Sciatica Sufferer - Need painkillers NOT surgery. Health system not helpful. Help?

[clear_sky]

Just to be clear - this is not an attempt to gather doctor-shopping info. I just want some info on how the health system works in cases like mine - my GP isn't being very helpful/clear on the subject.

For the last 5 months, I've had increasing discomfort/weakness eventually leading to moderately severe pain/increasing weakness in my left leg. Starting in the hip, echoing in the knee (hollowed out feeling), going all the way down into my foot. Not horrendous pain, but it interferes with my work - I have a desk job so sitting for long periods at a time aggravates it. I also study in my spare time - more sitting at a desk. And freelance work - more sitting! Damn you, desk!

Stretching/walking around helps for only 5-10 minutes, once I'm back at the desk, it starts all over again. It also interferes with my sleep - I can't get comfortable and I've developed a terrible case of RSL. This morning I woke up with weakness in both my lower legs.

I can't sleep on my back anymore, which is my preferred sleeping method. I actually have a theory that this problem may stem from a car accident I was in almost 10 years ago. The impact was on my side (ie - passenger side) but I literally walked away with nothing but a scratch on my knee. Maybe the hospital people didn't really scan me properly or missed something because I looked fine, apart from the shock. I'm not sure. Anyway, since that accident, I couldn't sleep on my back anymore but didn't really think much of it.

So I've been going to my GP with complaints of weakness/pain in my left side for the last few months. Finally, he referred me to get a CT scan, which showed a herniated disk in my lower spine. He says it's not serious enough to need surgery. Yet I'm in pain and serious discomfort most days. I do a lot of yoga and stretches, but that helps only for a short while.

At first, my GP was prescribing Panadeine Forte - the recommended dose (4-6 every 4 hours or something?) wasn't helping, so I learnt the CWE extraction method. I told him that PF wasn't doing much and he prescribed Oxycontin 10mg. 3 of those did a very good job, and I slept on my back for the first time in almost 10 years. Was comfortable, got lots of desk work done - yay! Finally! I went back to get a repeat and he said he couldn't give me one without an authority.

I questioned him about this authority business. Apparently, my options are: go see a private orthopaedic or spinal surgeon and pay retarded amounts of money for the consults. Even though I have private health cover, it doesn't cover those particular specialists. The money question aside, when I rang up the specialists to find out about fees, appointments, procedures, etc - all the receptionists (so far I've spoken with 3) start talking surgery and epidurals. My GP did warn me that they will try to advocate surgery instead of authorising painkillers.

My other option (according to GP) is to go on a waiting list to see a specialist in the public health system. I'm going to fill out the forms for that next week. Even so, he has warned me that I may not get an appointment until February next year or thereabouts. I'm not sure what the outcome of that visit would be. Hopefully not surgery recommendations. But that's a long time to wait...

My GP is willing to prescribe me plenty of Tramadol. But, in order to alleviate my pain, I need to eat crazy amounts of it (way over the 400mg seizure threshold limit in 24 hours) and top it off with a benzo because of the seizure danger. Needless to say, due to the SNRI properties of Tramadol, it sends me slightly loopy/happy and I get quite depressed and loopy/unhappy when I stop taking it.

In summary, my sciatica is not bad enough for surgery. I don't want to pay $150 to have a so-called specialist try to force surgery on me. It's perfectly manageable with painkillers, oxy did a fine job but I only have a few left and soon I'll be stuck with just CWEs or Tramadol (DO NOT WANT!). The problem with CWEs is they're time consuming and you can't really get one going at work. And I can't afford things like Lyrica.

Has anyone been in a similar situation? Is there another sort of specialist I can see? Can anyone suggest any other options apart from trying to source painkillers from a private individual - which I don't want to do, but if the health system won't help me, I'll probably have to end up doing that??

