Why no narcotics? Do/did you have an addiction disorder? You should know that just one medication reduced my pain by 80% and added 9 wonderful years to my university career. And my pain is not "incapacitating 2-3 days per month," it's been like that every day for the past 25 years! Without medication, I would have stopped living years ago. With it, my pain is managed successfully.
You should also request a referral to a comprehensive pain management program. Comprehensive means that they offer a wide range of treatments, including biofeedback, systematic relaxation, meditation, Yoga, TENS, acupuncture, etc. Mind-body treatments can help. Just one, biofeedback, reduces my pain by up to 20% at any given time.
As an axiom, all chronic pain patients should be using an anti-depressant. These drugs inhibit the reuptake of serum serotonin, one of the body's natural pain-fighting chemicals. Cymbalta is a fairly new anti-depressant that was off-label for pain until recently, as the drug characteristically reduces pain. But many other anti-depressants also work well for chronic pain.
Finally, our goal is not to eliminate chronic pain. That is impossible. However, we can learn to manage our pain so that it will not adversely effect the important parts of our lives, including work, family and enjoyment. By accessing the many valid tools of pain management, we can return to a meaningful and rewarding existence. Good luck.View Thread
Yes, millions of people have pain like yours. And millions more have pain much worse. Life with chronic pain is an exercise in perspective. For example, I can tolerate no more than five minutes of standing or twenty minutes of sitting. The rest of my life is spent horizontal - and I still have pain then. But I consider myself very lucky, because there are millions of people with my pain and worse, who will never be able to sit, stand, walk, feed, toilet or bathe themselves. Would you not rather live with severe pain than also be a paraplegic, quadriplegic or have a terminal illness? Perspective...
Some of your information cannot logically be related to a bulging disc in your cervical spine. Therefore, it may not be useful to discuss that part.
Before considering surgery you should try a comprehensive pain management program. They offer treatments such as TENS, biofeedback, meditation, Yoga and acupuncture. They also offer injections, rhyzotomy, brace, traction and spinal decompression. If all of those fail, they also offer the spinal cord stimulator and the intrathecal infusion pump.
Just please be careful to avoid a pain management group that primarily only offers injections. Research is clear that if injections do not help initially, then future iterations are also likely to fail - and injections are invasive with risks. Request a "comprehensive" pain clinic that offers the many varied treatment milieu mentioned above.
If the pain management program fails, then I recommend that you request a referral to a spine surgeon. A spine surgeon is an orthopedic surgeon or a neurosurgeon who has completed a fellowship in spine surgery (that's 3-4 years of additional training beyond a residency). No one on the planet knows more about diagnosis, treatment and possesses the most advanced surgical techniques. Spine surgeons can often be found at or near teaching hospitals.
What disease? You said nothing about having a disease - only that you have pain and depression. Perhaps you could be a little more descriptive.
P.S. Most of us with chronic pain can manage it better with a long-acting opioid. That helps you avoid the ups and downs associated with varying oral medication plasma levels. Long-acting drugs, such as Kadian, Oxycontin (which is exactly the same medication you currently use, Percodan, but in extended release format) or Fentanyl Transdermal (which is a patch that provides pain management for 48 to 72 hours) are examples of effective long-acting pain medications. You can then save the short-acting drugs for breakthrough pain. Just a thought.
Neurontin (Gabapentin) has been widely prescribed for many years as designed (as an anti-convulsant). In more recent years it has also been widely prescribed, along with Lyrica, for neuropathic pain. I have neither heard nor read anything about such dangers. Can you please provide citations to this in reputable medical and scientific journals, as wel as the FDA report?View Thread
"Unbelievable," I am so sorry to hear about your unsatisfactory physician care. It's not appropriate to wish chronic severe pain on another person, but if this physician could experience your pain for just a week, he might develop some compassion. Many of us require a long-acting narcotic and also a short-acting narcotic for BT pain, in addition to an anti-depressant (to inhibit the reuptake of Seratonin and an anti-convulsant (for neuropathic pain). Remove any of these and the pain jumps higher. Remove two of them and the pain can become unbearable. I know exactly how you must feel.
