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Misc The Pain Management Mega Thread version 3.0

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Doomed2pain said:
i'd try gabapentin or pregabalin for the nerve pain, or even amitriptyline, also an anti imflammatory like naproxen would help. i was severely injured in a rta 3 years ago too and i have suffered dearly because of it, im on strong medication but the lowest i get on the pain scale is an 8, most days im at a 9 and in complete agony, all day, every day. i would try anything other than opiates first as that is a road you do not want to go down if you can help it. a muslce relaxant like baclofen would be good for the muscle seizures too, i get them and they are horrendous. hope this helps Pagey
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Thanks a lot, very helpful :) sorry you're in so much pain, that sounds horrible...I hope it'll get better!
(Did not know those were called muscle seizures, I'm glad I'll finally be able to describe them)
 
Everyone is different-How many times have you heard that? When I was first prescribed methadone for pain I had no idea of its analgesic properties. I thought it was something used to get people off IV drugs. I didn't realize how potent it was until I stopped taking it. It doesn't provide any noticeable rush or signal that it is kicking in like oxy. That’s the thing about methadone. You might notice some kind of a comfortable buzz once you start taking it but the feeling wears off as it builds in your system (In my case anyway). You cannot feel it once you are on a stable dose but I found it to be incredibly potent as a baseline pain med at around 20-30mgs/day. I can say that my baseline pain went from a 7-4 while using methadone daily.

That said, it is not a breakthrough med like oxy. If you get an acute flare up and pop 5 or 10mgs of methadone it isn't going to do much to alleviate the pain like a breakthrough, fast acting opioid will. Please understand that taking more of it because you don’t notice a rush or like I call it an “ah, that’s more like it” feeling will lead to an overdose. Many people in my area died as a result of poor communication with their doctors. It is a med for baseline pain, not acute and breakthrough pain.

Here is the part of this post that may or may not apply to you. I want to share my reason for getting off it.

I was on it for a few months at 30mgs/day with oxy 15mg as a BT med. What happened to me was not supposed to because methadone will only block the effects of other opiates/oids at 80+mg/day, according to the literature. For me, that was completely untrue. I could take 90mgs of oxy at once and feel nothing while on the methadone. If you research methadone "blocking" you will find an abundance of conflicting data and people have their own words for how it effects intake of additional opiates. That is why I began and will likely end this post with the same sentence.

I do not know if others have had the same problem but I was having acute flare ups, pain at >7 and no breakthrough meds would work while on that dose of methadone. No one would believe that it was affecting the fast acting, BT opioids so I said to hell with it and stopped taking the methadone. After 3-4 days of abstinence the methadone wd's hit and hit hard but I had plenty left to wean myself off of it. But guess what? The BT meds began working immediately once I hit the methadone WD's. Methadone wd’s are pretty wicked and protracted which is another reason I wanted off of it.

I am new here so I do not know your story as much as others but I wanted to provide an example of how oxy and methadone are different (for me). Please do not let my experience be a strict guideline for you because "everyone is different". .

-Holy crap, I just noticed about 7 new posts after your question. It seems you have a myriad of folks to help you. I hope my example helps anyway.
 
^ thanks for sharing your expierence. That's very interesting. And welcome to Bluelight Milagro!!! What happened to you? How did you get on methadone for pain management?
 
^^^ i would still take oxy for breakthrough i just need a different extended release med. no-one has replied to the methadone question yet apart from you but thanks for the info, i like other's experiences more than numbers and statistics as for a rush i don't get anything like that from my pain meds as my pain is so severe it hardly even helps let alone makes me feel good.

is your pain nerve pain or a different kind of pain? i'm more interested in nerve pain.

also pagey, glad you found that helpful but my condition is degenerative so it just gets worse and worse instead of better. i am going to end up having amputations eventually as all my bones in the affected limbs are warped, my right foot is already starting, which really, really sucks!
 
^ Yes, if I don't keep up with Yoga (stretching for Fibro) and getting a cranio massage (for headaches) consistently, the pain does get MUCH worse! It's hard to do and also can be expensive though that's why I stop and then always seem to be starting over. It's hard to commit to schedules and feel like doing Yoga when you're in pain, even when you know - it helps. Need to stay consistent.
 
