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How to get Dr's to give out pain meds...

dmoddmo Posts: 109
edited 06/11/2012 - 9:01 AM in Chronic Pain
Hello all,
This is my second post at spine health pain forums. I have moderate to severe foraminal stenosis at three defferent levels in my cervical spine. I also have spondylosis in the mix. Large osteophytes all over the place to. My pain starts out sharp in back of my neck then goes down into my shoulder blades. From there it goes into my shoulders and down both arms. The pain in my arms is a numbing tingling sensation that leaves my muscles weak. I have trouble with fine finger coordination. The pain in my neck is worse than the arms. I dont have severe pain all the time. Sometimes it is dull. Its an up and down cycle for me. One moment light pain then two hours later heavy duty pain.

I have gone to primary care dr. and they just give me relafen or naproxen. They act as if giving me anything more potent will turn me into an addict. I understand people have abused drugs but this is rediculas. I am also an established patient. They look at my mri and say yes you have quote: significant arthritis and other issues but because you dont have a herniated disc you cant have that kind of pain. I do finally have an appointment with pain management and nerve conduction studies. This is my doing as primary care just drags their feet. I have done enough research after going to hospital and getting my mri report that I know I have nerve impingement problems. The nurse that called me said I just had arthritis and didnt mention spinal stenosis at all. I only found out after I got the mri report myself. Anyway I would appreciate any advice from forum members. I just feel having to battle dr's as well as the pain is not fun.

Thanks for listening
dmo

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Comments

  • Hi
    I have 3 herniated dics and scoliosis with nerve damage. I have been to three different doctors who have told me I am to young (25) for narcotics and I WILL become addicted..so I now am going to a pain management center so I hope to be able to get something stronger than voltoren just an nsaid.
    so I know how you feel. I just dont understand docs!

    -Natalie-
  • Primary dr,s often dont like to give out narcs, You best to get a referal to get in to see a spine specialist and if he feels surgery is not needed then he can give referal to pain dr to manage the pain,

    I think it might be because they would rather see a patient either get surgery if needed more so then puting them on high dose of medications for long term,

    But if spine specialist confirms there is an issue but he prefers to hold of with surgery then he will send you to pain specialist usualy anyways to try injections and if that dont help then combine injections with medications you need,

    Sometimes treatment takes a long time before spine specialists consider surgery because they know the risk of posibly making things worse if surgery dont work,

    They want to make sure you cant heal on your own or with conservative treatments with meds, Which sometimes is a good thing,

    Pain specialist will be more helpfull for both of you i am sure,

    Best of luck,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Hi Natalie
    Sorry to hear about your bad discs. I dont understand dr's either. I guess its easy to judge when you live on Mt. Olympus. Dr's have more connections than you or I. They dont have to wait for the medical wheels which turn very very slowly. I wonder how they deal with pain?
    dmo
  • SavageSavage United StatesPosts: 4,884
    ..primary docs will want to SEE me EVERY time I am in pain..and you can imagine how time consuming that becomes. So, the referral to pain doc such a blessing and the primary trusts the dosages ordered by pain doc.

    Also, like you, when I have picked up my reports I have read things that no one ever told me. It gets aggravating at times, but...

    If your insurance requires referral, good idea to get and see pain management doc. They will have new eyes and ways of treatment to hopefully make you feel better.

    Let us know how you are doing.
    Take care!

