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When strong opoids should be introduced

AnonymousUserAAnonymousUser Posts: 49,082
edited 06/11/2012 - 8:37 AM in Pain Medications
of course when severe pain is present, but what about if the patient was an active 18 year old with 5 monts plus with severe L5 S1 pain/siatica withought a disk herniation? i am that patient. and i feel like my pain fits this cagtegory of medicaiton but i also see why i would be denied becuase of my age. can anyone tell me how i can either convince my doctor or an alternative option? please i need advice i dont no where to turn? is it time to go to pain management again?? thank you all


  • Has your doctor/specialist determined the cause of your pain?
  • Hi hon - just thought I'd chime in...

    Normally, doctors will not just jump in to the strong opiod medications... And each and everyone of us here who are currently on these opiods will say that at first we were tried on NSAIDS (anti inflammatory meds), then a mild pain reliever, coupled with PT, massage therapy, maybe an epidural injection, nerve block etc. I was undergoing treatment for a few years, and had surgery before I was given a prescription of Oxycodone. The doctors will not prescribe strong medication just because a patient says they hurt. There has to be documented evidence to show a reason why the patient is in that much pain.

    Hoops? You bet. Unnecessary? Some times. Did I comply with my doctor's suggestions, treatment plans and jump through all those hooops? You betcha sweet bippy I did. But, my ultimate goal was not the strong meds... I was hoping one of the suggestions would reduce my pain...

    What happened to cause your pain? I agree, you are young, but that's neither here nor there. Your doctor should be running tests (xrays, MRIs CT, lab work, etc) to get to the cause of your pain.

    Were you in an accident? Do you have a family history of arthritis, lupus, fibromyalgia? Do you play sports? What is the specialty of the doctor who is treating you? General practitioners (family doctors) don't like to give prescriptions for narcotic pain medication very often. That is usually reserved for Pain Management doctors. Maybe your doctor could refer you to one?

    SCSoccer - good luck, hon. I hope you can find a doctor and a satisfactory treatment plan. You are way too young to be in so much pain. Keep us posted?

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  • As said above. I came to this realization when I went for minor surgery, and the Dr was tossing me T3's for it at 10-12 per day.

    I told him that I did not need them for the surgery, but they sure helped make the back pain let off a bit. At the time, I was realizing that I had the "flu" all of the time. And that had been going on for YEARS. That was the first basis of the chronic pain diagnosis.

    That began 5 - now 6 years of searching for an answer and rolling through a long list of NSAIDS and analagesics. Most were codiene based for a couple of years. I researched the issues with Tylenol and liver failure and gave that to my Dr and he switched me to the next level of World Health Organization - meds.

    From there I had 3 trips to the ER and they prescribed stronger IR meds. On the basis of that and some time studies and my own pain chart, we agreed on a Extended Release meds and Break Through meds.

    I also ran through a list of Trycyclic meds, as they affect pain as well, and can provide relief, and give you sleep when the pain intefers.

    It is not a short journey, at least it was not for me!

    Cheers - C45 -
  • i would get to your PM Dr and let him know the pain you're having. My Primary Dr. has handled my pain meds and had to return to her frequently to get a slow release med that helps me get through the day. Have you seen a Spine Specialist yet? Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • You asked: is it time to go to pain management again? Well, the answer has to come out of your doctors mouth, but it is definitely a question to ask them. With no bulging disks or anything that could be even remotely improved via surgery, pain management (i.e. phys therapy, home exercise, and or meds) is the only logical answer I can think of that may help you.

    Your age is less of a burden for you than is your actual situation. The fact that you have this severe pain present, with nothing on your MRI to back it up creates tough decisions for your docs. Is there anything at all that showed up on your MRI that you didn't post? I'm curious...

  • the mri was normal with a slight slight slightttt disc buldge at L5 which they deemed unimportant.. it was like 1.5-2 mm but i have no stenosis so i guess they have a point. but i mean they cant find the cause of the pain.. they just said it was chronic. its been 5 months with no releif.. and the epidural injection i have had for pain in fact was injected into my s1 nerve root made my leg useless.. and pain persisted.. its really not fair
  • What drugs have you tried already?
  • 2 norco 10/325 for pain every 4 hours.. it was a slighttttt relief and i stress slight. but apparently the spine specialists who perscribed it said that it was the strongest they could perscribe????? also i took diclofenec *sp* gabapentin soma methlypredisolone.. nothign major yet.. i had to go to the urgent care when i ran out and got a shot of nubain.. but right now i am drugless.. and its hell!
  • They said they didnt find anything on MRI. Have you had any other tests? Radiofrequency lesioning? Injections? How about discogram. That is the only thing that showed what was causing my back pain. I had tears in three discs. PM me if you wish.
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