I do as much gentle stretching, weight baring exercises by pushing my feet against things even though it really hurts and also desensitisation exercises. Im starting tai chi this week so that i can combine meditation with exercise, i think it will help me immensely
 
Captain Brewster said:
Brighton: cheers for that, yeah should be able to keep it to once a week, like you said the pain relief lasts fairly long into the next day, it is very awesome. But I would like to avoid dependence, I've heard some stories of horrific wd's from pst.
How long have you been using pst for pain management? Have you been on it for a while but had to stop for any reason, thus causing any type of wd.
You'll most likely hear from me in the future.

Thanks again sams, allready got a plastic neti on the way.
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Using pst once a week will avoid withdrawals/physical dependence. Some weeks I will go 4-5 days without any I and I dont get withdrawal symptoms. Ive been having pst usually twice a week for a few months without any problems, apart from having to chug large volumes of liqiud! =D
 
Doomed2pain said:
How does methadone compare to oxy for pain relief? Im seeing a specialist next week and Im hoping to change meds as ox no longer helps me. Any advice would be welcome
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I much prefer oxy. But the only times I have tried methadone have been one off days and it was probably watered down too. I think it could work really well for you though, I have heard good things from other PM people.
 
Doomed2pain said:
my condition is all my sympathetic nervous system and I haven't found anything that works yet. do you do physical therapy? also have you been offered nerve blocks? they help some people unfortunately they made my condition spread. i really do advocate meditation and gentle exercise though, if i didn't do my physio exercises i would have lost all movement in my arm and legs by now.
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Thanks for replying, D2P! I'm multi-symptomatic, and being that my primary area of pain is the right side of my face, specifically the three branches of the Vth cranial nerve, with most of the intensity from 11 o'clock to 4o clock around my right orbital bone, the optic nerve behind my eye, into the entire surface along my check bone and then lessens as it radiates into my upper teeth and jaw, I'm limited to mere facial movements. No one as been able to recommend a type of physical therapy on my face. I do have a movement disorder that affects my legs bilaterally, with a little more weakness on the right side. I do yoga stretches a few times daily for my gams in addition to a stationary bike that I can pump the peddles with my arms and lock my feet into the peddles so that my legs don't atrophy. Also, I get these killer leg spasms that, if anything contract the muscles so frequently that they actually start to build some muscle mass. I know this because my spasms are more frequent and intense on the right side and my calf muscle on my right leg is little more defined than my left.

I'm afraid of the nerve blocks, gamma knife et al treatments. Right now, I've been on Subutex for 6 days and have found the most relief out of anything I've tried up until this point. With the exception of my first acupuncture treatment, subsequent visits didn't yield similar results and a couple of other isolated incidents.

I will be hopefully going to a new pain treatment center pending Medicaid approval as there aren't any pain centers locally that will take on a new patient without insurance. I've waited three weeks so far for medicaide. I phoned for an update on that today, but was on hold for over an hour, tried back, was on hold for 15min, hung up and left a message. No one has called bak as of yet. Anyway, if I'm accepted for insurance, I'll explore the more invasive options. Being that there are more than one nerve involved, in this case the optic and trigeminal nerves, I'm not sure if I'd even be a good candidate for the nerve block. I can't even get my neuro to order another MRI to see what's brewing in my crazy little head. My Dad had naso pharyngitis caused by malignant tumours and the cancer spread to the optic nerve. One would think that with a direct relative with level 4 in a fairly rare cancer they might wn to take a look see. Hmmm. Time to be a squeaker wheel and get that grease. Once I have health insurance, of course.
 
Pretty good! Pain has been really bearable and Ive come out of my depression, I think the chlorpromazine im taking is helping my mood a lot surprisingly :)

How things with you ? and everyone else?
 
Doomed2pain said:
How does methadone compare to oxy for pain relief? Im seeing a specialist next week and Im hoping to change meds as ox no longer helps me. Any advice would be welcome
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Doomed, I think we spoke briefly about this. I would seriously consider adding methadone as an ER medication and using Oxy IR as your break-through med. So far this year I've rotated the IR meds but pretty much been exclusively on methadone except for the Fent post-op the last 2 back surgeries. But I found fentanyl a not-so-good ER med so I switched back to my methadone once I saw my PM doc post-op.
 