    moderator, ~~savage

  • #o I have fairly mild back problems compared to the vast majority of people on this forum, however my medical history is complex with lots of different illnesses all contributing to one another to some extent and of course to an overall increase in chronic pain symptoms.
    I presume what you refer to as a primary care giver is the same thing as a general practitioner here in Australia? and yes they are very reluctant to prescribe opiates. i used to work in the pharmaceutical industry as a purchasing manager for a large distribution company (no names sorry) it was common practice for me to meet with pharmaceutical reps to discuss market trends and research findings. let me tell you there are millions of dollars being spent trying to control opiate abuse it is a massive problem and it kills people.
    unfortunately tolerance to this category of drugs occurs very quickly and the patient will find what worked fairly effectively a week or two ago is now doing very little to manage the pain! The only way to achieve the same therapeutic relief is to raise the dosage and it does not take long at all before the patient is addicted. even while on very high doses their pain is largely uncontrolled.
    In saying that using them at the lowest possible dose (which achieves relief) for no more than 2 weeks is really the best you can expect.
    because of my knowledge and my desire to NEVER become physically addicted I have managed to succeed in getting my GP to prescribe them and my specialists support him doing so. They will usually only do this as long as i am not begging for them (it is standard policy in the medical profession to use that as an indicator of substance abuse - crap i know as you will beg for anything - even a loaded gun when you are in agony!!!)
    another trick is to refer to them only as pain relief - NEVER call them by their "chemical" or "generic" name e.g hydromorphone - this to is an indicator that you may be an abuser. Most importantly don't get frustrated or angry - speak calmly and rationally - these drugs can de-stabilise moods and if you seem a little off your rocker or overly emotional that will most likely rule you out as a candidate for their use. Be honest with your doctor explain that you know the risks associated and you will use them responsibly AS PRESCRIBED (you mentioned that your pain is chronic but subsides at times - tell them that if you can go a day, a week or even a month without using them you ABSOLUTELY will) Tell him you will suffer through the pain at times if it means you will not become physically addicted - it's important to mean it as well. by no means am i telling you how to rort the system and become addicted - I am telling you though that if you use them responsibly and stick to your word to do so - you will improve your chances considerably for having prescribed. ;)
    I wish you success and hope that in some way this helps!
  • dilaurodilauro ConnecticutPosts: 9,750
    Doctors (PCP,Pain Mgt,Surgeons,physiatrist,etc)write prescriptions for various medications based on several factors:

    1 - Formal diagnostic test results
    2 - Clinical examinations
    3 - Patient discussions

    The three of the above should be in line and somewhat consistent for doctors to prescribe narcotic medications.

    There are many situations where those items dont match. It then becomes the doctor's responsibility to work through all of that.

    Many times, you will find people that have very low pain thresholds. The may claim they do, but in reality , they are looking for high powered drugs to numb everything.

    On the opposite side, you will find people that have such a high pain threshold, that the doctor is puzzled as to why the person is not asking for narcotics.

    Over the recent years with a lot of drug abuse, the DEA has had to clamp down a bit. But, all that is really doing is making sure that the doctors can provide rationale and justifications when writing narcotic prescriptions.

    So, to answer the subject of this thread:

    Work with your doctor(s), communicate with them so they have a total understanding of your situation.


    Note: To some of the previous posters in this thread. Doctor bashing is not permitted, so please tone down your comments.
    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
  • I get so upset when I hear of a Doctor or anyone saying that a person will become addicted if on narcotics long term!! This is just NOT TRUE! Less than 4% of long term CP patients on opiates ever become addicted!! Addiction occurs when a person does not take a medication as prescribed, get's the medication from different sources(Doctor shopping) and does not stop using the medication when their Doctor stops their treatment! They also lie about their usage!
    Dependance can occur to anyone taking opiotes or benzos for an extended period of time meaning if they suddenly stop taking or reduce the dose to quickly they will go into withdrawal but that does not mean they are addicted!!
    Addiction is phychological whereas dependance is physical. Dependance is an unavoidable consequance(sp?)of opioid therapy!!
    No one should fear becoming addicted to any medication, even OxycodoneER as long as you take it exactly as your Doctor prescribes. Do not raise your dose without discussing this with your Doctor.
    Also never ask for any pain medication by name. It's ok to ask for something for your pain and then discribe your pain with your Doctor.

    Hope this helps.
    Patsy W
  • one needs to have all and i mean all tests aviable and take them to the dr. just having one does not cut it, the more the merrier, ie mri, nerve conduction tests, disectomey, x-rays and any that i have not heard of. you need to make sure there is an area of concern ie herniated disc and take all of this to a pain dr not a clinic. pain drs seem to be more sensitive to people in pain than pain clinics. so get as many tests as you can and take them to a pain dr. by the way arthritis seems to be a condition that seems to warrent NAISd's and not narcotics.
    jon
    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 think you need to address the problem with a spine specialist who knows what stenosis is, how painful it can be, and will be willing to give you the narcotic bandaid until treatment can be established.

    But with nerve pain that comes with stenosis, it's more likely that a nerve med like Neurontin or Lyrica would help more than a narcotic like Vicodin or Oxycodone. And there's nothing that will take the pain away completely.

