Pain with pain medication

I am 25 years old and here are my physical issues that cause pain: cysts in my left ankle, previous knee injury/surgery, 'nerve' pain where my quadriceps tendon was removed, 3 herniated thoracic discs, 2 herniated lumbar discs, an 'undiagnosed' right lower quadrant abdominal pain that's been going on fot the past 4 years.  I have had 2 left ACL reconstructions (1 using my quadriceps tendon and 1 with an allograph), 2 L knee arthroscopies, 2 L ankle arthroscopies, appendectomy, and tonsillectomy.  I am in so much pain all of the time so I take pain meds.  Well, addiction runs rampant in my family and I am already not doing well with the pain medications.  I am so scared to get off the meds because I hurt so bad but I need to stop the pain meds because I take to much and don't know how to take them like normal people.  I don't know what to do.  I already meditate, use progressive relaxation techniques, take baths, stretch, and I have an inversion table for my back.  I also have knee, ankle, and back braces that I use.  I need to loose 50lbs, I want to try accupuncture.  Any thoughts, help, advice, or anything?

Thanks,

J. Lee from Orlando

[J T Junig, MD PhD]

None of the conditions you described normally require opioids for treatment.  Everyone over 40 has disc bulges and herniations; the vast majority of people who have ACL repairs do not have chronic pain afterward-- same with appendectomies and tonsillectomies, two very common surgeries, and same for knee scopes.

My concern, were I treating you, would be that you list a bunch of minor surgeries as if they justify taking pain meds.  A person with that attitude is difficult to 'cure', as they are often motivated more than they realize or admit to stay on pain meds-- which means staying sick.

You are a healthy person with a history of the usual surgeries that many people have-- with neuralgia from nerve injury during quadriceps surgery.  That type of pain does not respond well to narcotics, but often does respond to Lyrica, gabapentin, or tegretol.  I would push the dose of one of those medication, get you off pain pills so that your head is clear enough to get rid of the 50 pounds-- weight that is likely aggravating all of your conditions.

The big lie that you have bought into is that the pain pills are doing something positive for you.  If you've taken them for more than a month, you are likely tolerant to them-- meaning that they offer no pain relief, and ONLY offer the misery of withdrawal.  Consider ditching them for buprenorphine, to avoid the withdrawal;  you can consider tapering off buprenorphine later, when you've lost the weight and you aren't feeling 'defeated'-- the way that pain pills made ALL of us feel.

Good luck!

[jlee72211]

Wow.  I do understand what you are saying and I wish I could get to a point where I do not need pain killers anymore.  In fact I'm working on it.  I don't understand how you cna be so judgemental about my pain.  Are you not a healthcare provider?  Did you loose your empathy?  You can't just put every type of patient into a pile and deal with them accordingly.  There are a lot of different aspects of patients that need to be taken into account.  Sure there are a lot of people with herniated diskks and such that live like nothing happened.  My pain is not.  Yes I have built up a tolerance and am physically dependent.  I'm most likely psychologically dependent too.  I know there are times in the past that I have justified getting a Rx of treatment for the pain.  That doesn't make my pain any less real or severe.  Narcotics and a horrible medicine to get onand I just happen to be one of the people on them.  I am 25 and I have my whole life to live; how do I do that when I can't even get outinto the realy world to live in it.  The pain I feel is going to be completely different from my mom and my mom's pain is going to be completely different from yours.  but how can you sit back and judge the pain I'm in.  I know about addiction, I've been in the rooms and everyone on my dad's side is an alcoholic/addict.  My problem is finding ways to manage my pain during my healing and therapy.  There are days, even with meds, that I cannot stand for more than 15 minutes at a time.  My 'minor' surgeries are not the core of my issue either.  It is my back and my knee.  Your advise was pretty harsh and useful for some people........not for me.  Believe me, I want off theses pain meds so bacd because I am missing out on so much life right now.  If you have any alternative therapies or ideas I am all ears

[sueduva]

Hi jlee,
I have just come off morphine and have been on it for 4years because of chronic back pain that I have had for 16 years.  And I completely agree that each person's pain  experience is differently,
but I think dr. Junic was saying if you never started opiods (before you developed and needed more meds to get the same relief). That most people with these same troubles wouldn't need  opiods but  far milder pain relief. Even after coming off morphine, I still need a different drug, I was hoping the pain receptors would calm down. I am just going to try Nucynta.

While you are withdrawing from your pain drugs, your regular chronic pain usually doen't bother you so much, because you get sick from withdrawal and that is what your brain register.,
I felt so good, after 3 weeks my brain was much clearer. And I had hope to get my life back.

You may want to talk to your dr. about starting over again. And watching you carefully with
your addiction. And then start trying each drug one at a time. No one deserves to live in chronic pain.
And yes, I need a wheelchair to to go out since I too can only walk for a few minutes, because the pain if I walk will put me in bed for the rest of the day.

Do what is good for you, but please get some help with your history of family addiction.
Be peaceful, Sue