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Pain Management

Hi, Around 6-7 years ago I started having bad headaches and my doctor told me it was caused by my muscles in my neck. I was put on Robaxin for it. I kept having problems, had X-rays, went to Neurology, did physical therapy, had a MRI of my head. Its been about 3 years since then. A few months ago I changed doctors because my doctor left the state. The new doctor said I need to see pain management because i should have to suffer in so much pain. So 6 months ago I went to pain management, he started me on Gabapentin 600mg. I had new X-rays done, EMG tests. They were normal. Seen him again and he increased gabapentin to 1200mg. Waited for MRI to be approved and went back again. Gabapentin increased to 1600mg. I got my MRI done, went back and seen his nurse practitioner. She told me it was normal. 

I am going back in a few days to see the Dr. They have me going every 30 days since i started. So this makes the 7th visit. I have constant pain in my neck and shoulders, numbness down my arm and in my 3 left fingers, sharp stabbing pain on the top of my head, jaw pain. I am wondering what do I tell my doctor about my pain to get something that will help. I know the current state of war on drugs, and the opioid epidemic and am weary to suggest it. Background because i know everyone loves to hear about those. I am 31 also on tylenol 1000mg twice a day, methocarbamol 750mg twice a day, valium 5mg twice a day. I can not take Nsaids because of being on blood thinners. Any feedback is appreciated. 

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Comments

  • Hi your symptoms sound very like mine, I also had visual disturbance; I had RFA ablation at c-2 and c-3 I think and got immediate relief; have had the same in cervical spine to resolve shoulder issues. It took me years to find out my issues are coming from my facet joints; did they do MRI of brain or cervical spine? I had two of the brain all clear and when they eventually did neck discovered marked spondylosis and I was diagnosed with facet arthrosis.

  • Personally I would not go down the opiate route...another option suggested to me was low dose anti-depressant off the box...this is to calm the nervous system and to relieve pain, doctors are using this more widely now...also meditation especially body scanning but you really have to commit like twice a day for half an hour!

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  • Ps I also showed no neurological impingement; sounds very like my symptoms...I was diagnosed by an orthopedic before being referred for pain management...I have mediated facet joint pain and cervicogenic headaches....

  • nutcase007nnutcase007 United StatesPosts: 672

    @john44052 - Sorry for your sake to hear about your chronic pain that has gone on for years.  I think I have some empathy for you after dealing with cervical chronic pain for 21 years and three ACDFs.

    Given the symptoms you wrote about, I'd highly suggest getting an evaluation from a spine surgeon (neuro of orthopedic).  MRIs are only one diagnostic tool and miss a significant number of spine issues.  My last two ADCFs were NOT diagnosed by MRIs.  Other tools are SPECT Bone Scans and myelograms with C/T scans.  From my experience as a patient, your symptoms sound like nerve, nerve root an/or spinal cord impingement.  Just because the cause of your pain has not been diagnosed, does not mean you don't have a problem.  It only means the cause has not yet been found.  For my last ACDF, it took ten second opinions to diagnose the cause. 

  • Tcbelle - I also have visual disturbances, seeing white spots, and increased eye pressure on the left eye. Most of my issues seem to be centered of the Left. I had both MRI's of my brain and of my Cervical spine. I have not done meditation but do yoga twice a day to ease the pain. I also had a steroid injection in the muscle below my skull which did not help. They wanted to do a facet injection but after my MRI the nurse practitioner said it probably won't help. 

    @nutcase007 - Thanks for your feedback. I will ask about the condition you mentioned. I have seen Neuro but he also wanted the MRI before going any further. Also said something about botox injections in my neck muscles. I also thing it might be nerve problems. Something is swelling because when I have been on one of my many courses of Prednisone it seemed to help a lot. 

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  • @john44052 do you feel pressure or is it intraocular pressure? I always had a feeling of pulling and dragging in the eye and seeing spots which my optician could also see when doing tests. My eye pressure was normal when I was reviewed by an opthamologist, his report concluded all the ocular issues were arising from the neck. Maybe get a proper review by an opthamologist. Then he referred me to orthopedic. My MRI showed the spondylosis but physical examination confirmed the facet arthrosis (that was the ortho); my pain consultant treated both the headaches and the neck pain. The c-2 c-3 ablation gave me instant relief. I would ask them to explore the facet injections with you. Sometimes the injections are a precursor to nerve ablation. I’m not sure how Pain Management works where you are but my guy specializes in neck and shoulder issues.... 

  • nutcase007nnutcase007 United StatesPosts: 672

    @john44052 - Sounds like your doctor (you called your Neuro) might be on to something that makes some sense to me.  Yes, when prednisone helps, there is very likely some swelling of impingement going on.  @tcbelle has advice I think is also good to consider.


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