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What can I expect on my pain management journey?

arvicariaarvicari Posts: 3
edited 03/27/2014 - 6:00 AM in Chronic Pain
I am 37 years old. I have been recently diagnosed with "mild" (facet hypertrophy) arthritis in L3 through S-1 except right L5-S1 is moderate, mild disc height loss at L3-4, mild bilateral neural foraminal narrowing from L-3 through S-1 .

I currently am seeing an ortho and he has me taking naproxen 500 twice a day, hydrocodone 5/325 1-2 every 6 hrs, stretching, heat, advised me to lose weight (God help me with that one!), and has given me one steroid injection in the soft tissue that has been causing me pain.

Nothing helps. The hydrocodone does if i take more than i am supposed to so what good is that when I don't have it later? The ortho said he wants me to get off of it, gave me a script for 80 and said make it last! lol Yeah right!

The stretches hurt, but I am doing them with high hopes.

My ortho will most likely refer me to pain management for the epidural steroids and maybe they will help me. I hope so. I know there are steps, but I am not sure what those steps are going to be. i am hoping that they wont leave me in pain just because they don't want to prescribe narcotics.

What did you have to go through to get to a good pain management plan, or at least to where you are now?
L3-4 disc height loss, L3-4 L4-5 L5-S1 mild bilateral neural foraminal narrowing and mild-moderate facet hypertrophy. Sciatica on right side.


  • dilaurodilauro ConnecticutPosts: 9,833
    Different pain management doctors have different styles and procedures for handling chronic pain patients. The best part is that they are the ones that generally can preform some of the conservative treatments such as ESI (Epidural Spinal Injection). Some will write prescriptions for narcotics, while others may not.

    The best thing to do is when you met with this pain management doctor provide them with as much medical details as you have and also tell them how different treatments have helped or not helped your situation.

    Here are some forum threads you might find worth reading.

    [Chronic Pain Step by Step

    Common Pain Management Procedures

    This is a medical article from Spine-Health Pain Management for Chronic Back Pain
    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
  • Thanks, I'll check it out. Right now each month between appointments feels like an eternity. I hate being in pain, as I am sure most of us do.
    L3-4 disc height loss, L3-4 L4-5 L5-S1 mild bilateral neural foraminal narrowing and mild-moderate facet hypertrophy. Sciatica on right side.
  • As you can see, I have included several links below, for you to read.......however, one thing about your post is alarming , taking more of any medication, specifically opiates than prescribed is automatically grounds for dismissal from any doctors care, but will get you nothing but problems when it comes to pain management. There are contracts which specifically state that the abuse/misuse of pain medications are a grounds for dismissal and can and will follow you from doctor to doctor. Urine testing for compliance is a very common occurrence, and you will likely not know ahead of time when it will occur, as well as pill counts which are randomly called for, and requirements in some offices to bring your remaining pill bottles with you to appointments otherwise they will not issue new scripts.
    There are many other methods to manage pain, without relying on the sole use of pain medications to deal with it.....

    Chronic Pain Treatment
  • I would caution you to research the ESI injections as I am quite sure it has caused my arachnoiditis as I have never had dye, surgery, or bacterial or viral infections. If you choose that route please know there is a risk as with anything but I will tell you had I been told of this possibility and I was not that I would have gone another route. Arachnoiditis is something that you don't want. Good luck I do hope you find a good pain management doctor that will listen and help you.
  • One thing I have found from several different spine specialists, physical therapists and pain management specials and in 10 years of treatment ending with fusions in lumbar and neck your back and your pain is different than anyone else. You say you have sciatic is the pain level above 8 and does it keep you curled up on the floor for two weeks? Does it prevent you from getting a good night sleep? Are you out of work? Can"t do stairs or stand up in the shower? Your 525 hydrocodone dosage is not much but before you go any higher to take care of your pain test yourself and stop taking your daily dose and see what happens? Can you do it? Your pain is not significant enough that a week without narcotics will cause no harm but if you are craving those little pills you will have a major league dependency problem when you graduate to oxycodone and you are only 37 years old.
    You should think again your flippant disregard for your doctor's request for you to lose weight. A pain management doctor will see your lack of cooperation on this or on any other non narcotic pain reducing technique or drug as a possible sign of future narcotic dependency and this is not something to wish on anyone. After my surgeries and nearly 3 full years of 8 to 12 oxycodone and valiums I am now taking 3 525 hydrocodones daily and my pain is around 3 or 4. It took me 6months of terrible daily withdrawals symptoms to wean myself off the oxycodone and lower it my doseage. I lost 40 lbs, walk daily and take other meds and do my exercises and do what the pain doctor tells me. I bring my pills to the office like a good patient. I have facet injections and the work. My physical therapy is geared around keeping my spine in alignment which means good posture and strong core muscles. If you don't do what doctors want you to do your pain will increase and no amount of surgery or narcotics will help if you dont give their advice a chance.
  • Controlling your weight is very important when dealing with back issues. That alone can take added pressure off of your spine. Staying fit and having a good, low impact exercise program can help also, though that part is hard to do if the pain is not properly managed ( and it must be cleared by your Dr). As stated above, be honest about your symptoms, what works, what doesn't and simply ask how to best manage the pain so you can move forward. Always take your meds exactly as prescribes like Sandi mentioned. Doctors will not respond well if they do not see that you are doing your part. Write things down, questions, concerns, keep a log of your symptoms so you can provide the most information possible. Best of luck to you!
    Progressive DDD
    Chronic S1 Radiculopathy
    Discectomy L5-S1 2002
    Discectomy, Laminotomy/Foraminotomy L3-S1 January 2014
    Bilateral SI Joint Fusion and 2 level spinal Fusion October 2014
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