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

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AE- I can't answer all of your questions unfortunately but I know this the subject of bupe and surgery was covered and this may have some relevance to your inquiry (hopefully).

http://suboxonetalkzone.com/?p=1115

This blog is written by a former anesthesiologist/fent addict who know is a psychiatrist and prescribed bupe.
 
i was wondering about lidocaine patches and if anyone (i think perhaps you do cane) has used them and how effective people have found them. Also could you tell me what kind of pain they work for. I'm really sorry if it has been covered but i couldn't find any mentions of peoples actual experiences of them and how they would rate them. Thanks in advance and also THANKS IN GENERAL to all people who participate in this thread which has become a great comfort to me. Not that i would ever wish pain on any of you but it really helps knowing there are people who understand the experiences i'm going through. Especially because when i was sent to a fibromyalgia group, some years back, at the hospital i was the youngest person there by 35 years and i was also the person who was the most afflicted out of the groug. It was actually really demoralizing and added to the severe depression i had at the time. The people here understand me so so much better.
 
^lidocaine patches (Lidoderm) work really well, at least for me. They are really expensive even with insurance and are hard to get prescribed. There are a few differant cases where you can get them covered if you have a certain illness. I went through the process awile ago. I'll try an find more info on them but they do work well.
 
I can get lidocaine solution in large quantities really cheaply from my local pharmacist. Maybe this is a bitof a stupid question, but i there any way it is possible to make a patch using this solution from the chemist?
 
I was recently diagnosed with polycystic kidney disease, similar. What kind of pain do you have? Is it daily pain? So far I've been lucky with pain and I'm only on a blood pressure med to keep my kidney safer. Apparently I'm also at an increased risk for aneurysms as well :\

I have varying levels of daily pain from my bladder and stomach problems, pain that varies with my menstrual cycle from the endometriosis, and then acute episodes of pain from my kidney and bladder problems. I was pain-free for a few months after laprascopic surgery, an anti-inflammatory diet, and a year on a bladder medication called Elmiron which tore up my stomach. So I stopped the Elmiron, was fine for a while, but then the daily bladder pain came back recently; now I'm back on it and the stomach problems are back too.

Aneurysms are scary; I'm sorry to hear about your diagnosis. Good luck keeping everything under control!

And I totally get everybody that's sick of being told they're too young for all these health problems and medications. I'm 22 and was first diagnosed with this crap at 19! Whenever I had to get tests done, the nurses used to do a double take at how many / how much medication I was on. I'd be like, I know I'm too young for all this, but what am I supposed to do? I definitely didn't choose it.

I went around the anti-depressant merry-go-round as well before doing opiates. I couldn't handle the mood swings; I think I am just very susceptible to that kind of stuff and while it dulled my pain for some time, that stuff made my life hell. The less medications I can manage on, the better I feel.
 
^lidocaine patches (Lidoderm) work really well, at least for me. They are really expensive even with insurance and are hard to get prescribed. There are a few differant cases where you can get them covered if you have a certain illness. I went through the process awile ago. I'll try an find more info on them but they do work well.

Thank you very much rainingdownoxy for your reply. Actually i live in england so you never pay more than £7.50 for each different med on your prescription. And i have a certificate to get free prescriptions anyway so cost is not an issue at all. What kind of pain are you using them for? Nerve pain? Muscular pain? Inflammatory pain? Does it only work for pain that's close to the surface if you see what i mean, like muscles just under the skin as opposed to deep muscle pain? I would massively appreciate some more details on the type of pain you find it effective for. Thanks. 2mp
 
Thank you very much rainingdownoxy for your reply. Actually i live in england so you never pay more than £7.50 for each different med on your prescription. And i have a certificate to get free prescriptions anyway so cost is not an issue at all. What kind of pain are you using them for? Nerve pain? Muscular pain? Inflammatory pain? Does it only work for pain that's close to the surface if you see what i mean, like muscles just under the skin as opposed to deep muscle pain? I would massively appreciate some more details on the type of pain you find it effective for. Thanks. 2mp