I just want an authority for painkillers that help me function in my daily life. I don't want unnecessary surgery. When the sciatica gets bad enough that I'm losing control of my bladder, I might consider men poking steel instruments into my spinal column. In the meantime, I have to work, study and sleep. And my condition is interfering with all of these things.

If anyone can provide any information on the workings of the medical system, or even info on alternative painkillers, it would be most appreciated.

Thanking all of you in advance, any bit of knowledge helps because I feel stuck and frustrated and in pain.


PS - Dear Moderator, I wasn't sure where to post this. I decided on Australian Drug Discussion because it's the aussie health system that I'm dealing with.

 

[Crankinit]

I think you just need to cough up and see the specialist.

 

[DeathDomokun]

You have a couple of options:
1. See a new GP
2. See a specialist
3. Buy opiates on the street
4. Change nothing

If you go with the third option, it will probably be cheaper in the long run to just pick option 1 or 2.

 

[clear_sky]

Tried option 1 - he had a little fit about getting deregistered if he prescribes anything stronger than panadeine forte. Then he gave me a script for Tramadol *facepalm*.
Will keep trying option 1.

I think option 2 warrants some research, just to find a specialist not fixated on the whole surgery idea.

Option 3 is starting to look very appealing.

Option 4 isn't very constructive, but, logically, it IS an option.

I was kinda hoping there was some kind of magical person in the health system that would just listen to me, not try and tell me I don't want what I say I want but want the other thing instead (which I don't really want) and then they would just write me a script. *sigh* I can dream...

 

[spacejunk]

painkillers can be very effective in treating chronic pain, but using strong opiates regularly also has a number of serious consequences for your health and general wellbeing. i understand you just want some relief, but i would suggest that there is probably good reason to look at all of your options before charging headfirst into what could potentially be a very difficult dependance.
it sucks that people who need pain relief aren't able to get it in the current political climate - and i don't know anything about your condition - but sometimes masking the problem can increase the pain you will face later on.

i don't think we can offer you any simple solutions, but i'm sure there are plenty of people on here who would urge caution with these drugs.
scoring on the street may seem appealing, but if your supply or funds get cut off - or your tolerance grows to unmanageable levels - you'll be right back where you started, probably a lot poorer and possibly experiencing withdrawal on top of the discomfort you are already suffering.

have you considered seeking a second opinion from a different GP?

 

[clear_sky]

I hear what you're saying, spacejunk

Research tells me that sciatica can get better in time. If it's not serious enough to warrant surgery, I'm hoping there's a chance it will fix itself. And until then any relief would be welcome. As I mentioned, I try to do as many physical things as possible (yoga, etc) to keep it at bay. But I can't be doing yoga every half an hour when I'm at work..

I did try to get a second opinion from a different GP (as I said above) and he just gave me more Tramadol.

I'm going to try and see another GP sometime soon, but I noticed they're a bit suss on you when you come in and see them for the first time and complain of serious pain. I'm pretty sure that second GP assumed straight away that I was doctor-shopping for painkillers. Whereas I actually have a legitimate reason. I mean, I just spent all night doing my freelance stuff - my back is killing me.

I don't want to turn this into a big whinge, but I just don't understand what other options I have besides going and getting second opinions until I maybe get lucky. And I don't even have the time to do that. I understand the doctors are just trying to protect themselves (against getting deregistered, or whatever it is they're so afraid of?) and myself (against addiction), it's not like they don't have a good reason - the number of people with opiate addictions, etc. I don't want to go down that path, just some relief would be nice once in a while, and I'll keep exercising and whatever. I'm telling them the truth and they're just so suspicious. I don't know.

Suddenly taking up pot seems like a good idea lol

 

[Divine Moments]

Research tells me that sciatica can get better in time. If it's not serious enough to warrant surgery, I'm hoping there's a chance it will fix itself.

You have a very good attitude :D That's very true, it usually resolves on its own - especially when it's relatively minor like yours. I think you have the right approach trying to avoid surgery, it should generally be a last resort. Obviously orthopaedic surgeons are going to push it since that's how they make their millions.

