Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

pain managemen question

dea-lynnddea-lynn Posts: 152
edited 08/25/2014 - 2:52 AM in Pain Medications
Hi all,
I'm fairly new here(only a few posts to date) and I'm having surgery on the 17th of Sept but in the mean time I have been seeing a pain manageement doctor and have had 4 steriod/ SI nerve blocks which don't really work. However when it comes to prescribing pain meds my doc seems a little stingy. When I first saw him he prescribed vicodin 5/325 for twice a day for the week before my first injection. At my followup I told him that my PCP didn't want me to take tylenol because my liver enzymes were elevated so he prescribed me dilaudid 2mg for once a day to take in addition to the tizanidine that is twice a day. At my next followup after my second injection I told him that by taking the medication once a day I was unable to get ahead of the pain so he increased the dose to 1-2 tablets once a day. This helps a bit more but I even taking 1 tablet twice a day I am still finding that the pain creeps back to where I began and that I can't geta head of it. Ihavemy next followup from my last injection back in July because he was on vacation and rescheduled appointments. How do I let him know that my current regimine isn't working ideally witout sounding like I just want more meds?
Medications I currently take for my back:
* Celebrex 200mg QD
* Tizanidine 4mg BID
* Dilaudid 2mg BID
* Naproxen 550mg only on occasion
* Gapapentin 1800mg BID (for migraine prevention)


  • sandisandi Posts: 6,343
    edited 08/25/2014 - 3:23 AM
    and dosages low, one is because you are new to opiates and too much can cause overdose and over sedation, along with breathing suppression, another is that since you are having surgery, higher doses of opiates can cause complications post op in being able to manage the pain levels.
    You might be able to manage the pain better if you were using the anti inflammatory medication on a regular basis.
    Since the medications were given to help ease the pain post injections, his dosages are reasonable.
    More pain medication does not always equal more pain relief. There are other methods as Liz posted in the "The Blend" link in her response, that reduce pain and should be the biggest part of anyone's pain management program. Ice, heating pads or patches, topical creams and ointments available in any pharmacy, stretching, excercising, swimming, yoga all are part of a comprehensive pain management program.
  • It's important to be open and honest with your PM Dr. Just explain it to him the way you just explained it here. Let him know that you're having trouble getting ahead of the pain and see if he has other recommendations. You may also want to ask what the regimen will be post operatively. He may not want to make any changes until then but at least you'll know what to expect.

    Good luck!
    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
  • dea-lynnddea-lynn Posts: 152
    edited 08/25/2014 - 4:17 AM
    Thanks again. I just wanted to say that I'm not new to opiates though as I have endometriosis which during flares I have had to either take oxicodone or in the er have iv dilaudid to control pain, I also have severe daily headaches which also have required me to be in the hospital where I was given iv pain meds as well.
    I haven't seen my PM dr since I was told I was having surgery, I am seeing hi on wed. I also use a tens unit daily, ice or heat, my home exercises from pt. I only take the naproxen on occiasion because I take celebrex daily and it too is an NSAID.
  • doctor, you want to make sure that you discuss who will manage your acute post op pain, and for how long. It is a violation in most pain management contracts to have two doctors prescribe you opiates for any reason, without your pm's permission first.
    So it is important to discuss with him, whether or not he wants the surgeon to manage your post op pain and for how long, or if you are to call him before your discharge or have the surgeon call him to discuss what is to be done, by whom and for how long.
    This thread might help you to understand the process involved .http://www.spine-health.com/forum/treatment/pain-medications/dos-and-donts-pain-management
Sign In or Register to comment.