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Best pain medication for severe pain

davidmddavidm Posts: 32
edited 06/11/2012 - 7:53 AM in Pain Medications
I went to a pain management doctor and told him about my pain, he ordered 2 MRI's 1 of my neck and 1 of my lower back. The results came back, and I have 3 bulging discs in my neck, and lower back which causes the severe pain, I have been having. Before I went for the MRI's he gave me lortab, he prescribed me to take 10 mg, 1-2 tablets at a time, no more then 3 tablets in 24 hours. This did nothing at all. Once the results came back he saw how much pain I'm in and he prescribed me oxycodone hcl 15mg. Up to 3 times a day. This is helping a bit, but the pain has gotten worse, The pain starts on the left side of my neck and triggers my left shoulder and it gets really painful and weak.

I have pain in my entire neck, mainly the lower, but when it starts in the left it makes my left shoulder really weak.

I have an appointment for him on Tuesday, but was wondering, what can he prescribe that will help me more? I tried Nucynta and it did nothing at all but give me a head ache. On the label it says oxycodone hcl, what does the hcl stand for? What does it do? Is there a difference between regular oxycodone and oxycodone hcl? How strong does oxycodone go up to?

He mentioned diladud, how would you compare oxycodone 15mg to diladud?


  • Oxycodone hydrochloride (HCL). They come in 5, 15, or 30mg tablets, but I know that they do come in a 20mg tablet as well, I just can't remember the pharm. co. right now.

    I don't compare medications as we are so different, and what works for one may not for another. Your Dr will probably have ideas of his/her own about what s/he thinks might be best if the oxycodone is not helping you. I have been taking the same strength for eight months now and though I have my bad days, the oxycodone is still pretty helpful for me, but like I said we are all different.
  • ...getting muscle relaxants. Your shoulder pain could be spasms.

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  • My Dr. has me on slow release Oxycodone called Oxycontin and it may take a few trips to see your PM Dr. to get a tolerable dose what med works for you.

    I think you need to see an Orthopedic Surgeon or Neurosurgeon for the next step. Not necessarily meaning you need surgery but you need to see one. If you're having any symptoms in your legs or arms like numbness or pain you need to see a Neurologist for tests and your Primary Dr. can do these referrals. Take care and hope you get some pain relief soon. 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
  • I agree with Robin, no medication will work exactly the same way on two different people, and since we aren't doctors, and don't know your medical history, it would be irresponsible for one of us to tell you what medication you should try. There is a saying in pain management, less is more. The lower you can keep the dose of your pain meds, and the more you can use other modalities to help manage the pain and discomfort, the better the result is for you. If you have long term, chronic pain, then you don't want to go through so many increases and or changes in the types and dosages of the medications so quickly , otherwise, you wind up lessening options available down the road.
    Your doctor has some ideas about what medications he feels are appropriate for your condition, given the results of your MRI's. Bulging discs are found in most everyone over the ages of 18-21, and in most cases don't cause pain at all. Unless there is some impingement of the spinal nerves causing the pain, simple bulging discs are far more common than not.
    It may be that your pain is being caused more by muscle spasms or overuse and pain medications may not be all that helpful in treating that type of pain. Muscle relaxers, or heat, PT and even ice can help relieve that type of pain.
    There are many other types of medications that work as well at managing pain, of any type besides pain medications and it might be worthwhile to persue some of those options, rather than looking to increase your dosages at this point. Neuropathic medications help nerve pain but you don't mention any symptoms of that, traditional tricyclic anti depressants work wonders for both neuropathic and mechanical pain, as well as help with sleep that is disrupted by pain and anti inflammatories also help with reducing both pain and inflammation.
    Injections of steroids, burning of nerves if your pain is caused primarily of neuropathic type pain is a good option, and of course, surgery if your condition warrants it. Trigger point injections might also help with the cause of the muscle spasms.
    I think that if I were you, I would be looking at my other options , rather than trying to get my medications changed or increased in dosage and possibly see about having further testing done, emgs, CT scans, discograms and myelograms can all be done to further evaluate the cause of your pain before going further.
  • of medications, interventional procedures, talk therapy, exercise/rehab, diet and reducing pain inducing activities.

