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My Dr. wont perscribe painkillers other than Tramadol

I am new to this forum, and thrilled and saddened by what I read.
I have a pile of back issues, L4-5 needs a fusion, L3 is marginal, slipage, arthritis, spurs, etc.
Both my o\Ortho and GP say they will perscribe anything more than Tramadol because everything else is too addictive.
I have been unable to work for the last 5 years because I cannot manage my pain. I have ceased all activities and cut off relationships with most of my friends (I could not do anything and I hated standing them up when I had unexpected pain). Just taking care of my basic needs is all I can handle.
Now I am mad. I am reading all these posts from others that are able to get Oxicodone, vicadian, etc.
Can anyone give me some advise on how to change my Dr minds? I HATE the way I live.
The Tramadol helps, but even Advil is better but I should take it since it gives me scary high blood pressure (I do use it sometimes)
Suzan, hoping to ski again one day


  • I took tramadol for years before my surgery, Some doctors swear by it to be beter then narcs,
    If you can deal with it with tramadol now somehow then after surgery if they give you narcs it will work much beter,
    This might be the reason they are doing it as they know you will be having surgery maybe ?

    They also have tramadol er time releise which might help you beter as it won't wear off as you take a few tramadol on top of it within limits,

    Best of luck, Hope it works out for you,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • All the surgeons in this area will give you pre-op and more than about 6 weeks post-op is tramadol. That is also the strongest most PCPs & GPs will Rx except for acute pain short term, like 20 pills, no refills. The reason has nothing to do with addiction. Tramadol creates a stronger and faster dependence than either hydrocodone or Oxycodone for most people. The key is tramadol is not a DEA controlled substance because it not likely to be abused. It is a synthetic narcotic, but you would become violently ill or die of a seizure before you could consume enough to get high.

    You need to get referred to a Pain Mgmt Dr who does medication mgmt in addition to injections.
    Severe DDD, Severe neural foraminal stenosis at 2 levels, moderate canal stenosis at 2 levels, significantly impaired left shoulder & arm function. Chronic moderate compression fracture at C6.
  • dilaurodilauro ConnecticutPosts: 9,846
    I didnt see anything about any upcoming surgery. If I missed, it, I apologize.

    The medical professionals are only going to prescribe medications based on the patients needs. Now, that can be a loaded question. You may see one need, while the doctor views a different need.

    In all of my experiences with various doctors, they use the tools they have at their disposal to help them determine what
    type of medication package a patient needs. Way too often I read posts here that members only talk about pain (narcotic) medications). There is so much more involved for pain management.

    Take a look at: The Blend to see what I am talking about
    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
  • Tramadol can be abused, just as many other medications, pain and otherwise can be abused, if not taken exactly as prescribed. Tramadol can also cause serotonin syndrome if taken improperly. If the medication prescribed is not helping, it may be that there is a neuropathic component to the pain, and for that opiates of any type are generally not as effective as medications like neurontin or lyrica. I don't know what dose of tramadol you are taking, and how often, but it may be that they might need to raise the dosage, or try another medication altogether.
    Are you planning on having surgery soon? Some doctors, especially PCP, and even surgeons are not in the business of giving pain medications, or if they do, only for short term ( acute ) injuries that are expected to be resolved soon. If the surgeon is discussing surgery- he may want to see how you do post op if surgery is on the agenda/ Even with a planned surgery, surgeons generally will only provide pain medications for a short time period ( less than 3 months post op), for any time frame after that, the patient is referred to a pain management physician.
  • Just out of curiosity, I was wondering if you are going through the VA for treatment. My brother is a Marine Corps veteran and he had to have biceps tendon rupture repair at the Philadelphia VA. He lives about 35 minutes from there. In the process I learned that VA physicians don't always have a DEA number, so they can't simply call it in or fax it to a local pharmacy, it has to be a pharmacy affiliated with the VA.

    From my experience, my primary has been willing to prescribe me what is appropriate for the level of pain. Tramadol was his starting point a few years ago, but something in it caused me to have an allergic reaction. However, he knows my history and has always been careful when prescribing. For example, he knows what dose, frequency and quantity he prescribed and if I ask for a refill sooner than what that should add up to, he will have a discussion with me. But it's usually because an episode of severe pain. Over the years he's escalated me to different medication when appropriate, but also asked that I follow up with him about two weeks after the change to reevaluate. With the next episode of pain we'd go through the same process.

    I work in health IT for a large health system in Philadelphia and what many people may not know is that depending on which systems your doctors practices use, there are ways of getting information relating to prescriptions from other providers --even dentists -- as well as different pharmacies, prescription insurance, etc. so when I had some dental surgery and was prescribed Vicodin and then went to my primary a few weeks later for back pain, this came up.

    As dilauro mentions in other posts, it's not that providers WANT to see you in pain, sometimes they have to weigh the risk and likelihood for abuse against the relief that you'd get. So I'd highly recommend that you have a serious conversation with your primary about the pain you're experiencing and how best to go about treating it. It could be that in addition to medication you need to have physical therapy, for example. In my experience, medication is only one component of a treatment regiment. But no one should have to just tolerate severe pain with no treatment.

    Best of luck,
    Tim Lewis
    Philadelphia, PA
  • I have always been honest with my doctors when pain was not being taken care of. I always ask doc what can we do this is not covering my pain. My surgeon takes care of me for 6 months after surgery then hands it off to my PCP or PM when I had one. Again I never asked forr anything by name I just say doc this is not cutting it and have never had a problem.
    If i was given something that did not help I would call in about it and not wait until next months appointment.
    Maybe I am just lucky but my three doctors have always done great for me. My only problem was a PM clinic at a university and each month I would see a new resident that always wanted to change everything.

    When I have a few good periods of time I also tell my PM and even ask to cut my meds when I am doing better.
    I wounder if your films have anything to do with what they give you?
  • Did you try diclofenac 50mg 3 times a day ? I also used tramadol to sleep at night but it didn't help me much (perhaps a low dosis), diclofenac is a much better painkiller then paracetamol etc. combined they are even better. they do have side effects like its bad for your stomach. maybe they can help you.
  • Both prior and post my 2 level fusion (L4 - S1) I have been prescribed both Tramadol and paracetamol. Apparently they work well together and perhaps that is why you mentioned possibly Advil working better, if you were taking it at the same time? I am still getting to grips with the right timing of each dose, but it does seem to provide reasonable post surgery support as I begin to heal.
  • I don't know if they work better combined, what I ment was, if you take a combination of different painkillers you are taking more, so you feel less pain. you can always try advil, or paracetamol combined with what you are using now. hope I'am making sense
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