This is my first post here, hoping for some advice on how to deal with ongoing chronic pain in my lower back.
I'm a 38 year old male, 6ft and 120kg (quite solid build, not 'overly' fat).
Due to my sporting background, I've developed chronic arthritis in my lower back and a pinched femoral nerve in both hips.
My GP put me on Lyrica for the nerve condition, however, I found that it made me feel quite 'loopy', so he changed my medication to Endep (50mg each night) which seems to have helped reduce the pain (only present when laying on my back) to the point where I no longer wake in excruciating pain.
He also put me on one OxyNorm 20mg (Oxycodone IR) tablet each night and anti-inflammatories for severe back pain, which only affected me at night while sleeping, due to extended periods of not moving. This worked well, as I was able to sleep through and get a good 6-8 hours sleep. Unfortunately, due to his concerns over the long term addictive risks associated with Oxycodone, he stopped prescribing this and changed to Panedine Forte.
I immediately noticed the difference, as I was waking every 1.5-2 hours is severe pain, having to get up and walk around until the pain stopped, or in some cases, having to stand in a hot shower for a good 30-40 minutes (a heat pad didn't work as I would still have to lay still to use it). I found that my back was hurting non-stop throughout the day, and I was taking between 10-12 Panedine Fortes each day just to function (still in moderate pain).
After about 6 months of this I started to have concerns about the affect that so much paracetamol and coding would be having on my body (i was experiencing rather painful constipation, and was taking natural laxatives), so I returned to my GP and asked if he could prescribe me Oxycodone again, so that I would only have to take one tablet at night, as opposed to 8-12 PF's each day. He then tried Tramadol, which I found to have little to no effect in reducing my pain, so I returned to see him again.
He referred me to a pain management specialist, who has tried a number of different medications, including;
Dolased Forte (Mersyndol Forte) - while this helped, and made me 'sleepy', it didn't stop me from waking in pain, and actually gave me terribly vivid nightmares.
Tramadol 100mg SR (plus Tramadol 50mg IR for breakthrough pain) - no affect at all
Zaldiar 75mg (a combination of Tramadol and Paracetamol) - no affect at all
MS Contin 10mg - helped slightly, but made me nauseous
Targin 10mg (Controlled release Oxycodone with Naloxone) - worked better, but I would regularly get headaches.
Now all of these have been over the last 2-3 months, and I haven't had a full night's sleep since taking the OxyNorm 20mg, even with taking various sleeping tablets (I don't have problems getting to sleep, it's just STAYING asleep that I have trouble with). I also have to say that I haven't taken the entire prescription of the above meds, as I went back to see the doctor after a week or so of trying each one (on his recommendation).
The last time I saw my Pain Management Specialist (and was prescribed the Targin), he said he was going on holidays for a month, but to make an appointment with one of the other Doctors at the practice and they would be able to either re-prescribe the Targin if they worked, or prescribe OxyCodone (or suggest another analgesic).
After about 3 weeks of trying the Targin, I decided to make the appointment as I was still waking in pain 4-5 times each night. The doctor I saw seemed to have immediately pigeonholed me as an addict who was chasing pain medication. Despite me telling him my complete history, and assuring him that I have boxes of unfinished medication at home, he refused to prescribe me any other pain medication (even the Targin my normal doctor had just prescribed me 3 weeks earlier), but insisted on prescribing me 2 x Endep 25mg each night, despite me telling him I was already on it for the nerve pain in my thighs (Meralgia Paraesthetica). He also prescribed me Lexotan 6mg (Valium) to "help me sleep and relax), however after asking my pharmacist, he recommended that I don't take it (also suggested by my GP after a quick phone call for a second opinion). This 'new' doctor repeatedly asked me if I took recreational drugs, and how much I drink, even though it told him that I don't do either. I left feeling belittled and extremely frustrated, after being made to feel like a drug addict who was shopping for scripts.
I now only have previous medications that haven't really helped, to get me through until I can get back in to see my Pain Management Specialist.
I suppose after all this, my question for you all is, have any of you had any success with other medication for pain that only seems to be able to be controlled with strong Oxycodone type medication?
Any suggestions on what to do in my situation would be greatly appreciated.
Last edit: 6 years 3 months ago by Razorback. Reason: Typos
The following user(s) said Thank You: Peter, Eliza
Did that doctor actually say anything about you being a drug seeker using those words? Also, did he actually ask you more than once about illicit drugs?
If a doctor ever did that to me, I would get up and walk. On my way out the door, I would tell that doctor that I am going to report him/her and I would tell them to not bother billing me, because I will never pay the bill. And I would definitely fill out the negative report to the AMA and any other organisation, such as an Ombudsman, that I could find. I would demand an apology from this doctor and demand that they be reviewed or have their license removed!
There are too many doctors out there with lousy attitudes like this and it is time we all started to stand up for ourselves and actually make some noise and report them to the authorities. If you were a druggie, there would be some history and it would have been in your notes from the doctor you normally see. There is no excuse for any doctor, no matter who they are, to treat any of us as illicit drug users (criminals) and we should all get VERY ANGRY when some idiot doctor starts to treat us that way.
You are not required to respect any doctor who disrespects you and accuses you of being a criminal.
Mate, as for the concoction you have been on, I have never had some of those drugs, because I have a sensitivity to most strong drugs. So I can't advise you unfortunately.
