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Chonic pain
I am a 46 year old female. I had a ACDF (C5-C7) two years ago. I have been in constant pain since the surgery. I have pain in both of my arms and weakness in both hands.My neck and shoulders hurt and I have terrible headaches everyday. I have been seeing a pain management doctor for a year and a half. I've had several epidural injections, nerve blocks, PT and I am on Duragesic patches 100mcg and Oxycontin, and I'm still in unbearable pain. My doctor says that I couldn't have a spinal cord stimulator because my spinal canal is to narrow from the fusion. He says that he is up against a wall and does not have any more treatment plans other than medication. I've not slept in a bed since I had surgery due to the pain and both arms and hands being completely numb. I may get 2 or 3 hours a night sleeping in the recliner. I recently had another MRI and it said that the disks above and below the fusion are buldging. I also have DDD, but my surgeon says that surgery would not benifit me at this time.
I am to the point to where I am ready to blow my brains out. I've been seeing a mental health therapist for about 6 months, but the antidepressants or the therapy are not helping. I have not worked since before the surgery, nor will I ever be able to work in this kind of pain. I have two young children and I can not even care for them. I depend on my husband and family to do everything for me.
Do you have any suggestions that may give me some relief? I've heard that Botox is being used to help with neck pain, are you familuar with this treatment? My doctor says it's almost impossible to break the chronic pain cycle.
I am to the point to where I am ready to blow my brains out. I've been seeing a mental health therapist for about 6 months, but the antidepressants or the therapy are not helping. I have not worked since before the surgery, nor will I ever be able to work in this kind of pain. I have two young children and I can not even care for them. I depend on my husband and family to do everything for me.
Do you have any suggestions that may give me some relief? I've heard that Botox is being used to help with neck pain, are you familuar with this treatment? My doctor says it's almost impossible to break the chronic pain cycle.
Thanks for the advise, I will discuss this with my pain doctor.
You must be careful with the narcotic, even in the presence of real pain. The narcotic will only cause tolerance in the long run, and that in turn leads to a host of other problems.
Bev, I have to echo what the Dr. said. I'm going thru physical withdrawal from a year and a half of narcotic use related to bone pain from treatment with arimidex for breast cancer. It started out a relatively straightforward, bone pain in the leg, worse at night because it was complicated by restless leg syndrome(which I had since my 30's). Before it was over I was on 20mg of vicodin/650mg tylenol every 6 hours. I had tried oxycodone and oxycontin but was afraid of escalating doses and preferred the self limiting vicodin because the tylenol limits how much you can take in 24 hours. That is unless you don't mind destroying your liver. Anyhoo, the pain got worse and worse. I also have osteoarthritis and even that became much worse, to the point that some days I couldn't even walk. I was depressed to the point of echoing the same sentiment, I felt like blowing my brains out, too. I went to a pain doctor who explained to me that tolerance can lead to a syndrome where the narcotic makes the pain worse. At first I felt threatened by her because she was determined to take my vicodin away and I felt I would sink even further down into pain and depression. I'd been taking the antidepressant, Celexa for 2 years and it didn't seem to work anymore. She gave me a series of drugs to deal with the physical withdrawal (clonidine, gabapentin and mirapex plus ativan for 5 days to take at bedtime, if needed.) Bev, it's been a week, the physical withdrawal really wasn't bad at all and I feel like my old self again. The arthritis pain is a fraction of what it was, as is the leg pain. It is back to bothering me mostly at night. I'm going to begin other treatment modalaties at the pain clinic to deal with that. The doctor was so right; the narcotic made the pain so much worse. I was practically crippled, couldn't get out of a chair without pain, had days I couldn't walk, didn't feel like doing anything and was so depressed I had totally withdrawn from doing anything I use to enjoy. I realize this is long, but I know some of what you are going thru. I have disc bulges in my c5-c7 and I experienced a couple of times when they got irritated and the nerve pain was awful. The point of all this is the narcotics are propably making your pain worse. Talk to your pain doctor. Don't be threated if he/she suggests taking you off of the heavy duty stuff. With medication the physical withdrawal isn't bad at all. Then see how you feel..both mentally and physically. You can always go back to the narcs if it doesn't work for you But I urge you to give it a try. It has been a miracle for me and I'm so grateful to have my life back. I wish you all the best, Sincerely, Diane (Beanoville)
Dr, Could you please elaborate on the problems in long term narcotic use as to tolerance and the perverse nature of it actually making the pain worse. Thanks!