OIC;) they work for muscoskel and nerve pain. I used to cut them in half and where them on the back of my calves and the top of my feet. I have a lot of problems with pain in that part of my body due to many diff mechanical problems, no arches, flat feet and so on an on. But I used them also for back pain when I tore a muscle and they were fantastic. You can where them for about 6-8 hours before they start to loose their touch. But they are def worth it and hella worth it since you dont have to pay much for them. Im coming to live with you;)
 
thanks again rain.d.oxy. I'm definately going to talk to my doctor about these things. The only thing is i've just remembered i had a skin reaction to nicotine patches and fentanyl patches. But these may be ok so are definately work a try. Don't they just make your skin numb though? How do they get deep into your muscles?
 
2mp- lidocaine patches are amazing in my book! I use them for nerve pain and its like putting a room temperature ice pack on that's twice as strong. I have used them for many kinds of pain... Burns, sun burns, my neuropathy of course, sore back, etc.

They may work for your muscle pain but they may not. If the muscle pain is inflammation based you should hit that shit with skeletal MR's or benzos and maybe add the patches.

I can't speak to how deep they go but my nerve pain is pretty fuckin deep and they damn near stop it completely in certain parts.

Any more lidoderm/lidocaine patch questions?

Not that it is relavent to you and your commie medicine ;) but my 2 boxes of 30 would cost $550 where I'm at
 
I can't remember what it was called, but I thought there was supposed to be some prescription type of cream that was supposed to help with nerve pain. I don't even remember the active ingredient anymore. I never tried it (to be honest I wouldn't think it would work - but then again, I also thought that the Lyrica wouldn't help at all either).

As for the lidocaine patches I've never had them though I believe my grandmother did once. It is supposed to be absorbed fairly deeply as far as the numbing affect is concerned, though I have no idea how it works in and of itself. If you've had a skin reaction to the other patches you probably will be out of luck though as it is probably the adhesive that you're reacting to. If the creme does exist (and I didn't just make it up in my own little world) then you could ask your doctor about that. Sorry I don't have even a name for it.
 
http://www.myalgia.com/treatment/addiction def.htm

This is a link to something i found through the uk fibromyalgia association recommending the site, it's useful for ANY pain management patient who wants to discuss opiate medication with their doctor, not just FM patients. But for anyone who has fibromyalgia i recommend looking around the whole site.

I'm re-posting this as it seems the link didn't work properly last time and i really think will be very useful for people on or considering going on to opiate medication. Also i told another pain management patient to post here with questions rather than a separate thread as people such as cane check here regularily to answer questions where they can. I also said that i would post this link for them where they can find it easily (I can't link to another post from my mobile phone easily so i just copied). Sorry for the link failure last time, it's hard to work this site from my phone.
 