    PCPs don't understand what all this spine stuff is about. When I first started having problems, my PCP looked at my cervical x-ray and said, "Oh, my, you've got some real problems here. I'm going to send you for PT." That didn't work, then she said, "You really have some very serious problems here" and sent me for an MRI. Lastly, she said, "Oh, you're cervical spine is gone, you must see a surgeon." But the whole time all she'd give me were muscle relaxants and that helped the back but not the other stuff. The first appointment with my surgeon, after he looked at my MRI, out came the prescription pad and asking me what I thought might work best.

    He's actually never sent me to pain management and still manages my pain. When things get bad, he marks on my record that I'll be taking more than usual.

    You can find a good pain management doc out there, but be sure to address the root of the problem too. If you're just looking for meds and not a solution to the problem, that in itself can be a problem.

    Cath
  • I can certainly relate to you dmo - NSAID's just aren't that effective alone, and it can feel like your pain is being trivialized by denying you access to drugs which will actually BLOCK the pain signals and give you some real relief.
    I'm not getting drawn into an argument about how severe ones pain is compared to anothers - its a silly argument and one i really don't think anyone should really want to win.
    I understand that there are definitely clinical differences in the source of pain. What is physically wrong can be more severe from one person to another. On that note pain cannot be measured diagnostically this seems to be the real problem facing the medical profession.
    The real concern is here is the pain itself and to what degree it impacts upon an individuals ability to function day to day and whether or not medications can help relieve it.
    i continue to use NSAID's daily as they are mildly beneficial and my doctor recommends them but i find that oxycontin provides so much more relief when the pain is on the upper end of the scale. my specialists and doctor agree with this approach (well at least here in Australia).
    I apologize patsy for not differentiating clearly between physical dependence and psychological addiction (thanks for making the difference clear). i don't know what the exact percentages of patients who end up with addiction issues are, but from an industry insiders perspective - governments, doctors and drug manufacturers are very concerned by it and are spending a fortune enforcing guidelines and regulating their distribution in order to prevent it.
    You are very right that recreational users are the major concern and main offenders when it comes to long term abuse and addictive behavior.
  • So sorry for all of the problems. I have been a chronic, intractable pain patient for approx 30 years now. It's no picnic. As the disorders progress, the meds don't help much anymore and I have just about all of the other options. Sorry, this should be about YOU.

    A good pain doc is a must. I find it most effective to confine my part of the discussion to the nature and degree of pain and how it is affecting my life. I take a family member to confirm my problems. I keep a pain journal and have him check it at each appt. I let the doctor be the doctor and receive the medication I can tollerate, given the fact that I live alone and don't have anyone to keep an eye on me. I tend to fall a lot now. Best wishes and don't give up.
  • dilaurodilauro ConnecticutPosts: 9,750
    It is true that there is not any formal diagnostic aid to measure pain levels. It can be subjective in the eyes of someone who is suffering the pain.

    Take Acute vs Chronic pain.

    You hit your finger with a hammer and you scream bloody murder! That is Acute pain. You ice it, you look for just about anything to take the pain away. If you had pain medications you might take 10. But within a couple of days, you hardly notice you had a problem.

    Now for Chronic pain. It is not just for a short period of time. At one point, there was a measurement that chronic pain was present IF a patient suffered for more than 6 months. I've read some studies where that threshold is being seen as more like 18 months.

    Back to subjective....
    NO one can really say if my pain is less than yours or more than such and such. I think we can all agree with that I might be able to handle pain better than so and so, but a lot less than that person.

    The doctors cant put a meter on our head to determine our pain level. But a seasoned doctor doesnt rely on formal tests all the time anyway. Clinical, Visual and one on one examinations can tell so much more.

    One doctor that I know very well has told me, that it is easy to identify those patients in severe pain vs those in mild pain and then those that claim to be what they are not.

    The eyes dont lie. Ever look into a person who is in real bad pain... There is no doubting that. Every look into a person's eye who is lying? The eyes tell it all.

    Plus there are other medical views that help. A patient can be flush, rapid pulse rate and heat beat, clammy, and more.

    So many doctors use those indicators to determine if, when and what pain medications a patient needs.

    Is that foolproof? No, I dont think anything is. But thats just another good reason to make sure you have a doctor you trust in , have confidence with and can have open discussions with.

    There are many members on this site that will tell you that at times about the open discussions they have had with their doctors and had great results.