My only advice to you would be to find another specialist, because you seem to be at a dead end with the mob you are seeing.
Also, have you been referred to a multi-disciplinary pain clinic? If not, you need to get a referral from your GP and go to one, because they should be able to assist you with self-managing your pain, plus they have pain specialists there too who know more about chronic pain than your average Joe blow.
There will be a waiting period unfortunately. Depending on where you live, some of them are quite long.
I hope you aren't in WA, because the WA state govt has just slashed the budget for one of the country's most successful pain clinics and it is not going to exist after a few months.
Anyway, be kind to yourself, don't let any arrogant idiot sitting behind a desk get away with accusing you of being a criminal, and if need be, get another specialist.
I use the strong language, because I am tired of seeing innocent people abused for no good reason. If we were criminals, there would be some history. So the only reason a doctor would behave this way, is because of their own personal prejudices against cp sufferers. There are very many doctors who think chronic pain sufferers are nothing but malingerers and drug users.
Yet the solid science is in and proven WORLDWIDE, that chronic pain is a condition in its own right and sufferers should be treated with respect.
I wish the ring (this Chronic Pain) had never come to me. I wish none of this had happened. (Frodo Baggins)
So do all who live to see such times. But that is not for them to decide. All we have to decide, is what to do with the time that is given to us. (Gandalf the Grey)
Yeah, when he was first asking me to gie him a summary of my problems, he was asking general questions like "are you married?", "do you have any kids?", "what do you do for work?", "do you drink?", and then when I said, "No. Well, very rarely. I had 2 beers on new years eve and can't remember the last time I had a drink before that", he said "what about recreational drugs?", I said "no, none", to which he said "so you don't smoke anything or take anything else?".
I was a bit taken aback, and then told him "I tried dope once when I was about 16 and was sick as a dog, and have never touched it since", so he asked again "but you don't take any drugs now?" to which I said "no".
He then went on to basically lecture me about the risks of "the types of medications [ive] been taking for a long time", saying things like "you have a wife and kids, it's not worth risking losing all that", and then went off on some tangent about having to focus on my mind/spirit/stress because that's a more important part of dealing with chronic pain than "pills, which are just a bandaid".
I really couldn't believe what I was hearing and was getting very frustrated, which he could obviously see, and I think added to his 'concerns' that I was an addict. This is when he asked again "so you're sure you don't take any other types of drugs?"
It was at this point that I realized that the appointment was an exercise in futility, so resigned myself to just saying "yeah, ok" and then left once he had finished writing the scripts - one for Endep which he insisted on writing even though I told him quite adamantly that I was already taking, and the other for the Valium type medication.
I have made an appointment to go back to see the actual pain management doctor I was originally referred to (the one who is currently on holidays) as he was quite reasonable and understanding.
Now I just have to make it through the next week and a half without any pain medication...
To answer your other question - I'm not sure if it's a multi-disciplinary pain clinic, as I'm not really sure what that means. All I know is my Gap referred me to see a "Pain Management Specialist" (he's also a GP) at a normal medical centre/clinic.
Last edit: 6 years 3 months ago by Razorback. Reason: Minor addition
Multidisciplinary Pain Clinics in the public system are based in public hospitals, this unit is only there for treating chronic pain, they consist of dedicated Pain Specialists, Pain Surgeons, Physiotherapists, Psychiatrists, and Psychologists.
All they do is treat pain, they also run pain management courses based on either the ADAPT or STEPS program, this course is designed for you to control your own pain as well as medical intervention as a whole pain management regime, at this group your are taught to accept your pain and tools to help you manage the impact of pain by pacing activities, mindfulness and relaxation, it should not be thought as giving up by accepting your pain, as we all know there is no magic pill to cure chronic pain, but learning to live and manage your pain is a whole lot better than the boom and bust cycles we get caught up in in the early journey in chronic pain.
Medical intervention can only do so much in controlling pain, how we minimise our pain is up to us, and this course teaches you the tools necessary to help achieve this, if you are offered such a course go in with an open mind, when you first start it may seem common knowledge, but by the end it will all fall into place, also be careful of some courses, some are only in it for money and insist you stop your meds, this is not the right approach, as any good pain management should include both for the long term best outcome.
You will need a referral from your GP to attend a pain clinic, once in a pain management regime will be set up, this will then be forwarded to your GP to follow, your GP should then continue to write scripts as dictated by the pain clinic, you will be reviewed by the pain clinic to see how you are going, any changes will be also forwarded to your GP.
GP's in general are not taught to treat chronic pain, so getting into a pain clinic is your best option, whether private if you are covered or the public system, just be aware the public system has a long waiting list depending on state, but once in, the service will look after you and your needs.
Hope this helps.
"focus on my mind/spirit/stress because that's a more important part of dealing with chronic pain than "pills, which are just a bandaid".
This is entirely correct. They now know that pills can only do so much. They can take the edge off and then by using the techniques that Don has talked about, we can learn to manage pain a whole lot better. Pain affects our entire system because it alters our nervous system, so there is no quick fix unfortunately. There is a lot of research going on at the moment and one day they will probably be able to treat chronic pain in a better way than now, but meanwhile, take note of Don's post
Not every day is a good day, but there is good in every day.
"“It’s delightful when your imaginations come true, isn’t it?” ― L.M. Montgomery, Anne of Green Gables