Proper pain medication

[Johndope]

Ok, this is my first time posting but I read alot here so here goes. Im in an extraordinary amount of back  pain everyday and it goes from bad to worse. I was diagnosed with mass degeneration of the spine and 2 discs and 2 slipped discs. I dont want surgury. So dont even say anything. I went from 120mgs of oxycodone a day to 40mgs of METHADONE and even though its more addictive, Ive been on 40 a day for 6 months it all adds up to about the same. It works to an extent but not near enough and the pain breaks out even in the peak hours the methadone is suposto last. I hate to be upped in MGs here, I really do, but the way I figure it is if Im not getting high, and IM NOT, Its alrite. But is there an alternitive here I can be useing with the Opiates? Im no stranger to them and even though Im not a fan... I need options here.

[Jeffrey T Junig, MD PhD]

The idea that you are OK as long as you are not getting 'high' is a mistake;  I treat opiate addicts every day and I rarely meet a person who is getting 'high' or even finding any enjoyment at all in using opiates!  Opiate addicts don't look like people having fun, getting 'high'-- they look like people who have pain in some part of their body for whom a doctor prescribed too loosely, running the dose up higher and higher until the person gets dreadfully ill if they are taken away.  Addicts tend to think about the drugs ALL THE TIME-- they cannot imagine life without them.... NOT because they are a source of fun, but because they will provide a break from the horrible sickness that comes when they are gone.

There is no end to tolerance;  if you raise the dose of methadone or oxycodone or any other opiate, you will only get used to the doe and end up right back in the same place, except on a higher amount of drug.  Finally, it is hard to know whether you have serious disc disease or not based on the MRI;  studies show that even people with no symptoms tend to have disc degeneration and bulges once they are over 40 or so.

If the pain is in your back, it is more likely related to muscle problems than to herniated discs and pinched nerves.  Pain that runs down the leg on the other hand tends to come from nerves that are pinched by bulging or torn discs.  The best approach for the former, i.e. back pain, is to see a 'physiatrist' or 'rehab doc'.  The other pain 'down the leg' may indeed require surgery if it causes significant muscle weakness, severe pain, or incontinence of urine.

[Johndope]

Well First I want to thank you for your answer, and I would like to elaborate to the best of my knowledge. I fully understant the getting high part and the only reason I brought that up is I used to partake in getting "High" with opiates, so I felt I should address the former issue I used to have that is not an issue anymore. Further on I have my father who is also on methadone give me my 4 a day in two incriments. I am open and honost with my doctor about this because I feel he needs to know every last thing.  Both of my legs from the hip down my thigh have a little pain Nothng I cant take, Some discomfert like nerve twitches, and constant numbness. I can pinh my skin and it feels like I was shot with novicane. My orthepidic surgon who did my fractured ankel in 5 placed tib and fib plus a dislocation put the 8 screws with a titanium plate and two pins that are still in there that also give me trouble every day, I did the Phyical therapy on that and they determined it is as good as it will ever get and the bone on bone might need to be addressed, I was taking Vicoden for this. He read my MRI for my back (I think my back problem came from walking wrong cause of my ankel and not listening to my doctors and doing heavy construction anyway, now I cant!) and said its mass degeneration of the lower spine and around the discs with 2 disc bulgs and he refered me to a pain Managment clinic. The Pain Manegment DR Asked me what I wanted while I was taking the Oxycodone I said how about aqua therapy? So he OKed it and I did that for a few sesions and it was just too painfull at the end of the day, and during the sesion. Plus I couldnt afford it, my progress reports will be read on my next DR APT, But even the therapists said they recomend "looking into" surgury by a "Nurosurgon" is what they said. In their oppion and "I am in more pain than most people that pass through their PT Sesions" The only reason I would want to up the does of Methadone Im taking is It wears off in 8 hour incriments and thats 2 10mg two times a day or every 8 hours as perscribed. The Oxycodone I am thinking will help the breakthrough pain I am having while even on the methadone. I TOLD my DR Lets just try the Methadone and cut the Oxy and he said that was my option anyway, so... Mabey more tramadol, but I do have Hep C I have to watch, Regular Percocet have to much acetiminophin. But Its low rating my liver funtions are pretty normal. I also took the aqua therapy and new found diabeties to heart, Im serverly overweight SO, started eating healthy, No sugar, no salty snacks, Im only eating a full meal once a day, and a nibble on a Veggie or two inbetween. Working out as much as I can tolerate, wall pushups, bed clinches, and walking as MUCH as possible. Im PROUD to say My results are HEALTHY I lost 40lbs in about 3 1/2 months sofar and it is helping my stamina, and My triglierides (sp) went from 890 to 120 something, Bad Cholestoral  from 500+ to 120, good Cholestoral is up, and my Blood sugar is avraging 115. I take it 4x a day on a Ultratouch 2 meter with UT 2 Test strips. Im also on 1000mgs of Metformin, So the weight loss is actualy better than any Pain pill. But the pain Im in is very serious.

[didee1961]

Hi Doc!  You may not remember me, but a couple mos back I asked about "secondary withdrawal".   Still clean, but having a terrible issue with insomnia.   Haven't seen a doctor since oxy was prescribed, so do you have any "home remedies" you might suggest?   Thanks SO much!