thank you very very much kovus and cane! I have a cream that numbs but it doesn't go very deep. I do use it on my shoulders though as they are just sore from being so tense (referred pain) as my lower back is very very painful and makes my shoulder muscles very tight, but they are not a part of me from which pain radiates. My lower left side of my back is my main pain site from which the pain radiates. The tension has caused trapped neck and shoulder nerves in the past and makes my upper back tense up. Also, my muscles in my left leg especially, but both legs to an extent, are so tense it's like i have cramp in my upper leg and thigh all the time. Touching it you can feel the muscles rock hard and lumpy like i have elastic bands wrapped round my leg there. On the most recent course of physio i've been on the physiotherapist said the that my left leg is the worst case of muscle tension in a leg she has ever seen (and she's been doing this job for a long time). She was completely unable to help me though. I have been through eight unsuccessful courses of physio now, but they only do hands off physio with no manipulation. So that has involved doing various stretching exercies they gave me each time exactly as instructed with hardly any relief. In fact because their lack of knowledge of fibromyalgia they have often given me many exercises which made me worse! So the tense upper leg muscles on both sides but mainly the left have caused knee problems as the muscles on the front are pulling my knee caps upwards and making them weak and prone to injury. Also my left hip has some kind of inflammation or something so that it hurts very deep inside but also so sore that just touching the skin with the softest stroke i can do is highly painful. I also get nerve pain down my legs and into my feet. Only very recently i think i have developed restless leg syndrome but i'm not sure if it is. It's like a twitching in my leg like little electric shocks and the constant need to stretch my leg out. So basically my whole left hand side is in agony and the right side hurts too just less! Now i thought of asking my doctor for a muscle relaxant but do you think that would help in my situation? My doctor doesn't want to prescribe more different types of medication but she can't just leave me like this. I've done everything i can do like i pay myself privately for osteopathy and i swim and use the hydrotherapy pools and have seen a top dietician and changed my diet and quit smoking and do relaxation so after all this effort on my behalf to reduce my symptoms i feel that what symptoms i still have the doctor should be doing her part and treating.
 
I saw this thread and i decided i needed to post here..

i am 19 years old and i am diagnosed with Polyneuropathy. I have very severe pain starting in my ankles, to my knees, to my pelvis and up to my lower back. I am currently on Duragesic 50mcg along with Lyrica 200mg once a day, and cymbalta 60mg once a day for pain. I am also in Physical Therapy 2 times a week.

I am having terrible nausea with Duragesic, i lost 13Lbs in the last month due to throwing up everyday, sometimes even multiple times. I am prescribed promethazine for the nausea, but it doesnt always work, and sometimes I am not able to take it fast enough before i start puking. I have lost a total of 40Lbs in the past few months.

It has been very difficult for me to get help with the pain at times since I am so young. I go to a Neurologist for the pain meds (and he does my normal treatment for the PN). His clinic doesn't do narcotics, and I am the only one in the entire clinic on narcotics. I keep asking to be switched off of Duragesic to something else, cause i cannot stand this nausea. My doctor will NOT change me, hell i even asked for vicodin! (even though vicodin would not work for my pain, i asked for the hell of it). I have tried everything and he said that its either Duragesic or nothing. Im not sure what to do! He has seen all the weight i have lost, I am nothing but skin and bones and i eat maybe ONE tiny meal every 2 days. The Duragesic makes it to where i can walk, but without it I am in a wheelchair.

I am currently trying to get into a pain clinic, i have a referral out to one but i dont have an appointment set up (and it will takes months before i can even be able to MAKE an appointment).

Is there anything i can say to get off the Duragesic and on to something else for pain? i cant take this not eating and throwing up bullshit because of it, and i think it is somewhat cruel to keep me on it when i am getting these horrible side effects. I just dont know what to do right now..I feel like i am being treate so differently since i am young, but i do have test results and everything proving my condition!

Other meds i have been on for pain have been Roxicodone 15 & 30, percocet 5 & 10, and OxyContin 20-40mg. But those were from a different doctor.
 
Thats really fucking terrible dude ^^^^^^

I would just try as HARD as i could to get into a pain manangement clinic, call around, ask for all the help you can get. Tell them your situation, and about the doctor you have now and all your history.

Thats all you could really do, just try to talk to as many people as possible, and book an appointment asap. I know how you feel about weight, my dad lost 60 pounds last year, because years of tons of oxycontin are starting to get to him, and even with smoking weed, he has troubles eating.
 
xyther did you read the info from the page i've posted a link to a few posts above yours. It has some good info on misconceptions about using opiate pain medication. I'm going to try and find some info on your legal rights with regards to this also, as i think the way you are being treated is abhorrent. If you ever need to talk to someone or just vent some anger at your mistreatment then please pm me anytime.

Edit-Can you tell me whereabouts you live please?
 
