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Starting to wonder if I even need narcotic pain meds anymore

LC84LLC84 Posts: 599
edited 04/07/2014 - 5:44 AM in Pain Medications
Sometimes it can be difficult to differentiate, nerve pain, from joint pain, to deep muscle pain. All my Dr suspects I'm dealing with. I keep a log of my symptoms and most if them seem to be nerve pain related ( I think?). I'm currently switching from Lyrica to Neurontin for nerve pain, the Valium helps relax my muscles and reduces spasms, but I'm also taking Percocet 7.5-325 mg every 6 hours. I've been on Percocet pretty consistently since last July and it use to help at least take the edge off. My pain has worsened over the past several weeks ( my surgeon will increase my Neurontin once I'm completely off the Lyrica if no improvements) but the Percocet doesn't seem to touch the pain like it used to. I have backed off from taking it every 4 hours to every 6 hours. I plan on discussing my pain meds with my PCP this week but I don't know if I need to try a different pain med or just kick it completely since narcotics don't help with nerve pain. I know that no one can answer this question or advise me on what I should be taking, I'm just not sure I even need it anymore. Maybe my body has built somewhat of a tolerance to it. My mom is a nurse and said that sometimes pain meds are more effective if you take them before the symptoms reach such an intense level as apposed to taking them when the pain is already hitting full force. Even when it does help some it doesn't seem to last very long, sometimes 20-30 minutes of very minor relief. I don't expect much advice, I just feel better writing out my thoughts.
Progressive DDD
Osteoarthritis
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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134

Comments

  • dilaurodilauro ConnecticutPosts: 10,613
    when pain medications provide a level of comfort or take the edge out of your pain, but dont really reduce it that much.

    I was at that point a couple of years ago. I was just tapering off from Oxycontin and was on Oxycodone 5mt IR as my primary pain medication. I was taking on my worst days 8 to 10 tables, but my norm was about 6. I dropped down to 4 and really didnt see much of a difference. At the 4, I still have daily pain, but the medication does what I want to do and help me get through the day.

    My physiatrist and I are now dropping it down to 3 a day. I see this as a very good thing. I know my body will adjust to this. The times I generally need pain medications are after 7:00pm. Thats when the 'melting/slashing' pain starts in my arms and legs. Dont know how else to describe it. I need to walk around and keep on rubbing my thighs and shaking my arms. Laying down or sitting is worse. But when I take 1 tab, 30 minutes later I am ok.

    I want to get down to 2 pills. I asked my physiatrist if that will become my norm. She said its hard to tell. With the number of surgeries and flares up I have had since 2006, I really havent had a norm.

    Sitll she feels that for many low dosages (which Oxycodone 5mg is) on a daily basis might be the norm.

    What your mom said is so true. If you take the pain medications before you are having intense pain, you will probably bypass that pain, if you wait until that happens, 1, 2, 3, or 4 pills will probably not help. But how do we know when that
    intense pain is going to happen? I think for post surgical patients, you can figure that out.

    But for long time chronic pain sufferers , its a bit different.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I have a great, well established relationship with my doctors. I know from past experience that I can say 'I want to titrate down on this med to see what good it's actually doing' & my PM will support my decision..and importantly he will let me change my mind! I don't like taking any meds but sadly there are those I just can't function without a little of. If you consider it in terms of 'spoon theory', I don't have enough spoons no matter what I do. My level of narcotics gives me a few extra spoons.

    In an ideal world you should be able to do the same as me but I'm aware that you're in the process of building new relationships with some of your specialists. I'd be worried that if you make this decision & live to regret it you could have trouble getting your meds back. I'm just being honest. I don't like it but in your position I'd try titrating down on your own & see how it feels. Be aware you could have a little increased pain just because of withdrawals. You're just getting over surgery, take things slow & steady. I know it's hard. ;-)

    If you can get by without meds that's great! I wish I could. I know you're just thinking through ideas. This is just my take on it.
    Osteoarthritis & DDD.
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  • For the past few weeks the pain has been constantly intense. Instead of giving a number, I can tell you that I haven't been able to do any normal daily activities. I spend a lot of time off my feet but push through the pain to make frequent walks around the house. I try stretches but some have caused my leg to go numb. The pain can hit full force even when I'm off my feet. I don't know when it's going to go from bad to worse unless I'm on my feet for too long. That's why I'm EXTREMELY anxious to try other treatments. I'm up for anything at this point to get the pain under control so I can be more active. The last thing I need is to cause more problems by not moving enough. I'm hoping the combinations of increasing the Neurontin and the SI Joint injection will provide enough relief to start physical therapy again. I forgot to mention that I take ibuprofen 800mg 3x daily, per my surgeon's instructions to help with inflammation.
    Progressive DDD
    Osteoarthritis
    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
  • sandisandi Posts: 6,269
    edited 04/07/2014 - 5:32 AM
    It may be that the neuropathic pain is one big part of your overall pain picture and once you get to the correct dosage of gabapentin, you might find tremendous relief .......battling nerve pain is one of the toughest ones, simply because most of the mechanical pain we can treat rather easily- reduce it most times, neuropathic is a bit different and it is difficult at times to get a handle on and because it is relentless, it seems to be more draining. At least it was for me.
    As far as the percocet goes, it may very well be that you have become tolerant to it......and waiting for the pain to get high, then taking the med, isn't really all that useful simply because by that point, it is more difficult to control
    What might help if I may is suggest it, is that if the percocet is not lasting as long as it once did, why not try cutting the tablet in half and taking one half a tablet every ( whatever your dosing schedule is- take 1/2 tablet half way through your dosing schedule). for example if you are supposed to take one tablet every 6 hours, try taking 1/2 tablet every 3 and see if that helps more.....
  • I appreciate the input. I've read the spoon theory, my spoons are limited. It just makes it more difficult when there are multiple problems.
    Progressive DDD
    Osteoarthritis
    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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  • LC84LLC84 Posts: 599
    edited 04/07/2014 - 5:42 AM
    I think I will try that and see how it goes. I appreciate your advice.
    Progressive DDD
    Osteoarthritis
    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
  • I know, I really do. It's horrible when you reach a 'still point', you want something to change, anything! So you can start to move forward & hopefully away from the bloody pain! Are you working on any 'alternatives' while you're waiting, or is that not your thing? Have you tried aromatherapy, visualization, heat & slow stretches..really feeling your body & trying to distance your mind? I know you've got my husbands terrible muscle problem..that's as bad as sciatica, I understand your pain. If you can just get that moving again, even in a little way it will take so much nerve pain away & at least you'll know what you're left with.

    Sorry, I know I'm combining a number of threads here but it's all so connected. ;-)
    Osteoarthritis & DDD.
  • It's still the same amount of percocet just taken a little differently but sometimes it does help. I hope it does in your case.:-)
  • LC84LLC84 Posts: 599
    edited 04/07/2014 - 7:40 AM
    I'm also dealing with nerve pain from damaged and other irritated nerves according to my surgeon. I've tried stretches, the last time I did a hamstring stretch my leg went numb, I've tried deep message of my left buttocks and sometimes it makes the spasms/radiating pain worse (could be coincidence I suppose). I walk, even though it hurts. I don't know if I'm doing more harm then good. I use my heating pad a lot. I've made it through this pain so far without going crazy. I do different things to divert my attention away from the pain. So yes, I'm not one that can just do nothing while I wait.
    Progressive DDD
    Osteoarthritis
    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
  • LC84LLC84 Posts: 599
    edited 04/07/2014 - 6:59 AM
    Sandi-I hope so too!
    Progressive DDD
    Osteoarthritis
    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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