After a lumbar fusion in 2012, all the modalities and meds tried before that, severe pain directly after and for the first year after surgery, and chronic pain since, with only minimal help from Butrans and Tramadol (voluntarily coming off narcotics), I finally got a breakthrough.
Last month, the pain in my lower back had gotten considerably worse. I had always suffered nerve pain and muscle pain in my legs and hips from the lumbar "assault", and recently developed pain in the thoracic area from the cascade up of the vertabra. I expected to have to eventually increase everything, and possibly go back on narcotics.
Well, the PA at my pain mgmt Dr. office, who , by the way, is awesome, was listening to me, and looked at what regimens I had been on throughout. She then asked if I had been on Neurontin (yes but zonked me out too much to work). I was curently on the Butrans patch 15 mcg, which has been a huge help but still left with me with a lot of pain: tolerable enough to work, but as soon as I got home, I headed straight for bed and slept 10-12 hours a day. Tramadol for breakthrough but I was up to 9 pills a day. She then asked if I had tried Topamax. Told her I never heard of it. She said why don't we try it. So picked up the prescription and started the next night.
She told me to take at night, because it could cause drowsiness. I wasn't happy about that since I am already sleeping so much but just wanted something to ease the pain some.
After a few days I increased from 25 mg 1x day to 2x a day. I noticed gradually that I was no longer falling asleep as soon as got home, and was staying awake a little longer, in fact, was having a bit of a hard time falling asleep. And, best of all, FORGOT TO TAKE MY TRAMADOL 2 DAYS! Just plain forgot!
I waited 11 days before I realized that it seemed to be consistently better, and wasn't one of those "flukes" where your body just feels ok for a day or two. I really was feeling pretty good! So I called the office and first, thanked her profusely for recommending it, and asked if we could gradually increase it and decrease the tramadol, and then eventually talk about decreasing the Butrans.
So not only is my pain virtually gone (and I have a very physical job, and I have tested it, trust me!), but I am more energetic than I have EVER been (actually, maybe too much- I haven't slept straight through, or for more than a few hours, per night, since I went up to 75 mg a day.
Imagine if my PCP had prescribed that drug BEFORE I had decided to have surgery......how different my life could have been.
The moral of the story is: if a medicine isn't working for you, TRY SOMETHiNG ELSE! There are a lot of meds out there, not necessarily narcotics, either, that could help you.