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xyther did you read the info from the page i've posted a link to a few posts above yours. It has some good info on misconceptions about using opiate pain medication. I'm going to try and find some info on your legal rights with regards to this also, as i think the way you are being treated is abhorrent. If you ever need to talk to someone or just vent some anger at your mistreatment then please pm me anytime.

Edit-Can you tell me whereabouts you live please?

I didnt read the links you posted, but i will do that here in a few. I live in very very north Virginia. I am working on pain clinics, but its gonna be a few months. I am tired of sick of single day from the Duragesic, but my doctor told me today that its either Duragesic or nothing.. Im not sure if im being treated wrong, but my doctor KNOWS and acknowledges that its the side effects from the Duragesic. And thanks 2muchpain, i might take you up on the venting offer sometimes, cause i got a lot of anger built up from this issue
 
xyther: Why will it take so long to make an appointment? I know that often it takes a long time to get in because places are booked, but you should be able to at least setup the initial appointment.

It seems your doc is providing the patch simply because they feel it has the least abuse potential. I couldn't stand fentanyl myself either. I never threw up on it, but I certainly felt nauseated.

How long have you been on the patch? Is it possible you are just adjusting to it? Usually affects like nausea will go away after a week or two. Everyone is different of course.

If it is going to take so long be seen at a pain clinic is it possible to see the other doctor you mentioned or even another "normal" clinic? You'd have to explain an awful lot considering your getting the patches from the current doctor, but as long as you aren't getting new scripts from both there shouldn't be a problem.

2mp: You can try a muscle relaxant of course, but there is not telling how well it will work for you. Most have done nothing at all for me except a few which simply made me fall asleep. If you've never been on them before here is what I've thought of a few of them:

Skelaxin: I believe one of the weaker ones it didn't do anything....at all... for me.
Flexeril: This would help, but at the dose that helped, I also was useless because I was so out of it
Baclefen: Never really noticed much from this one and I read somewhere that it may decrease the affects of some pain medications. I'm not sure if that is true or not.
Soma: Always here a lot of good things about this one (though usually about it's abuse). I wasn't on this one too long, but I think it worked alright.

I'd go ahead and ask your doctor about it and give one a try. You may get good results from them and the odds are they won't hurt you any.
 
I am on Adderall for ADHD and am prescribed Lortab 10s (90/month). The Lortab usually doesn't make me drowsy but has the opposite effect. The rare times it does make me sleepy, the Adderall reverses it. My hubby is a doc and often chronic pain patients are prescribed a stimulant such as Adderall or Provigil (modafinil) to offset any drowsiness so they can function.

I have no fluid between the 4th, 5th, and 6th vertebrae, at least 2 discs in my neck lying on top of each other and 2 others affected as well, spinal stenosis (narrowing of the spinal canal), pinched nerves which cause numbness, tingling, and sometimes a "burning" sensation/neropathy going down both arms and into my hands and fingers, Carpel Tunnel syndrome in BOTH wrists, and epicondilitis (tendonitis in BOTH elbows). the Degenerative disc Disease was caused by a personal trainer I was paying to train me about 15 years ago. It was a popular gym franchise and I thought the guy was certified but he was NOT. He had me doing 2 hour workouts, lifting heavy weights, overtraining, although I am 5 feet tall and weigh 90 pounds, on a good day. I had a shoulder injury and he said he was just a strain so i ignored it and didn't go to the doctor.

Fast forward 6 years where I went back to college for 4 years, carrying a real heavy bookbag across my shoulders. At the end of the 4 years I began to notice a numbness (reminiscent of when I had the Shingles) in my shoulders whenever I leaned back against a chair. That's when I went to the bone doc and he discovered I had an old injury.

Those of you having major drowsiness with their pain meds might mention that some docs DO prescribe stimulants to counteract thie effect from pain meds. I wake up several times a night with my hands "buzzing/tingling" like I was holding on to an electric fence. I wear braces for the Carpel Tunnell to keep from bending my wrists in my sleep but I have to make a conscious effort NOT to turn onto either side in order to try and prevent the pinched nerves from acting up.

