I hope someone out there has had this combo happen. Please discuss if you have. If it is similar, please let me know. I hope that someone has insight on this.
My radiology tells that I have central canal narrowing due to an annular bulge on at least L4/L5. When I sought treatment a year ago, the main problem was a very dull and constant lumbar pain. Sitting down and having a massaging + heating pad do some work was good, but just the moment I get up from the chair it came back. Very mild thoracic pain at that point and I did not really notice it.
I received the MRI and CT results. Nothing really huge going on but still abnormal. No steroids, just different muscle relaxants and increasing dosages of APAP. Over the last year as I went from 5mg up to 10mg hydrocodone, I seemed to notice that my lumbar was easing up on me when I sat down, but the thoracic killed me. My wife can locate and push down on them but only one doctor in five has even touched the area in the thoracic area I describe.
So I quit yet another doctor and try on another one that has an impressive career tainted by his own addiction. He admits to his failure and is never going to be able to get by with it again. However, he saw a dosage of 2 times a day from my initial consult to see how he was three months earlier. When he heard that I was taking it 4 times a day, he immediately suspected that addiction was starting. I do not feel any "high" when I take my medicine, nor do I normally get a pain level of 1.
I have thoracic pain only in the left and right area that can extend all the way to the outer sides of my back. It does seem to stay close to my spine and knot up around L3, but is not as "wide". It seems to not go any higher than five inches from my neck.
So, the thought now is that the knots in my back which appear to be myofascial pain in my opinion, is the pain medication speaking to me. I admit that when there is more pain, I want it to go away and rather than take something I am told not to, my wife helps me. I also have each week laid out in a pillbox and that keeps me from even thinking about it. Is this a sign of addiction or pseudo addiction?
My pain level is no better since I was told to not take four, but take three. I suspect now after reading on the matter, he was talking about opioid induced hyperalgesia. Apparently, as I had heard before, that is the name given to pain that develops when opiates are used. It is complicated to describe fully here but I'll give a summary. It can be pain in another area, but I believe it is pain that cannot be "found". My source of pain can be found, you'll hear me scream if you don't be gentle trying to release what I believe is trigger points.
Now here is the kicker: I took a 13 day dexpak and felt great for a week. I had to ask for the steroids from the prior doc because all he could do was write pain pills that the local pharmacy didn't want to fill. How can steroids help stop opioid induced pain? I know they say OIH causes the pain sensitivity to change, but I am having actual bigger knots.
During the steroid treatment, all of the pain went down to nearly none at all with combined pain medications. Slowly, the pain came back to where I am right now three weeks later. I kept a pain diary and told both docs, but neither that I have told want to see it. It gives a good outline on what happened after the steroids.
Anyway... anyone? Anything similar? Any good questions to pose here in ten days when I go back to the current doc?
Steroids work, so it is obviously an inflammatory condition. Are you on anti-inflammatories:Ibuprofen, Naproxen, Celebrex, anything like that?
You also don't sound like you are addicted in the least. Since you've been on pain meds for awhile, your body has surely developed a dependence on them, just like I have, but addiction is more psychological. You're not looking for a high, you're not taking more than you were instructed to do so by doctors. You are in pain and obviously need them to manage. You're not an addict and I think your doctor is way out of line to treat you like you are one. When a doctor can only see their own failings in others, they can't clearly see what the patients need. Their ability to care for paients is skewed by their own insecurities.
Good luck. I'd get another Dr. if I were you.
Diagnosed Ankylosing Spondylitis 2009. Arthritis in most of my back. Diagnosed Fibromyalgia 2008, T12-L1 herniation T10-T11 bulge, L1-L2 Bulge, L3-L4 bulge, L5-S1 Lumbar discectomy 7-08: severe nerve damage as a result. 32 years old with 4 "special needs" children.
we know for sure you have lumbar disc problem.
that can cause pain to be referred to your thoracic muscles...here is article that may throw light on your trouble.
http://www.medicinenet.com/muscle_pain/article.htm
my recommendation would be to try deep muscle massage so you dont have to take steroids. studies have shown that massage is just as effective as steroids.
hope it works
Banned from Spine-Health
Some night, a long time ago I think I visited that site. However, research so far had made me think Myofascial pain was not recognized by the medical field.