    I hope that you are hanging in there right now. The diagnostic process was rough for me. Knowing how much pain I was in and hearing the results of my first MRI back in 2007 was validating but humbling as well. Realizing I would not be driving on strong medications, and modifying my work then stopping work altogether

    I had an injury from repetitive lifting. What happened with you and how long have you been in pain?

    I was Rx'd Oxycodone at first as well. When that did not cover my pain we added a nerve pain medication called Neurontin and a muscle relaxant called Soma. I do not know abut Diladid.

    I am glad you found Spine-health! I will be following your posts, and do hope that you keep us posted about your progress. I am not sure if you have another thread started elsewhere as well, but I do know I have found a community of people here who have helped me throughout this process.

    Take Care,
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  • Sandi and everyone,

    I just meant in general which is stronger, in your opinion. I just saw my pain management doctor's physicians assistant ( the doctor wasn't in.), and she said that she looked at my MRI's before she came in and said something to the effect that my discs are really messed up.

    I have tried physical therapy, tens unit, ice, heat, stretches, etc... None have helped.

    I am for keeping the pain medicine dose low as long as long as it helps the pain. I will be seeing the Doctor Tuesday and asking about muscle relaxors.

    As far as overuese, I don't do anything. I don't/ can't play sports, I don't have a job.

    I have taken several different anti depressants, and have experienced negative side effects, so I have stopped them all together.

    I'm going to be getting injections at the end of June, I can't get it done before that. But I need something to help me in the mean time so I can have some sort of life. So I can do something besides be in severe pain and not want and can't do anything because of the pain.

    The Doctor and the physicians assistant understands my pain is severe. I seriously doubt if they didn't think that I was in a severe amount of pain they wouldn't have given me 30mg of Oxycodone 4x a day.

    Jackie, and everyone, The oxycodone was putting me in a bad mood, I went to my pain management doctor's physicians assistant today and she gave me dilaudid 4mg every 6 hours. I have only had 1 dose so far and it has done very little to none so far. I will be going for injections in my neck and lowerback on June 23, then 2 weeks another, then 2 weeks another.

    I went to a chiropractor ( thinking maybe my back just needed adjusted ) who took x-rays of my lowerback, neck, and left knee. I have narrowing of my knee, arthritis in my neck, and hip dysplasia. For a year I was doing good until July 8, 2010 I was in a fight, where I was grabbed from behind and thrown backwards on a hard tile floor

    .I told this to my pain management doctor and he strongly believes as I do that this is what caused my discs to bulge, and the severe pain.

    From then my pain slowly progressed, to worse, and started seeing the chiropractor more and more. In May of this year I couldn't stand the pain anymore so I finally decided to go to a pain management doctor. He ordered and MRI and, the results came back that I have bad bulging discs in my cervical, C5,C6, and C 7. My lower back, L4L,5 and S1. He also told me that I have spinal stenosis.

    This is the only forum about pain that I am currently on. I will be keeping everyone posted about my condition. I hope everyone's pain lessens, and can have a great weekend!

    Take care,

  • Hi David,

    The one thing I can attest to is not all meds are equal on every person. For whatever reason something just don't work well. For instance I have never responded to morphine. The one thing I can tell you is that it more than likely will take a combination of medications to help you. You may need something like a narcotic for pain, a nerve med for nerve compression, muscle relaxer for muscle spasms and then a anti-inflammatory. Have you tried any of the steriod paks, they can often help reduce pain in a quick manner for short term and do a reset. I know myself I use them now and then, but I also have a combination of medications that I am using. I do have serious cervical spine issues and my most important med I take is my muscle relaxer, for me it is soma. But before I went to soma I went through plenty different ones. They would work then loose their effectiveness so would switch. One thing is important when you see your doctor is to have a accurate description of the pain your having. For myself I journal it, so I have good information to give the doctor. Things like stabbing, aching, pins and needless, numb areas and then of course explain the weakness in detail. Those all give them a idea of what medications and treatments will work best for you. Hope the new med gives you some relief this holiday weekend and you can relax a bit. Keep us posted.
  • Thanks for the update, keep us posted David. I am glad to see that you are getting a lot of great feedback in this thread.


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