    There are always two ways in doing something. How to talk to a doctor about changing pain medications:

    WRONG
    Doctor, this pain medication XYZ doesnt take my pain away. I need a stronger dosage, plus I heard from my friend ABC that pain medication PLUTO is much better and stronger and will help take care of my pain

    OR

    RIGHT
    Doctor, the pain medication XYZ I am on right now, just doesnt seem to be helping anymore. I am not getting the relief I was before. Are there any alternatives? or do you have any suggestions as to what I can do?

    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
  • Hello all

    As I read all the replies to my original post I am really surprised at some of the responses. First let me say I am not trying to bash Dr's or the medical profession. If it seems that way I offer my apology. I am however upset at the way some Dr's offices handle patients. That being said I also know there is no perfect system. My own pain has increased through the years. I have more neck pain(DDD and spinal stenosis with a touch of subluxation thrown in) than anything else. The numbness in my arms, the tingling and muscle fatigue keeps me up at night. While this is not incredibly painful it is none the less disturbing. I called Pain management again today. They finally received all my info from primary care. They still won't set my appiontment until I fill out an 18 page new patient package. As I said before the medical wheels they turn slow. I am actually more interested in nerve conduction studies so that I can set my neurosurgeon appointment. It has been over two weeks since my mri and will be another two weeks before I can get into pain management/nerve conduction. Anyway until I can get all my ducks in a row I will keep taking my naproxen.

    You've got to laugh
    dmo
  • Hello,
    The development of chronic pain is very very complex, as Ron said it is attributed to the patients subjective notion of the pain itself, previous experience of pain and the concept of what we as individuals feel might work.

    If subject A went to the doctor and said this medication is not working would he would automatically increase the dosage, at the patients request, they then come back three months later and say this is not working also, that cycle of increasing medication is damaging and unsustainable in the long term. I have had pain 20 years do you think I would not be using this solution if it worked, most pain clinics are trying to reduce the overall volume as medication it is only one aspect of the management process and not the panacea attributed to its potential success.

    I know you think this is the solution and that is understandable, dependency is an overused statement, the pain cycle includes pain behaviours either knowingly or otherwise, we all develop these as part of the chronic part of our pain, doctors take an oath to help us, help ourselves, I as many do here live with pain of unimaginable magnitude and medication is a small percentage of the overall alternatives.

    PM is all the other supportive things that are learned at the pain clinic, it is about you coping with your own pain, developing tools and techniques over and above what you know now. You will learn things about yourself that you never knew and they will help.

    I cannot remember what not having pain feels like.

    Take care and good luck. John
    ps Well said, Pat !
  • I don't have a background on medicine, but I hate it when my doctor gives me a hard time on my condition. Sometimes, I think that he doesn't understand me at all. I heard about this pain killer which is really effective (according to a friend). I didn't remember exactly how I did it but I subtly "begged" for him to tell me to EDITED. It's a narcotic but I don't think it can make me an addict in the future. I researched about it and the worst thing that could happen to me while taking them is an allergic reaction.

    Link removed, solicitation not permitted
    Post Edited by The Spine-Health Moderator Team
  • Just wanted to add that I went through 2 yrs of terrible pain because the first MRI reading didn't find anything but a little arthritis. It wasn't until I went to a pain doctor who tried 3 ESI's and right and left rhizotomies with no resolution that he himself ordered a 2nd MRI which found a grade 4 tear at L4/L5 and bulges at l3/l4 and L5/S1 (confirmed later by discogram/ct scan).

    So don't give up, if you think there is something else going on, get a second, 3rd, 4th, 5th opinion and don't wait as long as I did! Good luck!
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • Hi dmo :wave: Do you have access to a pain dr? Please keep us posted how you are doing :)

    disillusioned - I disagree about people getting use to meds and needing more and/or different ones. After my pain was under control which took trying many different meds I have never increased them. I have been at this same level of meds for over 3 yrs. I also have had new injuries and/or more damage over these 3 yrs and still have not increased my meds, nor do I want to.
    Maybe I am just weird though and I think the rest of the world is like me ;)

    Also as to your no name - good call! we are nit permitted to post names here.
    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 have to say I am very fortunate in my spine surgeon. He will prescribe what he thinks will help me and having had to switch from my primary pain killer tramadol I had to go to oxycodone and hydrocodone.

    Having had 3 fusions I have a pretty good relationship with him. And if I say I still need the ambien he prescribed after my first surgery I can get refills.