I had heard of needles but never a larger TENS pad. I think there is a good chance I can engineer eight pads out of my four to give a better coverage area.
The problem has been that pushing out a few trigger points gives 30 minutes of pain relief. I like the suggestion of an actual massage instead of just that area, certainly no doctor has said this yet.
Thanks!
I do like to remember the conversation as being "I think you might be getting addicted". It is too bad that while I had a great hope in this doctor, he is walking a thin line. He has expressed that the danger of the addiction destroying what he has seen as a wonderful family.
I do take at least two ibuprofen a day. I tried the four x four a day and had to stop. Revisiting this later with something that can get the ibuprofen into my system without causing stomach pain is good. It does help, but I can only tolerate 2x4 a day. I do plan to rotate over to another class of nsaid soon. The 180 pill package is a great deal, but I forget that I can get aleve as well.
Prilosec is often combined with Ibuprofen to help stomach upset. I'm on Mobic(another anti-inflammatory) and prilosec. I have inflammatory autoimmune arthritis and have been on high dose NSAIDS for 2 years now without a problem as long as I take my prilosec.
I was rather pissed at my PCP last time I saw her- when I injured the T12-L1. One of the first things out of her mouth was, "you're in pain management, yuo know I can't give you anything, don't you?"
GRRR! I went to see her because I trusted her to order the MRI I thought I needed, not for pain meds. I'm usually on a 5-6 pain level when resting and it spikes to 8-10 when I get up, walk, etc. I don't want more pain meds, except I sometimes take an extra Norco to help me sleep better.
Diagnosed Ankylosing Spondylitis 2009. Arthritis in most of my back. Diagnosed Fibromyalgia 2008, T12-L1 herniation T10-T11 bulge, L1-L2 Bulge, L3-L4 bulge, L5-S1 Lumbar discectomy 7-08: severe nerve damage as a result. 32 years old with 4 "special needs" children.
I am going to try (and ask) about the prilosec. Maybe that will help with some of the unpleasant taste I get after a full day of NSAIDS.
I forgave one incident of being treated like you described and was assured it wouldn't happen again. The second time was too much and I left. It is amazing how many people with no pain get pills by self inflicted injuries that they are forced to treat due to the reality they cannot deny pain management.
Thanks
Dear I4pita,
Welcome to Spine-Health.
After reading your post... I wanted to toss in a couple of things that have worked for me, in hopes you will find additional relief.
You mentioned getting relief from sitting and applying heat. Several months ago, I purchased an infrared platinum heating pad which has helped tremendously with the muscle pain and knots in my back. It's different than the regular heating pads, in that it generates heat 2 1/4 inches into your muscles. It's a bit pricey (around $250.00), but well worth the expense.
Like you... when I first started taking 800mg of Advil twice a day, it tore up my stomach. I started taking the ibuprofen with a yogurt drink and my doctor prescribed an anti-nausea medication that I take once a day. The combination of taking the medication with a yogurt drink and the anti-nausea medication, rids me of the terrible stomach problems.
My PM has prescribed gentle massage therapy for me, however, I haven't started this yet. Although I am only allowed a very small area to be massaged (above bra line and shoulder areas only), I am hoping this method will work some of the knots out.
Have you tried any kind of physical therapy?
It's a shame your doctor has made you feel along the lines of being an addict. You are prescribed pain medication to help with your diagnosed pain, not for seeking any kind of "high". Having a pillbox is an excellent way to keep track of your daily medications. I did the exact same, during the first several months after my surgery.
Best wishes to you and take good care,
Tammy
11/08: Fell 8 feet from daughter's playhouse. Suffered multiple compression fractures, T2 through T10. Unstable dislocation fractures to T11-T12. Surgeon performed posterior thoracolumbar wire fixation with hardware fusion (pedicle screws, rods and harvested bone grafting). Confined to TLSO brace for 3 1/2 months. No BLT or above the head reaching until spinal re-evaluation in 2010.
Prescribed: Oxycontin, Percocet and Lyrica and a host of other medications. Self-help measures: Daily heating treatments with Platinum Infrared heating pad, lots of stretching, daily walks, low impact dance exercises and I have created my own anti-inflammatory diet.
I am 42 years old and married to my "hunka hunka burnin' love" hubby Mike (51). We have three awesome kids... Nikki (9), Zach (15) and Michael (21).