I'm going to try and see another GP sometime soon, but I noticed they're a bit suss on you when you come in and see them for the first time and complain of serious pain. I'm pretty sure that second GP assumed straight away that I was doctor-shopping for painkillers. Whereas I actually have a legitimate reason.

You said you had a CT scan - can you get a copy of the report or images to take with you to other doctors? That should help your case. You obviously understand their concerns very well; they really just want some evidence of an actual problem before handing out medication. Keep in mind evidence is poor for the use of medication in sciatica, which may limit prescribing to some degree, though your own previous experience should supersede that.

Suddenly taking up pot seems like a good idea lol

A completely valid option

 

[Busty St Clare]

Did you ever consider the fact that the doctor is actually doing you a favour by not prescribing an addictive drug? Opiate painkillers are not treating your condition, they are simply masking it. It's like going to a mechanic with a slow leak in your tyre, he pumps it up but says you need a new tyre. You drive off and come back the next day expecting him to pump the tyre again. Look around this website and you will see far more people trying to get out of an opiate addiction than wanting to maintain it.

You said your self it wasn't bad enough for surgery. If you are finding some relief with stretching and walking improves things then this is good. It means that it is possible to position your spine without pain. You are assuming the specialist just wants to operate without even seeeing them. Nothing worse than a google expert. He may even suggest corticoid injections. I would also consider seeing an chiropractor or an osteopath, I have had success with both. Like everything you need to find a good one. The other option is to consider changing your work or perhaps look at your seat. Saddle seats allow you to keep a straight spine and are really useful for a lot of people who need to sit long hours. Of course it all comes down to your individual case, it is impossible to diagnose over the internet.

 

[opi8]

I pretty much agree with busty (what!?), if you can't afford Lyrica, there's no way you could afford a street habit.

Getting instant relief from a pill initially sounds like the easiest solution. Unfortunately, at the present time, there are too many problems in our health system and society and this makes long term pain medication often unwise.

Firstly, it's extremely difficult to get prescribed adequate relief in the first place. If you do happen to find a doctor who is willing to listen to you, is compassionate enough to understand your condition AND treat you with enough medication, then you're already a lot luckier than most people suffering from chronic pain. Now, let's say for whatever reason you can no longer see this doctor. He's on holiday, moved, you've moved, he retires, whatever. You're going to be hard pressed to find another doctor like him, even with your prescribing history, new doctors hate prescribing pain medication.

Another important thing is the inevitable tolerance which develops when using any opiod based pain medicine. You need more and more for the same effect. Doctors are not very willing to up the dose, especially if you've been on the medication long-term and have hit a "ceiling" dose. Like, 10mg of oxy for a broken finger, 100mg for a broken leg, and hey, cancer seems to be limitless, but there is generally an amount you simply won't get prescribed, even if your medication is no longer working.

So, you've been on pain meds for a long time. You're now physically dependant, or in other words, you're addicted to opiods. This isn't like cigarettes, which are extremely hard to quit. This is extremey hard to quit, psychologically, but also immensely painful physically. It accentuate your initial reason for being on pain medication, adds a whole lot more and is extremely difficult to bare. This is inevitable.

At some point, you may find a good doctor. He may even prescribe you enough for adequate pain relief, then if you're extremely lucky, he may even increase your dose for the inevitable tolerance that develops. However, eventually it will all come unstuck and you'll be fucked. Either you'll turn to the street (financially unsustainable unless you're a mining magnate or a dealer and also making you one of the worst criminals our justice system deals with), go on opiate maintenance (handcuffs for life), rehab (fun fun with a very high relapse rate, go through the whole cycle again after weeks of agony) or kill yourself (maybe even in that order).

That is just my opinion (which is very opinionated and biased).