I hate to say this, but you might wish to consider moving to a medium-to-large city, where you can find dozens more pain management physicians, as well as compassionate internists and general practitioners. There are doctors willing to prescribe as much medication as each patient requires unfortunately, they can be difficult to locate. WebMD does not allow us to name or recommend specific physicians. But rural places are likely to have few, if any, of these doctors.
Speaking of moving, and this is only meant as food for thought, a large percentage of chronic pain patients benefit significantly from using THC, the active ingredient in marijuana. There are several states that allow for medical marijuana, with a Rx. There is also a medication with THC as the active ingredient, Marinol (Elan Pharmaceuticals). Created to inhibit the nausea and weight loss associated with chemotherapy, Marinol can be prescribed off-label for chronic pain. Again, I'm not suggesting that anyone here break the law. I am only repeating the fact that many research studies tout the efficacy of THC for chronic pain and that many states in the US now allow it legally.
I don't know how many PM techniques you have tried. Many of us have discovered significant efficacy associated with mind-body treatments, such as biofeedback, Yoga, systematic relaxation and meditation. Others benefit from TENS, acupuncture and hypnosis. If injections don't work in the first few tries, research reveals that future iterations as just as likely to fail, as well. Do not put yourself at risk of spinal nerve root puncture and permanent nerve damage if injections are not helping.
I wish that I had better answers for you. What makes your situation all the more frustrating is the fact that many physicians continue to prescribe long and short-acting narcotics simultaneously because... IT WORKS! How simple it sounds; use two narcotics and manage your pain, or use one of them and suffer. Use none and suffer even more. Some physicians need a refresher course in The Hippocratic Oath. Good luck. View Thread
There is no federal law that prohibits family doctors, internists or any other type of physician from prescribing any drug, including the most powerful narcotics (ex Schedule II drugs). I think that you have been misinformed.View Thread
You CAN take the narcotics you require and minimize side effects. To manage that, you need to visit an allergist. There are medications that will reduce the itching. I'd bet that a combination of anti-histamine medication and Rx-level cortisone cream will drastically reduce the itching.
I too had side effects from pain medication. Most of them dissipate after the first few weeks or months of use. Others can be managed by using anti-histamines and topical steroidal creams. But, you need to put up with the itching for those weeks and months before it dissipates. That's the hard part.
Finally, I live with constant severe pain. I've had it for more than 40 years. Honestly, with my severe pain, I would love to have to deal with itching, as long as the medication worked. I suppose we all have our own level of tolerance for pain.
Going to a chiropractor with an unstable neck (cervical vertebra) is like pouring gasoline on a fire. Chiropractors are NOT physicians. They do not go to medical school. They do not participate in a residency or a fellowship. They have minimal or no hospital privileges and they cannot write a Rx. In essence, going to a chiropractor for an unstable spine is like asking your auto mechanic to perform brain surgery. The chiropractor is over his or her head. I've encountered literally dozens of patients in physician waiting rooms over the past 40 years who were damaged permanently by chiropractors. I'm talking about permanent paralysis as a result of going to a chiropractor.
If you have had an MRI and you have been examined by a physician who informs you that you have a problem with a muscle or tendon, then go to a chiropractor to your heart's content. But know this... chiropractors use X-ray imaging for diagnosis. Yet, spinal discs and tumors do not visualize on an X-ray. If you had a tumor and you went to a chiropractor, you would never know about it until it had metastasized into a fatal cancer. Are you willing to risk your life by seeing a chiropractor? I don't know about you, but I would not allow anyone to examine my spine unless that person was not only a physician, but had also completed a residency and a fellowship in spine surgery. If you want to maintain or improve your health, then go to someone with the initials "MD" after his or her name. All others, especially chiropractors, are a dangerous substitute. They are not a physician. They never graduated from medical school. Isn't your health more important? Don't you deserve to be treated by a REAL doctor? Of course, Caveat Emptor!