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Chronic Pain Medication Options

cactus1229ccactus1229 Posts: 2
edited 08/06/2015 - 3:19 AM in Chronic Pain
I'm a newbie just diving in, so please forgive me if I am posting in the wrong forum or not following protocols. I have end stage arthritis in my left ankle from a fracture that occurred when I was 13. Time and excess weight have exacerbated the condition to the point of having virtually no cartilage left at the talus, navicular and calcaneus.(Read: bone on bone) The only option I've been told is arthodesis which fuses these joints together, thus eliminating much of the pain as there will no longer be any joints at the top of my ankle or my heel. I have also used alternative medicines such as tumeric and other natural anti-inflammatories/ Also with the ankle pain, sleeping beyond several hours is almost impossible and I am on a high dose of pain medication(80 mg oxycontin ER 3 times a day with (2) 30 mg oxycodone as needed for break through pain every 8 hours. I have been on this dose for over a year and I do not want to increase the dose, yet have become opioid tolerant and the ER no longer gives me even close to 12 hours of pain relief. The oxycodone works much better but I only get 2-3 hours of pain relief at best. I know that there is no such thing as being completely pain free unless you are knocked out, but I need to carry out my daily living actvities snd be relatively pain free to do so. I am on medical disability and have had to postpone the surgery twice due to other complications (gout, cellulitis) I have lost 65 pounds and am no longer taking diabetic meds, exercise as much a possible in the pool and upper body with dumbells, so I have done all I can do on my end, however the cellulitis and lymphedema will not go away despite being on antibiotics for4 months with a hospital stay of 2 weeks with IV and oral both antibiotics. Fortunately I have not had another gout attack(I am a vegan so it was likely not diet related) The operation is very risky in a healthy person and my orthopedic has told me that he will not even consider surgery until the cellulitis and gout have completely abated as the recovery period is 10-12 weeks of being non weight bearing. Should an infection occur, I could be facing gangrene and possible amputation. I have seem multiple orthopedics and researched this surgery online and they all confirm what he has told me. Sorry to be so long winded, but wanted to give as much information as possible to receive the best feedback and opinion. I have tried Opana and had a horrible reaction so that is not an option. No analgesic effects, just felt like I had taken a very strong sedative and was taking only 5 mg. as my primary physician wanted to titrate me as the conversion table for opana to oxycontin is about 2 to 1 based on conversion charts and what my physician told me (i.e 80 mg oxycontin =40 mg of opana) After the reaction I had with 5 mg. I would not even consider taking it ever again as it left me with nausea and a headache for 10-12 hours. As there is a possibility that I may not be able to have the surgery, what other pain medications should I discuss with my doctor? Again,,,,,,,,,,,,,,sorry to be so long winded but wanted to provide as much info as possible. Blessings to all

Welcome to Spine-Health

One of the most important things that members can do is to provide the rest of the community with as much information about themselves as possible. It is so very difficult for anyone to respond when we do not have enough information to go on. This is not meant to indicate that you are doing anything wrong or violated any rule, we are just trying to be pro-active and get the information upfront so that people can start responding and your thread is more effective.

So many times we read about members who have different tests and they all come back negative. The more clues and information you provide, the better chances in finding out what is wrong, The fact that your test results are negative does not mean that you are fine and without any concerns. Many times it takes several diagnostic tests and procedures to isolate a specific condition.

Here are some questions that you should answer:

  • - When did this first start?

    . Year, Your age, etc
- Was it the result of an accident or trauma?
- Are there others in your family with similar medication conditions?
- What doctors have you seen? (Orthopedic, Neurosurgeon, Spine Specialist, etc)

  • . Which doctor did you start with? Ie Primary Care Physician
    . Who are you currently seeing?
- What Conservative treatments have you had? Which ones?

  • . Physical Therapy
    . Ultrasound / Tens unit
    . Spinal Injections
    . Acupuncture
    . Massage Therapy
- What diagnostic tests have you had? And their results (MRI, CTScan, XRay, EMG, etc)

  • . Summarize the results, please do not post all details, we cannot analyze them
    . How many different tests have you had over the years? Similar results?
- What medications are you currently using? (details, dosage, frequency, etc)

  • . Name of Medication
    . How long have you been using this?
    . Results
- Has surgery been discussed as an option? (If so, what kind)
- Is there any nerve pain/damage associated?
- What is your doctor’s action plan for treating you?

Providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.

Please take a look at our forum rules: Forum Rules

I also strongly suggest that you take a look at our FAQ (Frequently Asked Questions) which can be found at the top of the forum menu tab or by going to FAQ There you will find much information that will

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    - General pieces of valuable information

Please remember that no one at Spine-Health is a formally trained medical professional.
Everything that is posted here is based on personal experiences and perhaps additional research.
As such, no member is permitted to provide

  • - Analysis or interpretation of any diagnostic test (ie MRI, CTscan, Xray, etc)
    - Medical advice of any kind
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What could be good for someone could spell disaster for another.
You should also consult your doctor to better understand your condition and the do’s and don’t’s.

It is very important that new members (or even seasoned members) provide others with details about their condition(s). It is virtually impossible to help another member when all the details we have are

I’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?

Diagnosing spinal problems can be very difficult. In many ways it’s like a game of clue. Especially, when the diagnostic tests come back negative – no trouble found! Then it’s up to the patient and the doctor to start digging deeper. The doctor is like a detective. They need clues to help them move along. So, you as the patient need to provide the doctor with all sorts of clues. That is like it is here. Without having information about a condition, its impossible for anyone here to try to help.

Specific comments :

Personal Opinion, not medical advice :

That is a very high dosage of pain medication you are taking. And on it for a solid year without any reduction. Personally, I would do anything medically to start to reduce that level
of pain medication. Surgeries always present some type of risk, but the eventual outcome , at least to me , would surely be better than taking the daily amount of narcotics that you take.

--- Ron DiLauro, Spine-Health System Moderator : -8/06/15 09:17est


  • sandi123ssandi123 Posts: 456
    edited 08/06/2015 - 3:38 AM
    We can't suggest other pain meds, only you and your doctor know what other medications he would be comfortable prescribing in your case.
    There are many different options in extended release medications that your doctor can choose from.
    You mentioned wanting to be pain free so you can function and there is no way that is going to occur.
    A reduction of 50% of your unmedicated pain levels is usually the goal of pain management, and using other modalities, you may reduce the other 50% some.
    Like Ron suggested, I would seriously consider reducing the amount of opiates you are taking, that is a very high dose after a year . More opiates does not equal better or more effective pain control.
    There are other options to treat pain aside from using opiates ,that may provide far better overall pain management than relying on increasing opiates.

  • SavageSavage United StatesPosts: 5,427
    You mentioned your primary doctor is the one who wanted to titration your medications.

    Have you seen a pain management doctor?
    With a pain management doctor, it is their specialty .....with what is best for you and your issues.
    My PM doctor always has a plan B,C,D.....depending on what else comes up with my care.
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • kelz415kkelz415 Posts: 19
    edited 08/06/2015 - 11:18 AM
    Hello Cactus

    I would also agree with Ron on reducing amount of opioid meds. And this is only from personal experience. I have had back/neck p pain for at least 20 years... My own fault it went in undiagnosed for so long. Two years go it brcame unbearable, I got MRIs and emgs --- I have stenosis and herniations and bone spurs at cervical, thoracic and lumbar with nerve damage. With all the pain I'm at 20 mg oxycontin twice a day snd percoset 10/325 as needed (never more than 3 a day) I endure pain but much less than without these life saving meds that enable me to continue working. Remember the meds will not get you at no pain at all...you must continue with the blend of exercise stretching meditation and what else it takes. My pain is always there but the meds keep me functioning and working . Good luck and remember it takes. Positive outlook and just moving forward.
  • I took Opana several years ago for the first time, after being on Oxycontin for a few years....I got severely nauseated each time I took it. My doctor and I tried other meds after two months of non stop nausea at my request.
    Two years ago, I decided to give Opana another try and have not had any of the previous side effects, including the nausea.
    As with any medication, there are side effects and you have to work through them. MOST side effects will disappear in time, as your body adjusts to the medication. Unless you have hives, swelling, itching or breathing difficulties after taking medication, most doctors want you to give a new medication at least two weeks to see if it is going to work.