 

[Halif]

That was a good post, opi8. That's the sad truth of opiate addiction.

 

[clear_sky]

You said you had a CT scan - can you get a copy of the report or images to take with you to other doctors?

You know what, this is so weird - my GP hasn't even shown me the images from the scan. He told me what it shows - but hasn't actually given me the printouts to look at. Seeing as that's the way things are, I don't have high hopes of obtaining the images to take away in my hot little hands. I'm going to try though. And I'm also going to get him to send a request for scans that were done by the hospital after that car accident. It's a long shot, but maybe there's something there. If I'm going to pay money to see a specialist (I'm thinking an osteopath..), I may as well have as much info for them as possible.

Did you ever consider the fact that the doctor is actually doing you a favour by not prescribing an addictive drug? Opiate painkillers are not treating your condition, they are simply masking it. ...You said your self it wasn't bad enough for surgery. If you are finding some relief with stretching and walking improves things then this is good. It means that it is possible to position your spine without pain. You are assuming the specialist just wants to operate without even seeeing them. Nothing worse than a google expert. He may even suggest corticoid injections. I would also consider seeing an chiropractor or an osteopath, I have had success with both. Like everything you need to find a good one. The other option is to consider changing your work or perhaps look at your seat. Saddle seats allow you to keep a straight spine and are really useful for a lot of people who need to sit long hours. Of course it all comes down to your individual case, it is impossible to diagnose over the internet.

I do understand that opiates are very addictive. It just frustrates me that if he wasn't going to prescribe them, why give me one script with the words "try these for a couple of weeks, see how you go." And then what? It would've been nice to know there would be no further prescriptions just so I could save them for the times when it gets really bad.

I am currently in the process of doing research and possibly upgrading my private health cover so I can go see an osteopath. It's encouraging to hear that they helped you - do you mind me asking what kind of pain/injury you were seeing them about?

The reason I'm assuming they will want to operate is because my GP said they will try to advocate surgery. Maybe he is wrong, but he is a very experienced GP and tends to be right a lot of the time. I hope he is wrong on this one though. However, as I said - when I rang specialists to find out about fees and their SOPs, the receptionists kept mentioning surgery. I know I shouldn't listen to them but the specialist they're working for, however their words are an indication of what happens at the practice, wouldn't you say?

Aaaaah, too late to change my work - I'm good at what I do. Although at the moment I'm in a desk/customer service job, which requires me to stand up and walk around quite often. I'm really enjoying it because there is much less discomfort involved. Now I only get it at home - when studying or sleeping. I want to get one of those giant balls for a chair - do you think that would be any good? By saddle seat, do you mean one of those where you place your weight on your knees? I had one years ago and found it really uncomfortable - I kept feeling like I needed to lean my back on something. I think sleep is the biggest problem for me at the moment, because I get the pulling in my leg and start tossing and turning to get comfortable. That turns into massive RSL episodes and I wake up with horrible muscle weakness. If nothing else, it's incredibly demotivational first thing in the morning

Getting instant relief from a pill initially sounds like the easiest solution. Unfortunately, at the present time, there are too many problems in our health system and society and this makes long term pain medication often unwise.

I completely agree with all of the arguments against the opiates. And I'm going to try (in fact, doing so already) to find relief every other way because opiates are a dangerous substance. It is just. So. Frustrating. It's like "Oh look, there's this pill that will help you. See how awesomely it works? You like it, don't you? And now - I'm taking it away!". WHY do that!

However, I agree - he's most definitely doing me a favour by not giving me a chance to get hooked. I would've rather never known this drug existed, to be honest. Because now that I do - I really want some on the days when I'm hurting, spasming, getting weak muscles and generally feel like crap.

Well, thanks to you lot, and your encouraging and realistic logic, I have decided that I am not going to make this about getting an opiate prescription. Everybody that replied - you have officially made a difference, because if I didn't know about this forum, I wouldn't have discussed this with anyone. I would've likely ended up doctor-shopping for opiates or trying to get them on the street. Thank you for taking the time to dissuade me from pursuing a shitty path and encouraging me to look at other, healthier pain-management options.

