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FNP doesn't understand or feel comfortable with chronic pain?!

I have been with the same practice for awhile (over a year)...had finally gotten a prescription for Tramadol, which was helping...then, 2 weeks ago, my FNP decided she didn't feel comfortable with me being on it "long term"...this is the same woman that doesn't feel comfortable prescribing anything pretty much other than anti-depressants...tries to give them for EVERYTHING!! Says they ALL have "off-label" uses, like some for Neuropathic pain, others for other things...told her she KNOWS what my problems are...have had numerous herniated discs, have DDD, and maybe ankylosing spondylitis- not nerve pain with no discernible cause....grrrrr....SO frustrating up here- seems NO ONE knows anything about back problems... could understand if there was no reason they could see, but there IS!! Any help appreciated!!


  • for pain management........they aren't equipped to offer you the more advanced pain management treatments available, nor are they comfortable with prescribing any medication for pain long term.
    Find a pain management doctor near your home and make an appointment there if you need ongoing treatment for pain.
    Why do you think that you have alkolyzing spondlylitis?
  • I know it can all be incredibly frustrating. As if living with the pain isn't enough!! Which country are you in? Once a problem has persisted for a while or you have diagnostic tests showing what's wrong the correct specialists are needed. This seems easier said than done depending on location & finances.

    Is FNP family nurse practitioner? Are you in England? Or is it GP in Canada? Sorry. One of 'those' days!

    Antidepressants off label do help some with diagnosed physical pain (not 'no cause' pain only) not that I'm supporting the 'hand them out like candy' approach some docs take! It sounds like you really don't trust her care. Maybe it would be best changing docs if its hard to get into pain management where you are. In England even a different GP in the same practice can get you to the correct specialists really fast where their partners have failed.
    Osteoarthritis & DDD.
  • is nothing more than (cortisone) shots...I have gotten those in the past and they not only did nothing to help, they temporarily made the pain 10x worse! After, they (the Doc that did them) told me that that happens sometimes....
    Alkolyzing spondlylitis was mentioned as a possible, along with others, but said I had DDD with numerous herniated discs....

    @EnglishGril- We live in northern Maine (US), and there seems to be a HUGE shortage in everything from specialists to knowledgeable help...They started me off on trying so many different NSAID's, that I lost count...and all they seemed to do was make my ulcers flare! Then they moved onto antidepressants, and they had lots of side effects (WICKED bad "hang overs" the next day, and I have kids, where I couldn't do anything the next day, never mind get out of bed....)- Finally, they put me on Tramadol, which helped substantially, but they took me off cold turkey, because, as she (FNP-family nurse practitioner) put it- it makes her uncomfortable for me to be on it for this long"...

    I told her at my last appointment- (Wed), that I was seeking a second opinion on this. I signed a release of information. When she cut me off of the Tramadol, she gave no other options for pain relief...told me she didn't know what else to do...Crossing my fingers that these new people can help...
  • Ugh!! I see why you need to vent. I remember when I was going through 'finding my blend', it so terrible when you cant function at all. I'm not exactly dancing a jig everyday & some days are still pretty bed but at least I've broken through to the other side & know it's very possible to live with this. I remember my Cymbalta, Savella, Lyrica, Nucynta days!! Talk about feeling totally monged on meds!! I'd be hobbling to the sofa at 6.30am with my kids. So white, cold, sweaty, shaking ugh!! I know it's really hard but don't let the frustration & depression take over. It nearly sank me. Keep fighting! You've caught a glimpse, you know there are meds that can make you feel a bit better...could you function enough to stretch & walk? For me it only started to get better when I developed a routine of things PT, meds, airomatherapy (don't knock it until you've tried). Once you're in a better place the shots might work better. I know it's strange but I had more a couple of weeks ago & it did help a bit, more than before!

    New docs & proper specialists seem to be the only answer for you at the moment. A nurse (no offence) isn't the person to be managing chronic pain & spine conditions. Rant & vent here. It's really helped me in the past. We get it! It can completely suck. I couldn't make it to my sons school fair last night & I feel terrible about it. Yet another missed activity, missed opportunity to watch my kids experience life. Ugh!! I'll be perky & helpful another time I promise. It hasn't been a good week. I'll take my own advise...hang in there. The good days are waiting somewhere in the fog.
    Osteoarthritis & DDD.
  • A lot of doctors usually do not have a problem prescribing Tramadol because it is not a opiate. However it can be addicting if someone is prone to that. I do not know how much you were taking but it can cause some major problems such as seizures and kidney failure. For those who it helps with pain it is very important to blood tests to test kidney function. I went to a pain management doctor about 8 years ago who refuse to prescribe it because 2 of his patient went into kidney failure after being on it for few years. But the thing with all medications (including over the counter meds) is that they can all cause side effect or possible other major health problems. Maybe your FNP was worried about the problems I mention. Maybe talking to her about having regular blood tests to make sure everything is OK might help her fears with prescribing the medication. It can't hurt. If it was me and she said no after talking to her I would go find another doctor to go to.
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