Harm Reduction The Pain Management Mega Thread - for all your questions on dealing with chronic pain

[Rexeh]

^They offered me an injection similar to yours, I am not sure about what they use but it was also epidural. They wanted to inject some sort of pain killer/blocker between my vertebrae (I have Scheuermann's kyphosis which damaged 5 of them) but I chickened out since I was too afraid about having an injection so close to my CNS. Also my needle phobia is a big problem, "butterfly" needles I can handle, but a needle in my spine would freak me out as well so you're not alone if that helps you.

I'm not sure if they would give you something to relax if you say you have a needle phobia but I think they would apply a local anasthetic (sp?) first when giving you the injection.

It seems to be the first treatment used by many pain management doctors here though and some people have told me that it actually works very well but only for a limited time IIRC.

Good luck with your injection and let me know if it works, I might try it as well then since it beats taking painkillers every day to be honest. I don't know anything about Methadone so I can't help you with that even though I would like to... in which form does your Methadone come in? I know that there are wafers, pills and syrup but other than that I know nothing about it except a few things I've gathered on this forum.

Peace o/

 

[Cane2theLeft]

thanks cane. I'm a chronic pain patient and often have questions. I'm thinking actually of changing the gabapentin (neurontin) i take for pregablin (lyrica) for my fibromyalgia. Does anyone know if this is a good idea? I've read lots of threads about how to get high off them but not too much from people who use them for pain relief. If i'm missing the place where this info already is then please no shouting! I can currently only use bl on my mobile phone so it's very hard to search, and i have but may have missed something.

I have gone through my medical history probably half a dozen times in this post and to just highlight one part- when my nerve pain first started to REALLY get out of control, I was going to the ER on average every 10 days curled in a ball in the most severe pain I've felt. In 2-3 months I went from ~15mg of hydrocodone a day to 60-80mg and the frequency of my ER trips was getting out of control. Then I was put on neurontin.

Neurontin (gabapentin) was a fucking godsend! My nerve pain was so much more manageable, I was taking far less of other medications (and smoking less pot for the pain) and I felt a lot better. The only real problem was I was too sedated all the time. I was passing out in class and always felt "medicated" so I was switched to Lyrica (pregabalin). I went from I think 1200mg of gabapentin to 225mg of lyrica (75mg TID) and it was wonderful. Gabapentin takes 2-3 weeks on average to start working and Lyrica is 1, sometimes less.

For me, after 3 years of medicating my pain, Lyrica remains THE cornerstone of my pharmacological pain regimen. If I stop the lyrica, I can barely walk and for 300mg/day of Lyrica (my current dose) I would need to at least triple my opiates and it still won't be as effective.

ps. i am having an epidural cortisone injection on thursday for one of my herniated disc.....anyone else had experience with these injections? i'm am extremely frightened of it. i cancelled my last appt for fear of a needle in my spine......

A

Rexeh is spot on saying this is the first treatment a lot of pain specialists reach for... which can be good and can be shitty. It makes sense that most doctors prefer to start at the benign treatments like physical therapy and progress throughout options up to surgery and steroid injections are usually one of the first options when oral steroids, PT and other very benign treatments are ineffectual.

Epidural Steroid Injection's (ESI's) only really help people's pain ~50% of the time, this could be because doctors are not very discriminating and give them out TOO frequently or maybe they are just unreliable. I was ordered to have 3 of these in 3 consecutive months by an orthopedic surgeon and 1 month after they didn't help at all, a neurosurgeon told me it was a horrible decision to give me ESI's without figuring out the EXACT cause of my pain first. If your pain has been adequately diagnosed as discogenic than ESI's are not a bad choice.

They are also a lot scarier in name then in practice. They DO use a very effective local anesthetic like lidocaine and you barely feel it at all.

If you have any further questions please feel free to ask.
______________________________

AS ALWAYS if you have any questions you'd like to discuss privately, please anyone feel free to IM/PM/Email me ANY time!

Take care

 

[Cane2theLeft]

Alicat- Its really great to hear from you however I wish the circumstances weren't so grim. I'm really sorry that you are seemingly playing whac-a-mole with medical symptoms... smack one down and another pops up.

Have you asked for a prescription antiemetic to help in the meantime with the methadone-nausea? Ondansetron (zofran), Prochlorperazine (compazine) other dopamine antagonists like metoclopramide or even dronabinol (marinol) or marijuana may be options that are helpful that you can ask your doctor about (I probably wouldn't ask about marinol/pot).

Nausea from pain medication does usually subside when you build up a tolerance to the side effects (usually between a couple days and a couple weeks). You should be able to find a medicine to take away the nausea and if its that problematic, maybe you discuss other pain management options.

Again, its really great to see SOME things are going well for you, I just really wish the rest would fall into line!

take care and much love!