Thanks, guys! I wish you all the best of health

 

[wazza]

That was a good post, opi8. That's the sad truth of opiate addiction.

From the various medical /injury forums and specialists I've seen since my injury in06,opiates for pain can actually be useful without addiction / withdrawal being inevitable. I was on 400-800mg oxys daily rising from initial dose of 20mg SRs for several months 4-5. He was doing the prescriptions without authorization and must've got told off as one day he told me oxys wouldn't be happening again from him and he was narky to me.

Besides my fucked shoulder pain no other symptoms /WDs occurred. Had some major invasive surgery soonish in my neck for the injury relation which resulted in getting back on oxys. Found my GPs locum was MUCH better so moved to seeing him.


Anyway, anecdotal posts from people in similar situations of big fuck off pain were / are on opiate doses that probably would blow the minds of some GPs here mention either surgery or natural healing stopped the pain, they went off the doses instant and many report no WDs. But I'd say that is IF it's literally for pain relief and not recreational. The body and mind probably react different with the drug use.


Anyway, I'm sleep dep, myself, my wife and daughter got rammed up the rear by a truck literally like http://www.primemovermag.com.au/uploads/trailer/articles/tm-november-fotm-boral1.jpg while we were waiting at traffic lights. Thought my 2.6 yr old daughter could be dead or injured from hearing BOOM when we got hit. My head is done in atm, no injuries to the family, car is rear end fucked and the dudes company doing my head in due to their due process with paper work. Got told to call them if I don't hear back within 2 weeks.

So I apologise if my post is gibberish, sleep dep and this crap doesn't make for a happy wazza. Even forgot about upcoming mothers day until my wife reminded me tonight we're supposed to visit our mothers. Lucky we kept the 'old car'. But fuck me dead1,I want to kill at the moment.

Wish the OP the best, sorry for the hijack. Fucken trucks running up your rear plays tricks on the mind. HA

 

[Busty St Clare]

My back/hips pain is from years of rugby and working as a dentist. I see a really good chiro but you might find an osteo is better. I have my spine adjusted weekly and also keep fit as well as stretching. I would also suggest you look into a musculoskeletal doctor rather than a orthopaedic surgeon. Once again everyone is different so surgery may be your only option but an orthopaedic surgeon by the nature of their job description are more knife orientated.

By saddle chair I mean something like this...

Several of my colleagues work with them but personally I find it squeezes my balls, and not in a good way. You might enjoy it

 

[chugs]

Tried option 1 - he had a little fit about getting deregistered if he prescribes anything stronger than panadeine forte. Then he gave me a script for Tramadol *facepalm*.

Mods you can edit this if you want but this is what I do/would do.

I would tell my doctor that I'm consuming far more then the recommended dose of panadiene. The doctor will say that's perfectly fine but you tehn explain that your doing this on a regular basis and that your worried about your liver.

If they suggest Tramadol advise that they doesn't provide an effective pain relief. Ask as a result if there are any other painkillers they can prescibe that don't not have a NSAI in the formula.

At this point the doctor will be forced to explain that he can prescribe purer codeine S8 (restricted though). The problem though is getting a regular prescription. Ask your GP about whether he prescribe refills. My said they couldn't prescribe two S8 at the sametime, so perhaps there are restrictions on how many refills they can prescribe on pure codeine.

Funny enough though I find that the effect of APAP with codeine somehow better then just eating purer codeine.

Re option 3 I would dare say that if your too cheap to see a specalist that opiates on the street are going to be way to expense. A gram is just under the average wage per week (see what I did there mods, no actual direct quote on prices). That's a lot of cash.

Like to get Oxy from SilkRoad its a fair bit of cash.