Like some of you, I also get nothing but pain relief from pain meds, and on bad days I have taken up to 6 Lortabs, 2 at the time. Most days I try and keep it between 2-4. If I miss a day or two, my stomach acts up (runs off) but other than that, I haven't had any problems. I've been on the same dose since starting them in 2004. I can't usually take N-Saids(anti-inflammatories) because they hurt my stomach but the doc did give me Mobic. Flexeril knocks me out so I ONLY take it as a LAST resort. Muscle spasms can be quite painful, as YOU ALL know!

Do any of you here with pinched nerves find that they get worse when using your hands? All I have to do is grip my steering wheel when I drive and whichever hand I'm using goes numb. Gripping a paintbrush or roller (I'm a painter, among other things) also sets it off in both hands.There's no way I could function taking Lyrica. I understand that Fibro also has a neuropathy similar or worse than pinched nerves. My husband didn't treat many with fibro but referred them to specialists.

Xyther-GET a DIFFERENT doc ASAP! He CANNOT keep you on the duragesic, especially when you have even asked to be put on weaker meds just to avoid side-effects! Here's what you do, (I've worked in a doctor's office and been around medicine for over 20 years, besides being married to a doc): You tell that doc to give you a copy of your medical records and tell him that your lawyer/legal counsel has advised you that it is medical negligence to put a patient on medication that causes them to lose so much weight that their health is endangered further from malnutrition, among other things. Even CANCER patients have meds for nausea caused from chemotherapy! If all else fails, call the medical board hotline in your state and report him! Tell them that he keeps trying to keep you on a patch that makes you so sick you want to die, suffering horrible side effects, and how much weight you've lost and that you've asked him for something not as strong. THAT will get their attention AND if you're REALLY pissed, tell them that there are also other patients that he keeps pushing to put on that patch. Ordinarily, I wouldn't be telling ANYBODY to do this to a doctor BUT this one sounds like he deserves it!!! Obviously you are NOT some dope head looking for strong shit to get high and the fact that you DON'T want the patch proves it, given the amount of people who abuse THOSE. Usually, some docs are hesitant to put peeps on the patch, NOT trying to force them on it! Maybe he's getting a kick-back from the pharmaceutical reps or company for every prescription he writes for it........believe me, it happens.

I hope you find another doc that will treat you right.
 
xyther: Why will it take so long to make an appointment? I know that often it takes a long time to get in because places are booked, but you should be able to at least setup the initial appointment.

It seems your doc is providing the patch simply because they feel it has the least abuse potential. I couldn't stand fentanyl myself either. I never threw up on it, but I certainly felt nauseated.

How long have you been on the patch? Is it possible you are just adjusting to it? Usually affects like nausea will go away after a week or two. Everyone is different of course.

If it is going to take so long be seen at a pain clinic is it possible to see the other doctor you mentioned or even another "normal" clinic? You'd have to explain an awful lot considering your getting the patches from the current doctor, but as long as you aren't getting new scripts from both there shouldn't be a problem.

Well i just got referred to one the other day, so the doctor is basically still doing the paperwork needed to get into there for me.

i have been on the patch for about..4 or 5 months now too. I'm pretty sure my body is used to having it, i also have a huge tolerance so i know that is not the problem.. I am not sure why it makes me so sick though. No other pain medicine has ever done that to me.

I can't go back to the doctor that was prescribing the other meds, he was my PCP and he didn't feel that he was competent to deal with chronic pain, so he kept doing the pain meds until i found somebody else to come take his place.

I have considered going to another place, but my schedule is so packed with other dr appointments and physical therapy and other stuff, i dont really have time to look into going to a normal place for a while.. Plus, it seems that not many doctors are willing to prescribe narcotics where i live, and to just come in and see a doctor for, say, 3 months might raise up a red flag just because im so young
 
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