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Knee Pain/Spine Problem

Because of Osteo arthtitis, I had to go through TKR on right knee on 12/11. Recovered from the surgery, but no relief from pain. Surgeon did not comment about the failure or success. I never went back to him. Now, I am dealing with another type of pain: back pain. MRI showed herniated disc, bulge disc and spondelysis. It seems pain is increasing every day and coming from all sides: knee and back. Going to pain mgmt doc. Getting pain meds Percocet 10/325, 2 tab every 6 hours and other long acting narcotics. Problem with long acting is I cannot tolerate them. Tried Oxycontin, MS contin 60 mg, Duragesic, Dialudid. Just gives me abnormal feeling. Only percocet seems to work. Since, this is the only med work, often I run out early. Sometimes doc prescribe early, but the pharmacist refuse to fill it earlier then its due. I go through hell. However, I want to get off the med; but the pain is unbearable. Recently, got epidural and radio frequency something. Don't see any result. Pain is even worse. Its affecting my entire life and work.

Getting depressed and lack of sleep making even more depressed. What should I do now? Don't know where to turn. Now, I see why people committ suicide. I feel more when the pharmacist comments that I got hooped up pain med. Am I really addicted to pain med?
First: Knee replacement/No relief from pain, then Spine problem. Herniated disc, Bulge disc. Done epidural, Radio freq. No relief. Pain comes from all corner


  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • that there is some big difference in the formulations of long acting versus immediate release or short acting medications and there isn't. The only differences are that with extended release medications, there may be an abuse deterrant component added to the medication, and the longevity of the medication, meaning that it does not have to be taken quite so often as the short acting versions. Other than that, the medication that relieves the pain is exactly the same......percocet contains tylenol and oxycodone, Oxycontin contains oxycodone and the abuse deterrant but not the tylenol...
    The extended release medications do not usually have the feeling associated by someone with the medication starting to work, so the delivery is much smoother, without the sudden onset and drop off of pain relief that comes with the short acting version.
    Running out early is a sign of misuse of the medication since if you are following the dosage instructions, there is no reason to run out 'early'. Tolerance is not the same animal as misuse of the medication. Taking more than prescribed is misuse, not tolerance. Tolerance only comes into consideration when a medication no longer continues to be as effective at the same dose as it once was. It is entirely a separate issue than misuse.
    Misuse is taking more than prescribed, taking it more often than prescribed or altering the delivery of the medication.
    Extended release medications are meant to be taken on a regular scheduled basis, over 24 hours....that medication should provide basic coverage for your normal pain levels. If, you do something that causes a major increase in your pain levels, and you have tried ice, heat, rest, heat patches, massage, etc and still have pain that is more than you can deal with, only then should breakthrough meds be considered. They are not meant to be taken on a regular basis, since all that does is increase your baseline amount of medication that your body will quickly becomes accustomed to, leaving you nothing for those flare ups.
    It might be something to consider talking over with your doctor and asking them to consider changing your medications to another type of both long acting and short acting and possibly considering a dosage adjustment after you are switched to a different medication. You are on a lot of medication for a short time frame when it comes to dealing with what might be a lifelong problem. Less is more when it comes to a realistic amount of pain- most pm doctors look for a reduction of about 50% of your unmedicated pain levels to be a successful treatment plan.
    Otherwise, sooner or later, you will find that doctors become uncomfortable prescribing above a certain dosage amount and then it becomes even more difficult to find a doctor who will treat your pain.
  • kamgramkkamgram Posts: 483
    edited 11/05/2013 - 3:46 PM
    Wow, we have so much in common. My surgeries began with a lamenectomy at L4-5 in 1994, then two more lamenectomies L4-5 in 2008 then a microdiscectomy at T7-8 in 2012. I started having back pain in 1984 but the knee pain began in 2002. I had right knee scoped and torn meniscus repaired in 2003. Have had lots of arthritic changes in spine and knees in past 5 yrs and in Jan.of this yr. Had a microfracture surgery on left knee for severe arthritis. Then MRI showed severe arthritis was back in 6 months so had TKR of left knee on Aug. 16 of this yr. And have had nothing but spine and sciatic pain since. The sciatic pain is worse than before surgery in 2008 which re-herniated. I think the knee surgery somehow has either damaged or irritated the nerve. Has been a very miserable 18 months.

    I am sorry you are going through all this but I truly feel for you. I would like to keep in touch to see how we both do :)

  • I had a TKR on left knee in 2006 and on right knee in 1998 but revised in 2000. I have had numerous spine operations starting with L4/5/S1 plus rebuild in 2008, then ACDF C3/4/5 in 2010 followed by Posterior CDF C5/6/7 in 20/12/11 but unfortunately due to loose screws redone 23/12/11. After my knee replacements were done the initial pain was bad but some 12 months later the pain had almost all gone however since my cervical spine operations I have had dreadful pain in left knee particularly.
    I am now due to undergo a MAJOR 6 hours operation on 4th December 2013 from C2 to T3 as previous cervcal operations have not taken/fused. I had a thorough check done on both my knees by a Professor and was told nothing was wrong with either knee.

    I am riddled with osteoarthritis mainly caused by playing professional sport i.e. football in my younger days. I am now 74 years of age and live in UK. If I can be of any help please send me a private message. Good luck.
  • I have lower back pain for more than a year now. My ciroprater said it's my SI joints that unstable. My back is slowly healing(I do back bends and it reliefs the pain) Don't know why but my knees get real tight and cracks and pop alot. I've tried streaching but in morning when I wake up it's tight again.


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