I dare say if you have a legit medical condition that you should just keep looking for a GP that is sympathetic. doesn't hurt to be sufferring as you see them so they can see the pain your in.

Anyway, I'm sleep dep, myself, my wife and daughter got rammed up the rear by a truck literally like http://www.primemovermag.com.au/uploads/trailer/articles/tm-november-fotm-boral1.jpg while we were waiting at traffic lights. Thought my 2.6 yr old daughter could be dead or injured from hearing BOOM when we got hit. My head is done in atm, no injuries to the family, car is rear end fucked and the dudes company doing my head in due to their due process with paper work. Got told to call them if I don't hear back within 2 weeks.

holy shit, that utterly fucked. lucky your daughter was fine. unbelievable that the truck just barreled into you at the lights. did you find out why?

 

[TBS4ME]

May I ask why you're trying to just deal with the pain rather than addressing the problem itself?

 

[someguyoz]

G'day clear_sky,


What you are going through sounds very similar to what I've experienced; I have had chronic pain since 2001 (L5/S1 herniation originally) and terrible sciatica - so bad I could not sit at all for 4 1/2 years. I washed up at RPA Pain Clinic around 2006 in a state of utter desperation having been to any/all doctors and specialists I could track down...thinking all this time that I was "injured" and that I still had sciatica. My folks had had to sell their car and buy a station wagon I could lie down in just so I could get further than walking distance from home. Which had been driving me even more crazy after a couple of years.

Thing I learned at the Clinic is - after about 3 months after an acute injury (like a herniation) that heals, but for a small subsection of the population the pain continues. The precise method by which this happens is not understood, but it is now recognised to be a malfunction between pain receptors in the spinal chord & the brain, ie neuropathic pain. I was never really given painkillers so suffered in silence for years, and have been told than for many CP sufferers painkillers don't really work - I am on as low a dose of Gabapentin as I can get away with. Many others at the clinic are on significant amounts of opiates including topping out on fentanyl and the docs really can't give them any more - not a good place to be.

My advice is to get on the list to be seen by a public hospital Pain Clinic asap (there may be a fair wait) they have all the multidisciplinary docs on hand to check you out thoroughly and ascertain if you need surgery, pain relief, cognitive therapy, meditation as it relates to pain relief etc. The sooner you get some answers and they sort out a comprehensive plan for you, the better.

Good luck mate.

 

[chugs]

um guys this is a thread from 4 years ago. OP hasn't been on BL for 4 years.

Re your comments SomeguyOz. holy cow, you get fentanyl for sciatica, that's insane. Fentanyl withdrawal scare me. I found a supplier on the darknet who was offering an analogue of fentanyl. Huge amount, which would last forever.

but when i read into the withdrawals, it was clear that unless you can afford in-patient care for 20-30 days then there is no way you're ever going to kick it

 

[zephyr]

I had a cortisone injection into my disc and it was covered by medicare. Also a script for lyrica and celebrex.

There is no need to get hooked on serious painkilkers for this condition and surgery is not needed unless extreme.

 

[hotgirls.jpg.exe]

Lyrica is a bloody lifesaver for neuropathic pain, I'd go mental without it.

Still sucks how difficult it is to get useful opiates prescribed even in times of genuine need. My neurologist has straight up said to me 'we have to be realistic about the fact that sometimes you're going to be in pain that we can't treat' err I think you mean, we can treat it we just don't want to. They were quite happy to keep prescribing me tramadol (lol) up until I developed a severe allergic reaction to it though.

ETA: They also tried to prescribe me Darvocet - I don't think so m8! Talk about harm reduction 8)

 

[consumer]

I have a fucked back and get Endone or Oxynorm from my GP when its acute but otherwise i just put up with it, do lots of walking and yoga and core exercises. Long term opiate prescriptions are not a good route to go down. I cant stand Tramadol. It's a horrible drug with so many contra indications. Non drug remedies are the go long term