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How long to find a good combo?

Just wondering how long it took everyone to find a good combo (or just one) of meds that actually work to relieve pain. I'm trying to stay away from the heavy pain pills, but that's not working too well. Right now, we're not sure if my pain is nerve pain or an underlying problem with the muscles in my neck. Either way, I'm in a great deal of pain and can't seem to find anything that works. Lidocaine patches don't touch it, the Voltaran gel isn't doing any good, 800mg ibuprofen was a joke. I even took some oxy last night and while it took the edge off, it's not something I want to take on a regular basis. Started PT last week and she says it could take up to 6 weeks to see if it's working. I don't know if I can go another 6 weeks in this much pain. Should I be calling the surgeon again or just suck it up till my appt on the 14th of next month?


  • I'm assuming this isn't your first round with chronic neck pain as you stated "calling the surgeon AGAIN" as opposed to "calling a surgeon." I would personally use the painkillers (I'm assuming you have an oxycodone prescription in the form of OxyContin, Percocet, or Roxicodone from a previous surgery or something) to get through physical therapy and as needed when the pain is at it's worst.

    As long as you use an immediate-release preparation of the oxycodone (Percocet/Roxicodone - no OxyContin, or generics of) and aren't taking it around the clock, a strong dependence shouldn't (keyword: shouldn't) develop in 6-weeks; however, your body might get used to the oxycodone to take care of any pain relief at that point, so if you take this route, proceed with caution.

    To answer your original question, It's been 4 years and I haven't found a combination that is effective enough as I would like. I take a pretty liberal view on medication myself though: if its benefits outweigh the risks, it's not adversely affecting my life, and long-term possible issues aren't too bad, I have no problem with being dependent on a medication.

    Opioids, in the long term, don't pose many health issues (the big scare the media has put out is from combination products containing acetaminophen (Tylenol)) and as long as toxic doses **(there's a BIG difference from dying of a toxic dose as opposed to an overdose)** are avoided, which would call for a drug switch, the amount can be increased with tolerance, theoretically, forever. With that said, doctors won't bump your dose up forever and ever and you might have to bounce between different ones to avoid further tolerance (a very useful tool if used correctly, actually).

    **Dying of an overdose of pain medication will more than likely result from the cause of one vomiting while sleeping and choking on it or from respiratory arrest (ceasing to breathe); whereas dying from a toxic dose would result in organ failure. Some painkillers become toxic at lower equivalent doses than others.**
    I am not a medical professional, and everything that I say should be taken with a grain of salt. No diagnoses or truely medical opinions can be drawn with out a physical, face-to-face doctor visit.
  • Thank you djw, and no, this isn't anything new. I had a 1level ACDF for a herniated disc on the 10th of Dec (had been dealing with the pain before the surgery for a while) and so far, I'm not any better....in fact, a bit worse. I'll talk to my PT tomorrow and see what she recommends, I hate feeling like I'm harassing my surgeon, though I totally will if I have to. If I remember correctly (and I could certainly be wrong), PT's don't deal with pain management at all, but she'll hopefully have some sort of advice. I hope ;-)
  • dilaurodilauro ConnecticutPosts: 9,878
    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
  • Thank you Ron, makes me feel better knowing that I'm on the road to figuring things out. Something that really stuck out is the lack of REM sleep (haven't had a real good night's sleep in a very long time) and the depression. Two things I know a lot about!
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