Bev, I have to echo what the Dr. said. I'm going thru physical withdrawal from a year and a half of narcotic use related to bone pain from treatment with arimidex for breast cancer. It started out a relatively straightforward, bone pain in the leg, worse at night because it was complicated by restless leg syndrome(which I had since my 30's). Before it was over I was on 20mg of vicodin/650mg tylenol every 6 hours. I had tried oxycodone and oxycontin but was afraid of escalating doses and preferred the self limiting vicodin because the tylenol limits how much you can take in 24 hours. That is unless you don't mind destroying your liver. Anyhoo, the pain got worse and worse. I also have osteoarthritis and even that became much worse, to the point that some days I couldn't even walk. I was depressed to the point of echoing the same sentiment, I felt like blowing my brains out, too. I went to a pain doctor who explained to me that tolerance can lead to a syndrome where the narcotic makes the pain worse. At first I felt threatened by her because she was determined to take my vicodin away and I felt I would sink even further down into pain and depression. I'd been taking the antidepressant, Celexa for 2 years and it didn't seem to work anymore. She gave me a series of drugs to deal with the physical withdrawal (clonidine, gabapentin and mirapex plus ativan for 5 days to take at bedtime, if needed.) Bev, it's been a week, the physical withdrawal really wasn't bad at all and I feel like my old self again. The arthritis pain is a fraction of what it was, as is the leg pain. It is back to bothering me mostly at night. I'm going to begin other treatment modalaties at the pain clinic to deal with that. The doctor was so right; the narcotic made the pain so much worse. I was practically crippled, couldn't get out of a chair without pain, had days I couldn't walk, didn't feel like doing anything and was so depressed I had totally withdrawn from doing anything I use to enjoy. I realize this is long, but I know some of what you are going thru. I have disc bulges in my c5-c7 and I experienced a couple of times when they got irritated and the nerve pain was awful. The point of all this is the narcotics are propably making your pain worse. Talk to your pain doctor. Don't be threated if he/she suggests taking you off of the heavy duty stuff. With medication the physical withdrawal isn't bad at all. Then see how you feel..both mentally and physically. You can always go back to the narcs if it doesn't work for you But I urge you to give it a try. It has been a miracle for me and I'm so grateful to have my life back. I wish you all the best, Sincerely, Diane (Beanoville)
Dr, Could you please elaborate on the problems in long term narcotic use as to tolerance and the perverse nature of it actually making the pain worse. Thanks!
Seeing a manual therapist or tmj specialist is advised.
Well, i don't have any medical advice, but as to dealing with pain... are you meditating at all? Clearing your mind and disconnecting from your body is a great way to keep from snapping at those you love. I know with all the pain meds you are on that it must be difficult to focus... Hang in there...
MEDICAL PROFESSIONAL
A very difficult situation, obviously. I would try to break down the sources of the pain-- how much is from spasm in the muscles of the 'shoulder girdle'? How much pain is from nerve compression at the foramen as the nerve roots exit the spine? How much is from the bony spine-- did the fusion 'take'? Is there pain coming from the facets or connective tissue of the spine? Telling these apart depends on a combination of exam, imaging, EMGs, and response to procedures... for example, if the epidurals helped, that suggests that you have nerve impingement from narrowing at the foramen, and further surgery might be helpful. If there is permanent numbness, that would suggest nerve injury either from the compression before surgery or injury during the surgery, and a med like gabapentin might help. If the muscles have sore 'trigger points', the botox might help.
You must be careful with the narcotic, even in the presence of real pain. The narcotic will only cause tolerance in the long run, and that in turn leads to a host of other problems.
The hopeless feeling caused by chronic pain always causes a psychiatric component eventually, and so seeing a psychiatrist to try to keep your mood from sinking too low would be appropriate as well. If there is nothing more that will relieve the pain, the psychiatrist might end up being helpful by getting you to a point where you can accept the severe disability the pain is causing. Not a happy outcome, I know, but it can sometimes be difficult for parents to avoid feeling guilty for the limitations on their parenting that are not their fault.
You must be careful with the narcotic, even in the presence of real pain. The narcotic will only cause tolerance in the long run, and that in turn leads to a host of other problems.
The hopeless feeling caused by chronic pain always causes a psychiatric component eventually, and so seeing a psychiatrist to try to keep your mood from sinking too low would be appropriate as well. If there is nothing more that will relieve the pain, the psychiatrist might end up being helpful by getting you to a point where you can accept the severe disability the pain is causing. Not a happy outcome, I know, but it can sometimes be difficult for parents to avoid feeling guilty for the limitations on their parenting that are not their fault.
Does anyone have any suggestions?
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