  • I appreciate your input and your recommendations for providing additional information; however I felt like I gave a fairly general overview of my condition( ankle fractured at 13, different modalities for pain(NSAIDS, turmreric) extensive research on the ankle arthrodesis operation and numerous postings from people 1-2 years post surgery, seeing both a primary and orthopedic both and the other health issues that are preventing me from having the surgery as it is a very high risk surgery. I appreciate your feedback and as stated in my post I realize that meds are not the sole answer either and I did mention that I realize I will never be 100% pain free; hence I get into the pool and do stretching and have a recumbent bike that I try to use daily. Somedays it is difficult to even walk or drive to the pool but, I push myself to the greatest extent possible.. Sadly, most of the reviews I have read on arthrodesis have not been encouraging even if my health would currently support it. In retrospect, based on the your reply and the others, I should have rephrased the post to solicit experiences with modalities including alternative drugs which I did receive some from other members and appreciate. It is a conundrum;Having no cartilage makes exercise a challenge; however not moving makes the condition even worse so I fully understand the value of exercise to the greatest extent possible. However, as the cartilage has decreased substantially makes it increasingly more difficult as cartilage does not regrow and the pain level is extremely high. I do not wish to increase my current dosage and my primary is in full agreement and I have come to terms that I will have to live with pain the rest of my life , I was simply seeking some other medical options that several members did provide and I appreciate, Again, I appreciate your input and understand your desire for more information, however as this was my first post , I tried to balance the most information I felt necessary as I had some reticence in how my post would be received by other members since this was my first experience in a forum such as this. Again, I appreciate your input and will continue to research to strike a balance to eliminate as much pain as possible while maximizing the analgesic properties and mitigating the side effects . One other quick question as I noticed that some of these replies came in several weeks ago. I thought I had set it up in my account to have e-mails sent to me when a post was made, but evidently I haven't. Is there a link that you can point me to where I can confirm if I am receiving notifications to my posts. Again, I appreciate your feedback
  • SavageSavage United StatesPosts: 5,427
    edited 11/21/2015 - 11:46 PM
    I sent you a private message re finding responses to your posts, etc...

    Please click on "inbox" on left of page.
    Thank you!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • dont if any body can relate live in savanna ga lost job so every thing i do is self pay i have had 7 surigeries on my abdominal wall first in 1997 had hole in colin had a colostmy done with a bag then take down 4 months latter got a sergical hearnia and ended up having 7 operations last 2 at EMORY were they had to pkace large mess into ribs down side and into pelvic dr galiway performed them after told he could not connect me nid section because of having to cut out so much muscle he said my back would be the problem and would get worse iam now 51 just stop working due to med reasob went to a local dr primary care gave him all paper work about my stomach and i noe have a hernica disc in lower back along with deng back desize but alot of that is age iam ex vet gulf war vet working on va diss to get help most know how that is well this dr because of the pain iam always in gave me 30 mg oxy 90ct said he would refer to pain clinic he said if ineed to take 4 a day that would b ok most pain med wont take self pay so i had to go back and see him 3 weeks latter while waiting to get into pain clinic he gave me 30 mg 90 ct o yea iam6ft 290 so thats not alot for me egot the appt on 18 went paid 250 just to get in meet the dr she is a anastizoolagist that only does ependurials had thoes done at ortho ga in macon ga 6000 a pop and they also had me on meds self pay so she could not help sent me back to the refering dr due to him ttelling me its ok to take more than 3 a day ran out of pain meds he then said he was not going to see mee any more because he is not specialised in this kind of treatment i can not have any more surgies the only thing that helps me is the meds 8 days ago i did a 4 mile with little pain of corse until after but the office manager said they still trying to get me into pain mang one said i have to see primary care 6 months and wants mri that i cant afford i had to get a appt with a new dr tue but i called the office were i was and told them and i dont them to say iam dr hunting is ther any thing i can do about the dr not seeing me untill i get into the painj clinic i know people abuse these kinds of meds but its the only thing that helps and i know it wont cure the csuse ther is know cure for what i have any body

  • SavageSavage United StatesPosts: 5,427
    edited 11/28/2015 - 4:33 AM
    Welcome to Spine-Health
    Pleases click on link for helpful information!
    Spine-Health Moderator
    Please read my medical history at: Medical History

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