    I truly appreciate the feedback - all of you. You are all so kind and caring.
    I will take the advice and try to figure my way around the board tomorrow (duh) but I'm so sleepy tonight and really need to lay my owchie back and bottom !! down.

    I hope all of you are feeling as good as possible. Have a good night.

    ((())) Abbey
  • I have always been a "rule follower", so when signing my first pain contract in August, I took it very seriously. But..apparently my doctor did not. I tried to talk with him on numerous occasions about my ongoing severe pain, but he refused to talk with me, putting me off till my next visit(which was an invasive lysis of adhesion procedure). That happened twice, and then I called and spoke with his nurse, and still...no evaluation of my pain, and obviously no treatment of my pain. He actually decreased my pain medicine by two-thirds, and only gave me that dose for a week...until my next (third) procedure. I asked if that was safe, since I had been on oxycodone for almost one year. I got ah, ah, from the nurse. There was much more that happened that I did not appreciate and felt disrespected.

    I thought a pain contract was an agreement between two people, and that both parties had responsibilities to uphold.

    Luckily, my neurosurgeon is seeing me for a scheduled appointment for my one year visit of my fusion, and has been decent enough to treat my pain until I find another PM doc.

    I will uphold my end of the bargain; just want the same in return. Someone who will be my advocate.

    Hope I didn't hijack your thread Starshine. I agree that we must be proactive and educate ourselves as much as possible. Ask the tough questions. It can be difficult with some.


  • I have been in severe pain due to several health issues and have tried everything my pain specialist have sugessed.
    Edited by Tamtam for solicitation something you agreed to when becoming a member of this site.
  • life raft is being sent, a little late, but better late then never.................love ya

    Coast Guard has been called too.......lol

This discussion has been closed.
Sign In or Register to comment.