Stacianica said:
Just wondering what other sufferers of nerve pain have found to be helpful? I've never really had relief with then non-narcotics like off-label antidepressants and anticonvulsants. Really only opiate/opioid based meds. Except, I've found Cymbalta to actually help my mood and for some reason it renders my typically useless legs a little more movement. I don't have to focus so diligently to get them to do what I'd like them to do. But, as far as chronic nerve pain goes, the C2s and 3s have really, honestly been the only thing to bring my pain from a 9-10 down to something where I can actually function, talk and make. Ay way through life. It makes me feel like a damned junkie, but it's true. Thank you poppies and derivatives of those lovely flowers for giving me a chunk of my life back! I fear it's only a matter of time before this relief is deadened by tolerance. Then, I'll have no head room, as there may not be anything stronger. Then, what? One can only be expected to "live" with pain at a ten a short time before either a heart attack or some other tragedy strikes. And what if another accident happens? Another car crash? It makes me a fearful person, where before this I was pretty happy and normal. Eccentric, but functioning. Anyway, I digress...sorry. I guess my actual question is what has worked, or not worked for others. I know everyone is different, but maybe I can learn some other trick to help me. I've been experimenting with various sound waves in an attempt to help pain along with the mess and various relaxation techniques. Just looking for some wisdom from others in the same or similar boat(s). Any ideas?
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Methadone!

It may not be such a tempting choice with the long half life of methadone, but I've been on it since I first had a fusion and while it is not my favorite back pain killer, the effect it has on my nerve pain (along with Pregablin) made me ignore the fact it is not the prime choice for excruciating back pain. But some of my nerve pain in my feet is almost not noticeable with the Methadone so it is worth it under the right circumstances.
 
Oh and BTW, went to the PM doc and no one mentioned any pill bottles and I was given my regular meds....


This happened to any of you?
 
Doomed2pain, I'm so sorry to hear you're suffering from such a debilitating malady. For me, methadone worked better for pain relief. Though, when I got it, it was before I was a chronic pain patient. But, I found it to be more effective for the shitvi was dealing with then. Though, it doesn't compare to the wicked, evil pain I am forced to endure now. So, I guess I can't be very helpful in giving you a proper answer. Sorry, buddy.

For the spasms, have you tried Tizanadine? Trade name, Zanaflex? It helps a lot of people, not me however. I had better results with cyclobenzaprine, trade name Flexeral. But taking the Flexeril in conjunction with strong opiates can be dangerous due to the sedating effect on the respitory system.

Hang in there. Feel free to PM me if you ever need to vent.

XO
 
^ Orphenadrine (Norflex) is also supposed to be a good muscle relaxer, according to NT's info from a recently closed thread, but I haven't tried it, personally.

I usually use Kava Kava tincture (very physically relaxing), 300-600mg chelated Magnesium, and/or 300-400mg potassium to deal with muscle spasms, and they are all quite effective.

EDIT: Damnit, tricomb! you goddamn ninja :)
 
BiggDirty01 said:
Methadone!

It may not be such a tempting choice with the long half life of methadone, but I've been on it since I first had a fusion and while it is not my favorite back pain killer, the effect it has on my nerve pain (along with Pregablin) made me ignore the fact it is not the prime choice for excruciating back pain. But some of my nerve pain in my feet is almost not noticeable with the Methadone so it is worth it under the right circumstances.
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Yes! I like the way you think, BiggDirty! At my last pain center ppointment, they were gonna give me it. Then, the boss lady came in and nixed that. Only offering me Tramadol and Nucynta (Tapentadol). I mentioned that tramadol was useless for me and Nucynta was out of my financial reach at $600 per month. She averred that those were my choices, I repeated myself, she repeated herself, I showed her the letter I received that day telling me I have no insurance, she reiterated that those were my only options. I pointed to the list that the other doctor wrote up with methadone on it. She said no. I explained how I never buse my Rxs, never fill early, try to make them last longer than one month at a time, she angrily repeated no. I subsequently told her to stick it up her ass. She dismissed me as a patient and wrote a nice little blurb to blacklist me from future pain centers. Mind you, I was at a 9, was at the appointment for 3 1/2 hours of painful neuro tests, jumped though all of their fucking hoops and then just fucking had enough. I've been polite every month for the three years I've seen her and I make one bad choice and I manage to fuck myself. I made a bad choice. But, I still think tht doctor is a cunt. So, who knows how the holy quest for future methadone will go for me. Hey, does methadone have more analgesic properties than subutex, bupenorphine withOUT the Naloxone? Yes? It's full vs partial agonist, right?
 
BiggDirty01 said:
Doomed, I think we spoke briefly about this. I would seriously consider adding methadone as an ER medication and using Oxy IR as your break-through med. So far this year I've rotated the IR meds but pretty much been exclusively on methadone except for the Fent post-op the last 2 back surgeries. But I found fentanyl a not-so-good ER med so I switched back to my methadone once I saw my PM doc post-op.
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Brilliant! Please be my doctor, BigDirty01! Ha!
 
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