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Need Advice Please

mbrennanmmbrennan Posts: 3
edited 06/11/2012 - 8:56 AM in Pain Management
Hi there, I am new here and need some advice.
I have been dealing with lower back pain for years but it became so bad and recently started with the butt and leg pain to the back of my knee. About 3 months ago my primary doc perscribed me Vicoden 5/500 4Xday, Flexeril 10 2Xday and Lodine 400 2Xday.
The medicine hardly helped and I was ordered an MRI which revealed a mild herniation at l5/s1 and some facet damage (calcium deposits or something). I was referred to a pain doc who upped the Vicodin to 7.5 and switched me to another NSAID. He also scheduled me for 3 epideral steriod injections.
Well the vicodin and Ibuprofen help for about 2 to 3 hours but after that the horrible pain comes back. It is so bad sometimes, there is nothing I can do but clench my teeth until it passes. I can't think or deal with hardly anything else when it's at full roar.
I went for the first injection 10 days ago and have had absolutly no relief. Before we the procedure I asked the doc if there was something for the pain that would last the full six hours so I don't have that agonizing 3 to 4 hours. He frowned at me and said that those meds are for down the line if the injections don't work. He looked kind of annoyed that I would even ask. This concerned me because I've read all the articles about perscription abuse and felt like he was suspicious of me.
My question is should I call and tell them that I can't take this pain anylonger or are they going to lable me a drug seeker? Maybe it would be better to sit and try to take the pain until the injections work or he is comfortable uping my pain meds? It just seems stupid to wait in pain if there is something available that could help me. However I have read so much about doctors distrusting patients and I don't want to risk that. I just don't know what to do. I feel like I can't take this pain one minute longer.


  • that it might be nerve pain? I have a disk bulge at l5/s1 which is sitting on my sciatic nerve and causes me huge amounts of pain. I am on pain meds as well, but they don't do much for the nerve pain.

    Just something you might want to bring up with him/her as if it is nerve pain, the pain meds won't help that much. I know others can chime in about this as well.

    I find also that using heat and ice on my back helps.

    I hope you can get some relief from your pain soon.

  • Welcome to Spine Health. Are you saying you are asking for stronger meds directly after your ESI? Are you sedated for the ESI? Have you consulted a NS or OS yet?
    I have had some bad injections where the nerve pain flared and never went away once the lidocane wore off. At that point I think it is safe to get a surgical consult or a second opinion from a different pm who uses floracopic guide for the ESI and better pain control.
    feel better
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  • No what I am saying is that I've not been able to control this awful pain since it started. At the appointment for the ESI I told the PM doc that the vicodin wasn't touching the pain. He told me that he didn't want to up my meds until after the three ESI's.
    It's been 2 weeks since the first ESI with the second one coming up in about 10 days. My question is should I call and be persistent about my need for better pain management or do I risk getting on this doc's bad side.
    It sounds stupid to be afraid to talk to your doc but like I said when I asked him about trying something different he looked at me in a sort of annoyed way and I've read all these stories about people being labled drug seekers and then not taken seriously anymore. I am really hurting and I don't know what to do.
    I asked once but I was fairly timid about it. Should I call this week? The ESI has not done one thing to help so far but I really am hoping it will the second or third time.
    Thanks for the help.
  • You cant worry about geting on dr,s bad side, you have to tell it like it is. I am sure he is hoping that injections will help and wont need to increase the meds but if the meds are not working for you yes of course dr needs to know.

    How else will he know if you dont tell him, Forget about what you read about dr,s not trusting patients about seeking drugs. The dr knows the diference for the most part who might be just after the drugs.

    What was mentioned above was that if you have more nerve pain by some chance then the regular pain meds wont help too much with that. Lyrica or neurontin might have to be aded for you to try along with the pain meds. But thats only if you described nerve type of pain to your dr.

    We understand what you are saying! If a person cant take the pain and almost ready to go to er, Then it makes sense to call dr office and tell the nurse you cant take it so dr might call in something that helps.

    When i am in serious pain i dont wrap my mind around what drug seekers do or what they dont do because i simply dont care as long as i get some sort of releif.

    Good luck. Ps. Dr,s only know how a person is feeling is if they are made aware of it,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Welcome to spine health. I am so sorry you are in pain. As Alex said, you can't worry about what might or might not be in someones mind. The journey with spine problems is sometimes along one. There are many things out there to help you. This site has many things you can read to help educate you. Where are here for you.
    It will be almost 2 years since I joined. I never feel alone. The support here is amazing.
    We can never tell or gave you medical advice, but share our own experiences. We are all different. Your Doctors will have many options. What works for you could take time. Alot of times, PM's are super careful with pain meds. Pain meds are just one part of it. The more you take the more you might need!!! That has been my experience. Talk to your Doctor's. You know what's working. Gave yourself time, it takes many things to do. Good luck. We are here for you. Brenda C.
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  • What kind of pain do you have? Does it hurt in your back and leg? Is your foot tingling and numb and hurt? Are you getting facet joint injections or just the ESI? Did the MRI show that the herniated disc material is in contact with the nerve? I take Cymbalta for this nerve pain and it helps. Have you seen an Orthopedic or Neurosurgeon yet?

    Keeping a pain journal may help the Dr. better understand your pain and what makes it worse or better. Does icing help? Keeping track of your symptoms is the best way to describe to the Pain Management Dr. I had to see my Dr. several times and let her know the pain meds wear off after so long. I hope the ESIs help you and you get some pain relief. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • When I was having my first series of ESI's on my lumbar my docotor doing it would not prescribe meds. I had to rely on my PCP- she was very chintzy with the meds.

    When the ESI's failed to work I returned to her and said you have to send me to some one else. She did refer me to a NS whom came highly recomneded from people I have met along my journey. My first MRI didn't show a lot of issues either (or rather didn't match my symptoms). The NS ordered more test and found my problems (instabilty & also changed my medication from Vicoden 5,and Flexeril 5 to Vicoden 10 (1-2 every 6 hours) and flexerile 10 (1 every 6-8 hours). Until my surgery was scheduled.

    My thought to you if you are unhappy with your care is to get a second opinion. If the ESI's are not working and you are in extreme pain and the PM will not change your meds you should go to the ER if it cant wait until you canget back to your PCP(maybe you can get referred out of the ER). Since you have documented spinal issues you should not be labled as a drug seeker.

    You might also want to ask for the lidoderm patches. You can place up to 3 on your spine and leave them on for 12 hours. They Numb the local area. They are lidocane (not narcotics). They help me tremendously. I have been using them since my 2008. Not daily, but when ever I have a big day. Also a Tens unit can help- along with heat and ice.
  • Thank you guys so much. I realized with your comments that I shouldn't care what anyone thinks. I have an MRI that confirms a herniation and hypertrophic changes with the facets. I will tell this doctor tomarrow that we need to try something different. I am interested in the non-narcotic alternatives for nerve pain.

    I have very intense burning stabbing in left butt and to a lesser extent in my back/left side of thigh.
    I am also developing a small burning pain in my pelvis that comes and goes and is not yet that bad. My lower back pain can be real bad (aching, dull pain)but most times it's the leg/butt that I just can't take.

    I had the ESI for the disc as opposed to the facets. By the way, does anyone know if you're allowed a second opinion with state medicaid?

    Anyway, thanks for the support everyone.
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