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I have been takeing hydrocodone on and off since back surgery in 1986 for a herniated disc on L5. With the gegeerative disc disese and time it has progressivly gone down hill. Now with severe spinal stenosis also. I have had two facet blocks in the last year and a half with really no results. I take 5/500 hydrocodone 3 x a day and recently the pm uped it to 7.5/500 and it just doesnt work anymore. Could i now have a tolerance towards it? They gave me tramadol and its useless just makes u feel weird. Ialso take soma for the spasms and it seems to help some. Flerill knocked me out and zanaflex tanked my bp.What else is there? THANKS RKM


  • I believe you can develop a tolerance to it. I take 2 10/325 hydrocodones every 6 hrs and they don't work. I have only been on them for a year. Valium is a better muscle relaxer than flexeril. Flexeril did absolutely nothing to me. Tramadol just plain sucks. I am wondering how do approach the subject of narcotic not working with your doctor without sounding like someone who just wants another pill?

    Discectomies 05/08 and 04/11, fusions L4-5 Feb 9,2012 and L3-L4 June 28,2012, Staph infection washout 3/2/2012, Bulged L5-S1. SCS trial on January 17th, 2014, which was a success! Permanent SCS on February 20th.
  • What surgery was done years ago for the disc ? I been taking norco which is prety much same as hydrocodine for many years myself, I simply changed to norco as dr said its beter for the stomach when i had ulcer issues,

    The flexiril also knocked my arss out and could not take it, I take the zeneflex which seems beter as it dont put me to sleep,
    For years before my surgery i always switched from tramadol for maybe a year and then back to norco as it seems it was helping beter this way changing it up !

    If nothing is working for you any longer you could of course ask for higher meds of other kind but is it posible meds are no longer the answer ? Is surgery an option yet ?

    Alternative treatments are of course safer the surgery but have you used up all alternative treatments for geting rid of the stenosis like injections with pt and such ?

    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • dilaurodilauro ConnecticutPosts: 9,842
    when you already have a solid relationship with your doctor. It is much more difficult with a new doctor or a doctor that you see only time to time.

    The best approach is always honesty. Tell the doctor that the current medication dosage you are on doesnt seem to be helping anymore. Do NOT ask for more, instead, talk about what could be some of the reasons the medication isnt working that well anymore, and then ask the doctor for suggestions.

    I think that works more times than not
    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
  • Ihad an lamanectomy on L5. Ihave an appt tomm with the pm tomm ill let you know what she says.Been like 2 weeks now with no meds OMG im climbing the walls.
  • May I ask why you are out of meds the last two weeks?

    And was the Tramadol from the same Dr. to take at the same time as the Hydrocodone? That is unusual to be on two short acting meds.

    I agree with others in that you just need to speak with your Dr. and let them know that you are still hurting and what else can they do. But asking for anything specific usually doesn't go over well as the purpose of seeing a Dr. is that they know more than we do...LOL....Of course it's our job to let them know what we can and can't do and what our pain levels are. They may choose to add a nerve pain med which is what many of those with spine issues take. I don't see you mention being on one of these..

    Do you have a TENS unit to use each day?

    Keep us posted....

  • And yes i have a tens unit that helps the back spasms. and i did take a nerve pain pill but the name has eluded me rite now. But it made u think crazy thoughts and was soon off those, Dont get me wrong im not drug hunting i work everyday just need to be able to, Far to many times i see soo call dissabled folks stroll out with there med and go watch opra and need not be.The foot burning is another issiue i just deal with.But when i cant roll out of bed in the am or turn at nite is another issue but i still do it.. just want some releif to survive and pay the bills and not be taged the pm pataient.BTW the nerve pain med was neurontin.Bad med. I am going today to see what transpires. THANKS AGAIN RKM
  • LovetrotravelLLovetrotravel Posts: 296
    edited 01/11/2013 - 8:37 AM
    All the nerve pain are different chemicals so just because you didn't have luck with the Neurontin, you should press forward and try the other ones. I had a terrible time with the Neurontin but then used Cymbalta for 3 years and it did a great job for my nerve pain. The other is Lyrica

    Also Nucynta has now been shown to be both a good pain med but have nerve pain relief to it.

    Because your description of a lot of your pain certainly sounds like nerve pain...I would not just give up after one med.

    The main reason I asked why you don't have any of the Hydrocodone left is because with regulations getting much tighter, many Drs. are using pill counts and urine tests to monitor patients.

    So, if you are given a 30 day prescription and then take more than prescribed and run out early, when you get to the appt. if they test you and you have nothing in your system, this can cause huge issues..

    I'm not accusing you of anything...just stating in general since you didn't want to seem to answer that particular question.

    Again....chronic pain management is really about using a lot of different treatments/meds/techniques to help with the pain.

    Good luck today and let us know how it goes..