    My primary care doctor is actually the one who prescribed my neurontin (for nerve pain which the other drugs didn't touch). Again I am very fortunate. When I was first taking it I was experimenting with the dose to see what was the best results with the least amount of pills (per my doctor). When I went thru a lot and the insurance denied a refill all I had to do was call her and tell I was taking more and she called in a new prescription.

    I wish all could have my wonderful doctors.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • After having terrible results getting any pain medications from my pain management doctor I discussed it with my PCP and she has since been wonderful and recently was willing to switch me from my tramadol to hydrocodone which has been a wonderful help. I didn't ask her for them by name but they had given me a 20 pill script of them in the ER so I just showed her the bottle and told her they had been helping me to be able to work a little longer and play with my kids a little more (the truth). She doesn't like to prescribe narcotics just like most PCPs but she has been very caring and helpful through all this and that was reason for her to give me the script.

    I do think that age can have a factor in the situation. Both my friend and I are young (24 and 26) and we are met with a lot of resistance. My husband on the other hand is thirty and he just found out he has a lot of lumbar issues and his orthopedic had no problem immediately starting him on a steady supply of hydrocodone 7.5mg. Maybe he just lucked out with the right doctor first shot, but it is is odd.
    Microlaminectomy and discectomy at C7-T1 on April 26th.
  • dilaurodilauro ConnecticutPosts: 9,750
    edited 02/19/2013 - 3:35 AM
    Is that Doctors will prescribe what is appropriate for the patent based on all the information the have on hand both from, clinical and diagnostic information.

    It is not in their scope to deny medications.
    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
  • MrGrouchMMrGrouch Posts: 109
    edited 02/18/2013 - 6:23 PM
    As Ron said true pain can not be faked. Both my chiropractor and my pain management doctor know exactly what to move and the reaction I should have. true pain does not have a time delay, they touch the right spot or in my case just move my foot ( while talking to me to distract me) and I just about jump off the table. If you faking it there is a delay and they can tell if it is an involuntary response or a voluntary response as they can see and feel it. Also he is right about the eyes, dark circles, wereiness, cringing, fatuigue all can be seen in the eyes. My Primary care does not have this expertise and is afraid to prescribe the required medications. I am now with a good Pain Management place ( expect for the office staff sometimes) and they prescribe the right medications. Much less in strength than the last place I went and with much greater results. The meds and the levels prescribed are much higher than a Primary care doc would do but from what I am told much less than many chronic pain patients. Lastly there is merit to your age and the opiods prescribed. 3 docs have admitted that they have no issue prescribing daluidid and Fentanal to patients over 60 ( A friend who is 62, his doc was the first to confirm it to me, I am 48) but would never prescribe them to anyone under. In my area there are many Pain Clincs that will only take Cancer and gereatric patients, why I do not know.

    Oh I guess not lastly, I have found that there are many many many doctors out there that do not beleive in the differnace between tolerance, dependence, and addiction. To My Primary care and all others I have see tolerance= addiction. It is sad to see and very frustrating as you know.

    3 bulged torn leaking disks and many DDD disks ( although the tears seems to be healing over).
  • dmoddmo Posts: 109
    edited 02/18/2013 - 10:49 PM
    Hello all, its been almost a year since my original post. What a ride. Have been in pain for years. Not like kidney stone pain but still it gets my attention. I've had three neuro apts and all three recommend 2 level acdf surgery. Had mri's and been to pain management. All my doctors would rather see me cut open than give me pain meds. Even with evidence of pain generating problems. Funny thing is, even after surgery they say I will still have pain. I will always have neck pain but maybe arm and shoulder pain will be better.

