^I agree. Oxymorphone/Opana has blown up in recent years and is some of the most commonly used medications in pain management. It seems a lot of PM doctors switched patients to or started using this when oxycontin got so much heat with the lawsuit and all.
EVERY opioid that agonizes the Mu receptors in the brain produces analgesia, that is indisputable. Maybe for you, Unknown, it was unsatisfactory but it does produce analgesia.
I see heroin users saying codeine and tramadol have no effect for them but that is due to their tolerance, its not that those drugs don't produce analgesia.
Its just silly to say an OPIOID ANALGESIC doesn't produce analgesia!
For various reasons it seems very possible to me that opiods will vary in their analgesic efficacy from person to person, setting aside tolerance of course. No analgesia at all seems unlikely, but dramatically less than usual, or a naturally extremely high tolerance to a specific drug - sure. And this seems to occur pretty frequently, too.
For example, I have always responded very poorly to tramadol (I don't even consider this really an opioid, but for the sake of completeness), oxycodone, and fentanyl. All of them are much less analgesic for me than they 'should' be, with intolerable side effects. Supposedly oxycodone is at least as potent if not more so relative to hydrocodone, but I find the latter VASTLY superior for analgesia.
I have a severe case of scoliosis which mostly results in a lot of muscular pain/tension (including spasming) that is unresponsive in the long term to non-drug treatments. So things like stretching, massage/bodywork, chiropractic, heat, etc help but only during the actual process and if I'm lucky for a couple hours afterward. I am doing quite a bit of yoga now but every other day or more for a couple months and I am still not seeing any relief - if anything, it makes my pain worse.
![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")
The best treatment I have found is valium, which reduces my pain more dramatically than any opioid. I also have severe insomnia, partly due to pain partly unexplained and of course it's wonderful for that. Klonopin helps a bit but I find it amnesiac which I dislike. Some of the other benzos are useful for me for sleep (triazalom, xanax, temazepam, oxazepam, nitrazepam) or anxiety (lorazepam, not sedating for me at any reasonable dose) but these don't help my pain at all.
I've tried all the non-benzo muscle relaxants and none of them are useful for me. I had an extremely mild effect from baclofen, likewise from soma. Flexeril doesn't relax my muscles at all; it used to knock me completely out for 14+ hours but now it doesn't even touch my insomnia. Zanaflex is mildly useful (for both relaxation and sleep) but tends to give me nasty headaches. Skelaxin does nothing that I can tell at all. TENS units do nothing at all.
Opioids vary in how much they help my back pain, but none of them reduce my pain as much as valium usually does. I am still in pain, but I feel distracted and separated from it - classic opiate mechanism. Morphine was somewhat effective until I developed hyperalgesia, which unfortunately happened in a matter of months. While it still worked I mostly alternated between morphine, valium and nothing to prevent dependence and tolerance, though I was up to 20-60 mg of valium.
I have been out of valium for nearly 6 months now (the supply I had was loose powder I inherited) and my pain has been crippling since then. Even when I had it because of my rotation schedule I spent much of my time in excessive pain anyway. At this point, as soon as I can afford it I will pursue being on valium constantly because as much as benzo dependence terrifies me, I would rather be dependent than be in pain so much. I didn't realise until I ran out how much of a miracle valium was!
Heroin works the best of all opioids for my pain, but is obviously not available by prescription - I think used occasionally in addition to constant valium use I would probably be able to keep my pain at manageable level. After reading this thread I'm interested in trying methadone for my pain; I've also long been interested in hydromorphone and demerol.
I hate oxycodone and fentanyl so these are NOT options (my prior PM doc wanted me on oxycontin but agreed to morphine when I complained). I am scared of oxymorphone since it's an oxycodone metabolite but I realise it's a rather minor one, so I'd give it a try. I'd also really like to try lidocaine patches and the shots (which must be steroid?), although the expense of these may not make them very feasible for me.
Eeek, that was long. I haven't seen much discussion of muscular tension and its treatment so I figured I'd chime in with my experience. I found this thread both depressing and mesmerising to read through; regardless it is nice not to feel so alone. Both chronic insomnia and pain are, IMO, completely inexplicable to those who haven't experienced them and it can be VERY frustrating being surrounded by a pointed lack of sympathy.