  • Well went to the pm today and they wouldn't do a thing. As said earlier the med wasn't due yet tho I explained it no longer worked. Had been doubling up and ran out. They wouldn't even give me one pill instead they gave me a bottle of klonopin to ward off the withdrawals . Said I need to see the doctor on Tuesday as I saw the nurse practitioner today . Kind of made me feel like a drug addict off the street even tho they have my full records. Just another number in society but they sure are pushing the epidural. To be continued! Rkm thanks again
  • U absolutely can build up tolerance. I was on 5/500 hydrocodone and after 6 months it just does nothing. Valium works for my spasms and I'm on oxycodone now but that's because I just had surgery. That works smazing
  • odile53oodile53 Posts: 65
    edited 01/14/2013 - 2:31 AM
    A person can develop tolerance to any opiate or codeine type medication, whether the medication is natural or one of the newer, artificial, and more potent ones. An epidural may, and frequently does, target the specific nerve that is causing the pain. I'm still on Lortab and Valium one month postop, with my MD's encouragement, and don't particularly like the "snowed" feeling I get at times. Actually, most of the pain I'm having post L 4-5 fusion is psoas nerve pain from the procedure itself (apparently, they have to stretch it out of the way during the operation,) and if an epidural would work for it, I'd gladly climb up on that table to get one done! I'm also a little achy at the left iliac crest, where they harvested bone for the autograft they used during the fusion. I think that will go away in a few more weeks (after all, it's basically a broken bone, broken under controlled and sterile conditions, but a broken bone nonetheless. The really funny thing is that the fusion site does not hurt at all, and I'm really grateful for that! However, the neurosurgeon said that the pain from both sources will improve with time, and should be gone anyplace from six months to a year, and that an epidural would interfere with monitoring the recovery of the psoas nerve. He will not give me an antiinflammatory this soon after surgery, apparently, inflammation is part of the body's mechanism in healing, especially at the autograft donor site. He thinks that might work in a few more months, and told me to take the Lortab and valium to try to stay ahead of the pain. I tested this theory after meeting with him, and didn't take either the Lortab or Valium before going to bed one night. I had no problems sleeping, but in the morning? YEEEEOOWWW! I could barely move!

    Pain management is highly specialized nowadays, and you might want to see if your doctor thinks you might benefit from seeing a pain management doctor. To get your pain managed more effectively, phrase your discussion with your MD in terms of what you're feeling as well as what you can and cannot do functionally in terms of activities of daily living. That will help him target specifically what mechanism of pain is the most troublesome in your case. Also, different nerve-specific medications have different contraindications. Some, for example, can be dangerous for people with conditions such as coronary artery disease or hypertension. That might be one reason that something is not being offered to you.

    We compare notes on our treatment and pain management here, but remember, we are all individuals. We have different pain mechanisms and sources, we perceive pain differently, and different treatments will work in different cases. We also have different comorbidities, or pre-existing health conditions, different stressors, which aggravate pain, and different levels of pain tolerance. I think that because of the current epidemic of prescription drug abuse (by people who do not have acute or chronic pain,) some doctors are sensitized to requests for specific things. A few years ago my state cracked down on doctors who demonstrated a high pattern of prescribing opiates, and within the past year, a "Dr. Feelgood" was arrested for writing scripts for Lortab for $80, cash, for office visits with no physical exam. This bird had his license yanked and is looking at jail time. High profile stuff like that scares the crap out of MDs who should know better. In other words, there's an incentive for doctors to not write for high powered narcotics unless it won't be questioned by an insurance company or state pharmacist.

    Regarding those disabled folks you see out strolling: Is it possible that they are adhering to postop instructions and out walking, per doctor's orders? Or trying to manage their weight, which would improve their health? Just because someone is moving does not mean that they are capable of performing job duties for an eight hour day, five hours a week, with a reasonable amount of comfort or safety.

    I'm not a spinal diagnosis. I'm a human being with a spinal diagnosis.
  • I am currently seeing a pain management doctor not my primary dr. I have a case history as thick as a phone book. And also pay out of my pocket for acupuncture to try and relieve the pain. All I'm asking is not for more meds but something to actually work. So don't get me wrong as someone looking for recreational meds. And no I'm not a doctor but when they treat u like ur pill shopping it pisses me off, and don't no so naive when your st the pain management there not all there for pain believe me!
    All I'm asking for is for some relief I'm sure the wife is tired of dragging me out of bed
  • RKM,
    The reason that the NP /PA wouldn't give you a new prescription is that you took more of the meds than you were supposed to.and ran out early. This is a huge problem for the doctor. If a medication is not relieving the pain, then the patient is supposed to either call the office and talk to the doctor to find out what he wants them to do about the additional pain not being managed effectively, or come in to see them about getting it changed. A patient is NEVER supposed to make adjustments in their medications on their own, without their doctors' approval first.
    Did they give you a urine screen? If they did, and it shows none of the hydrocodone in your system, then it might be a huge problem for the doctor.
    Tolerance is most likely a huge issue, given the length of time that you have been taking the same medication but you also drive up your body's tolerance by taking more than you are supposed to at one time, so when you do take only what you are supposed to take, your body starts sending increased pain signals to convince you to take more-
    Even having a case history doesn't make it right to adjust your dose on your own. Do you have a contract? If you do, I'm sure that it must state in their that they will not give early refills and that taking more than you are prescribed can get you dismissed from their care and it also can make it more difficult to find another doctor who will prescribe those type of medications to you.
    Stenosis, depending on how bad it is, may require surgery to relieve the compression. It might be time to see a surgeon to get his opinion on whether surgery might be an option for you to consider.
    Good luck,
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