    I tip my hat to all you wonderful people here on this forum. To my brothers and sisters in pain I salute you. My heart aches for those of you dealing with spinal issues because at best the medical community is not an exact science. Doctors are as different as colors of a rainbow. May God bless...
    DMO
  • IT is not all that surprising when it comes to surgeons or any doctor for that matter , when they have a patient, with a condition that surgery or other treatment can fix/repair/prevent from becoming worse not understand why a patient would rather take long term medication over surgery to correct/address the problem.
    It is one thing to try to avoid surgery for a family situation or a job situation for a time period, however a long term pain medication treatment program is not ideal when it comes to treating a medical condition that can be treated with surgery or minimized at any rate.
    I think that too often , the surgeons see patients who want to delay what is considered to be an easily repairable problem- in terms of surgical technicality, but the patient refuses to consider surgery but wants to proceed with long term pain medications...it makes no sense in their eyes, and the long term risks of increased damage, or damage becoming permanent increase with the longer the wait becomes before addressing the problem. Avoiding surgery to risk further damage is not rational, at least from their perspective..if the pain is so severe that you are needing to seek pain medication to treat it, then why would a person refuse surgery if it can help?
  • it is not the pain per se that puts off doctors, it is the way patients try to get them. by saying, naisd's don't work or i need something stronger puts up a red flag for doctors among other things that patients day and do. sometimes even going in to the office with the look of pain on one's face puts doctors off. like i said before, one needs to have as many tests, mri's cat scans, x-rays, discographys, nerve conduction tests and take them to the doctor. in fact, the more history one has with back pain or chronic pain the better. in fact, drs are becoming more nervous now when dealing with chronic pain. unfortunately it is the sign of the times. i wonder if i were to see my pain dr now would i have problems with meds? who knows. by the way, back pain is the most frequent form of complaint especially with disability patients. it is hard to diagnos even with all of the tests. when one goes in with back pain that definitely puts up a red flag with drs. like ron said, drs have to show why a patient needs pain meds and that is also why most have people sign a contract. even with seeing my pain dr for 6 years and my old one for 5 years, i still get nervous seeing my dr. i never feel comfortable going in and i have a great relationship with him. these guys are savy and are on the look out for people scamming them for narcotics. don't go in with a look of pain on your face. be open and honest and don't say or do things that seem like you are looking for narcotics. like i have said, go in with as many tests as you can muster up. try everything that you can, ie injections, naisd's etc. if you see a pain dr, he will probably start you off with weaker meds to see how things are going on then work his way up to stronger ones. don't expect oxycontin the first time you see a pain dr. if you don't like the way you are being treated, see someone else.
    jon
    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.
  • avenellaavenell Posts: 2
    edited 05/21/2015 - 2:28 AM
    dilauro said:
    Is that Doctors will prescribe what is appropriate for the patent based on all the information the have on hand both from, clinical and diagnostic information.

    It is
    not in their scope to deny medications.
    I signed up just to counter this and previous comments you have made. As many people here are telling you, as is my experience and many people I have recently spoken to, doctors are with-holding pain-killing medicine on a massive scale, under this worry that everyone will become addicted. So it IS within in their scope to deny medications, and they ARE doing so.

    I broke my foot two weeks ago. I was discharged from hospital with no painkillers, I have been in some of the worst agony of my life yet getting any pain-killers from doctors has been very very difficult, and i worry about how I will cope in the next few weeks as I envisage further problems getting strongy painkillers (I am on codeine now, they originally wanted me to use Ibuprofen - for a broken bone. Codeine barely covers the pain often, Ibuprofen is an joke for a broken bone) Listen, I am NOT going to get addicted to this stuff, or Tramadol or any opiod painkiller as I hate them. I hate the way they make me feel, queasy, not right in the head, can't urinate, I want to be off them asap - but with a broken bone that takes 6-10 weeks to heal, I cannot avoid the need for painkillers and I am very frustrated that I am made to feel like I am somehow faking pain to get my hands on them, or whatever. Most people who need strong painkillers are 'legit' and will come off them when the time is right. There is a widespread failure by doctors to properly prescribe pain relief to people who are in very serious pain. It's bad enough having whatever the condition is causing you pain, you do not need a doctor on top of that denying you proper pain relief; they are supposed to be helping!
  • Antiinflammatory medication is usually given for an acute fracture to aid in reducing the swelling and inflammation surrounding the fracture. Prescription strength anti inflammatory meds are very helpful in treating acute injuries.
    Part of the problem is that for many years, doctors automatically wrote prescriptions for opiates for everything from an abcessed tooth to a sprain, when for years before that , the treatment for acute injuries was RICE- rest ice, compression and elevation, along with aspirin or Tylenol, or ibuprofen.
    Perhaps you should give the ibuprofen a try and use the codeine for the increased pain, and see how it works. Some of the pain should resolve once the swelling goes down and the fracture heals.