 

[sweetbeatlvr]

2muchpain...i was tried on Lyrica for Fibromyalgia, and for me, it did not work. it in fact, gave me more muscle pain in my legs. i do not suffer from nerve pain, per say, besides some numbness and tingling which i believe is from the svever muscle tension, pinching nerves. some people w/ FM have had great relief from it, so it may be worth a try.

i have a question for those that suffer from muscle tension... i have been through a long list of muscle relaxers: flexeril, robaxin, zanaflex, soma (maybe more, just can't remember), and none have provided me with any significant relief. the muscle tension and spasms drive me crazy.

has anyone here used Valium (or something similar), with any benefit for muscle tension, with good results?

i went to the ER a couple months ago for bad spasms, and they administered a shot of valium w/ 10mg oral hydrocodone (i normally take 7.5mg), and it completely relaxed my body, it was wonderful.

i'm going to my doctor in a couple hours and want to suggest this with her,to se if we can try it. just wanted to see if anyone could offer any info on the subject.

glad to see this thread alive again.

 

[Cane2theLeft]

Like you, sweetbeat, I had problems with persistent muscle spasm and went through all the common skeletal muscle relaxants you listed (and again, probably more). I was given ativan IV for one acute episode in the ER also and so I talked to my PCP at the time about it. I have been Rx-ed valium (briefly) and ativan/lorazepam (for 5-6 months) for muscle spasm and both were far more effective than flexiril, zanaflex, robaxin and only soma was comparable however tolerance rose too rapidly. The biggest drawback for me was that they did produced more pronounced sedation. I have also used xanax and klonopin but I found more relief with ativan and valium.

I'd say if nothing else, its worth a try. You deserve relief and there is no reason that valium or other benzos should be excluded without trying them. Good luck and take care!

 

[TheDankaholic]

Yeah and a lot of people tend to think the slightest amount of pain means they require a vast amount of narcotics at their disposal to relieve "their "pain".

and the others seem to think that managing that pain means they need to be high all day .

these are the two groups you definatly dont want to be in . especially if you have any interests in actually "managing" your pain .. listen to the above poster and seriously think long and hard about other alternative therapies before insisting on narcotics .. especially if abusing them was your thing less than a few years ago .

Very true words, and once you are in enough pain to require being that medicated don't think it's ANYTHING recreational. I wear 50 mcg or 100 mcg fentanyl patches depending on how severe things are at the moment and im scripted 100 4mg Dilaudid pills a month for breakthrough pain along with 10 mg percocets. I don't get high off my meds at all. Mainly I manage my pain and fight not to go into withdraws from missing doses. Not fun or "recreational" at all. I don't misuse my pathes at all though, i simply wear them so I never come up short on them.

 

[LightTrailz]

Cane2 is right about the nausea , however i can tell you personally that some days , even after a year or more that some mornings and even some evenings , if i eat one thing or even take a sip of a drink at the wrong time , i will feel like im going to blow astronomical chunks into hyper space at any second.

But for the most part its usually pretty tame , i mostly get my ass kicked by the drowsiness especially if i dont get much sleep the previous evening ..

 

[2muchpain]

i knew a resurrection of this thread would be widely appreciated. Thanks to everyone who has showed an interest and replied, i really really appreciate it 'cause i'm in a bad way pain wise at the moment. I think, since the gabapentin has definately has some results and especially after cane's comments i'm going to ask to switch to lyrica asap. I'm really pleased to hear it worked faster for you cane as the gabapentin took about six weeks to fully work for me.

 

[sweetbeatlvr]

Like you, sweetbeat, I had problems with persistent muscle spasm and went through all the common skeletal muscle relaxants you listed (and again, probably more). I was given ativan IV for one acute episode in the ER also and so I talked to my PCP at the time about it. I have been Rx-ed valium (briefly) and ativan/lorazepam (for 5-6 months) for muscle spasm and both were far more effective than flexiril, zanaflex, robaxin and only soma was comparable however tolerance rose too rapidly. The biggest drawback for me was that they did produced more pronounced sedation. I have also used xanax and klonopin but I found more relief with ativan and valium.

I'd say if nothing else, its worth a try. You deserve relief and there is no reason that valium or other benzos should be excluded without trying them. Good luck and take care!

thanks for the reply cane.

well, i went to the doctor, and explained that my muscle pain was not being relieved w/ flexeril. i asked if i could try Valium, and she agreed, letting me try the 5mg 3x/day.

i took my first dose when i got home, and ahhh, relief! it's not totally gone, but i wasn't expecting a miracle. i will take any relief i can get though.=)

 

[billywitchdoc.com]

so i just tried to fill my roxicodones, and they are on a nation-wide 2month back order supposedly, im sure there are some that have back stock. I have been on them for a few years now, and just got my script for hydromorphone 4mg filled. I was wondering if anyone else is on them curious how they stack up to the roxis. I know the ba for them so i am getting the most bang for my buck w/ a needle. Im in FL went to 8 pharms that had no roxis and got this sub, i feel good now but i want other opinions is anyone gots em.