  • terror8396 said:
    it is not the pain per se that puts off doctors, it is the way patients try to get them. by saying, naisd's don't work or i need something stronger puts up a red flag for doctors among other things that patients day and do. sometimes even going in to the office with the look of pain on one's face puts doctors off. like i said before, one needs to have as many tests, mri's cat scans, x-rays, discographys, nerve conduction tests and take them to the doctor. in fact, the more history one has with back pain or chronic pain the better. in fact, drs are becoming more nervous now when dealing with chronic pain. unfortunately it is the sign of the times. i wonder if i were to see my pain dr now would i have problems with meds? who knows. by the way, back pain is the most frequent form of complaint especially with disability patients. it is hard to diagnos even with all of the tests. when one goes in with back pain that definitely puts up a red flag with drs. like ron said, drs have to show why a patient needs pain meds and that is also why most have people sign a contract. even with seeing my pain dr for 6 years and my old one for 5 years, i still get nervous seeing my dr. i never feel comfortable going in and i have a great relationship with him. these guys are savy and are on the look out for people scamming them for narcotics. don't go in with a look of pain on your face. be open and honest and don't say or do things that seem like you are looking for narcotics. like i have said, go in with as many tests as you can muster up. try everything that you can, ie injections, naisd's etc. if you see a pain dr, he will probably start you off with weaker meds to see how things are going on then work his way up to stronger ones. don't expect oxycontin the first time you see a pain dr. if you don't like the way you are being treated, see someone else.
    jon
    I know what you mean, but why should honest patients, who genuinely need pain relief because they are in serious pain, always have to worry the doctor is suspecting them of being a 'pain-killer addict'? The majority should not get inadequate or bad treatment because of a minority. I agree, if you know 'too much' like the name of a certain pain-killer, it's as if you must be a pain-killer fan - I know what tramadol is because I know someone with a painful condition that has it, it was also in the name of a sketch show, we all might know someone who has been on painkillers, I know a few people who have broken limbs and so sue me, i'm aware of a few of the more famous painkillers. But i know I have to act as if i haven't got a clue. Because you feel scrutinized as a faker, like you I think 'shouldn't say that, that would sound like drug-seeking behaviour.' Even knowing the term drug-seeking behaviour will probably look bad! I just read it in the newspaper. Can doctors please stop treating us like criminals or drug addicts just because we seek pain relief?
  • Anti inflammatory meds are regularly given for acute fractures to aid in reducing the swelling and inflammation surrounding the fracture.
    As the swelling recedes and the inflammation around the fracture also reduces, the pain will also even as it's healing.
    Before , doctors wrote opiates for everything from an infected tooth to a sprain, and many believe that only opiates will reduce pain, which is simply not true.
    Before writing opiates became such a common occurrence for everything, fractures, sprains etc., were treated by RICE -rest, ice, compression and elevation and anti inflammatory meds.
    It might be worthwhile to give the anti inflammatory meds a try and only use the codeine when the pain is really bad.


  • I had my first back surgery Nov 2009 and post surgery was percocet 5-325 every 4 hours or 3 times a day.
    My pain returned in August 2010 and Neuro tried everything again shots, PT and continue pain meds until he gave up and sent me to pain management.
    Pain management continued to push the percocet but increased dosage to 10-325 but he wanted me to do a spinal cord stimulator which I would of done until I had pre-surgery discussion and I was told I would be out of work another 12-16 weeks because of the number of laminectomies he would have to do to shove this rod up outside my spine and I said no. My pain doctor wasn't at all happy when I changed my mind.
    I went back to my GP and he said he would do my pain mgmt but he prescribed Oxycontin 60mg twice daily and Oxycodone 15mg every 4 hours. I survived and worked with that medication until my GP decided he was getting out of the Oxycontin prescribing and said I had to learn to live on just Oxycodone.
    I have been on Oxycodone 15mg since 2013 three times a day. My GP counts pills every month and I have had a few times I was off and I got yelled at. He did recently increase the dosage to 20mg and was giving me 100 pills a month, 3 times a day and extras if I had bad days.
    I have survived with that but the pain in the back and feet are non-stop so I going to my third Neuro next Tuesday 05/26/2015


  • SavageSavage United StatesPosts: 4,884
    edited 05/21/2015 - 7:04 AM
    You write.....why should honest patients, who genuinely need pain relief because they are in serious pain,always have to worry the doctor is suspecting them of being a pain killer addict?

    I compare it to the faithful spouse regularly assuring the other as to continued love and faithfulness and behavior that puts away suspicion.
    It's good for the relationship!

    moderator, ~~savage

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