 

[alicat72]

Alicat- Its really great to hear from you however I wish the circumstances weren't so grim. I'm really sorry that you are seemingly playing whac-a-mole with medical symptoms... smack one down and another pops up.

Have you asked for a prescription antiemetic to help in the meantime with the methadone-nausea? Ondansetron (zofran), Prochlorperazine (compazine) other dopamine antagonists like metoclopramide or even dronabinol (marinol) or marijuana may be options that are helpful that you can ask your doctor about (I probably wouldn't ask about marinol/pot).

Nausea from pain medication does usually subside when you build up a tolerance to the side effects (usually between a couple days and a couple weeks). You should be able to find a medicine to take away the nausea and if its that problematic, maybe you discuss other pain management options.

Again, its really great to see SOME things are going well for you, I just really wish the rest would fall into line!

take care and much love!

thanks cane.

i have not asked for anything. the hand out that comes with my methadone says you can take antihistamines for the nasea. i have told my pain doc about it especially when i was taking pepto bismol for the nausea and it made the constipation worse. they just gave me a script for miralax to ease the latter problem.

it just seems to me that after 2 months the nausea should go away. i will make note of the ones you mentioned and ask at my next appt.

i think things will fall in line eventually. i didn't expect that i would have so many other problems once i was able to actually see the pain management doc.

thanks again
A

 

[2muchpain]

so i just got back from the doctors and they have upped my gabapentin again instead of lyrica because i'm coming off antidepressents (sp?) at the moment and they want me to know what's going on and what's effecting me how if you know what i mean. But they are going to change me to lyrica soon. They have also upped my dihydrocodeine to 3 four times a day which is way over the usual maximum dose just because in england they would rather do that than prescribe a lower dose of something stronger. Which doesn't make sense to me but all i care about now is not being in so much pain so i'll cross my fingers that this helps.

 

[alicat72]

2muchpain- glad to hear that at least your doctors are listening to your request and adressing your needs. i too have fibro and take gabapentin. my insurance won't cover lyrica so i've never tried it but i love my gabapentin. it not only helps some of my pain, it makes me feel less stressed out.

i have my epidural injection here in about 2 hours and i'm really trying not to be nervous wish my luck guys!

 

[2muchpain]

2muchpain- glad to hear that at least your doctors are listening to your request and adressing your needs. i too have fibro and take gabapentin. my insurance won't cover lyrica so i've never tried it but i love my gabapentin. it not only helps some of my pain, it makes me feel less stressed out.

i have my epidural injection here in about 2 hours and i'm really trying not to be nervous wish my luck guys!

Thanks! And GOOD LUCK! oh and let us know how it goes please.

 

[LightTrailz]

Very true words, and once you are in enough pain to require being that medicated don't think it's ANYTHING recreational. I wear 50 mcg or 100 mcg fentanyl patches depending on how severe things are at the moment and im scripted 100 4mg Dilaudid pills a month for breakthrough pain along with 10 mg percocets. I don't get high off my meds at all. Mainly I manage my pain and fight not to go into withdraws from missing doses. Not fun or "recreational" at all. I don't misuse my pathes at all though, i simply wear them so I never come up short on them.

Thats another thing i love , Even if i happen to miss my dose , sometimes ive slept for hours i think the one time i missed a dose by something like 16 hours and i still did not have withdrawl . Im on roughly 120mg of oxycodone a day and even on a good day i can cut that in half and be comfortable , i dont take that extra bit just because i can , which is unbelieveable .. and is wonderful when i know its going to be a few days before i can afford to refill my prescriptions.. and even after all this time its been a year and 3 months im still sitting here noddin off on just 40mg taken about 2 and half hours ago..

i dont know why so many people buy into this tolerance bullshit . If i can do this , then obviously tolerance can be controlled .

 

[Cane2theLeft]

2muchpain- glad to hear that at least your doctors are listening to your request and adressing your needs. i too have fibro and take gabapentin. my insurance won't cover lyrica so i've never tried it but i love my gabapentin. it not only helps some of my pain, it makes me feel less stressed out.

i have my epidural injection here in about 2 hours and i'm really trying not to be nervous wish my luck guys!

Thanks! And GOOD LUCK! oh and let us know how it goes please.

Agreed- Ali, I would really like to hear how it went... both how it was for you today and in the next few days-week if you get some relief! I hope it helped.

 

[mmmCHRISx]

Im glad we finally put your knowledge to good use here cane

 

[Cane2theLeft]

me too, Chris... and its all made possible by your generous contribution to the cause

 

[2muchpain]

i was just telling my dad today how much comfort and support i have gained from this site and fellow pain management patients. And just having people there (not nec pain man.) to stop me going crazy when i'm in agony and can't sleep.

 

[betsym]

dhcdavid, you can get Modafinil online with no prescription....