Undergoing 2nd round of Spinal injections on Saturday

It's been a lil while since I've posted on this forum and I had my first round of injections which helped immensely for the first couple weeks then my back pain returned but not as intensely.
I was supposed to get my 2nd round of injections about a week and a half ago but missed the appointment and then got ill along with my family with a really bad cold and upper respiratory thing. My appointment was for next thursday but the doctors office called asking if I could come in Saturday because my doctor will be out of the office during my originally scheduled appointment.

I've got a high tolerance to most medications including sedating medications for some reason... seems to be a family thing and this time I'm going to INSIST that they give me the Versed while I'm sitting upright that way if/when the first dose does nothing they can do as they said they would before and give me a 2nd dose because last time they gave me a dose after I was on my stomach and it had NO effect on dulling any of the sensations and about 30 seconds after giving me the IV versed they began the injections which hurt like H***.

My appointment is at 11:30am and then at 2pm I've got our house warming party scheduled so I'm gonna be relying on my hubby and MIL and sis to help out and today I'm picking up a script for Nucynta 100mg so that I'll have some back-up against the extra pain from the injections.

Later on after my appointment I'll post an update on things. :)
TTYL

Cindie

[Tuckamore]

Good to hear from you again. I am glad that the first injections reduced your pain. Let's hope the second round will provide even better results.

I'll look forward to your update.

Best of Luck and Take Care,
~Tuck

[martikadragoon]

Turns out today is just a follow up (nurses got it mixed up on what they were doing) but when I have my 2nd round I'll definitely update.

[femmy29]

Hi Cindie,

It is great to hear an update from you.  I am glad that the first round of injections were very beneficial to you.  I am going in for a repeat lumbar MRI to see if there is any new damage as I have been experiencing shooting pains down the backs of my legs worse than I have ever experienced before.  It has been 5 years since the last MRI was completed.  And then on the 14th, I am going in for another epidural injection.  It has been 6 months since my last injection and that alone could be the cause of the increased leg pain.  I have been wanting to get away from these injections because they can cause bone loss over the long term and I have already been through these 5 times before.  But I am on extremely powerful pain medications and the leg/hip pain is relentless so I plan to go back in next month for another injection and I am hoping to repeat them every 6 months versus every 3 months.  Will see how that goes.  I found out last week that have mild Scoliosis in my lumbar and thoracic spine but that is not the expected cause of my pain but rather the disc/nerve impingement and/or SI joint dysfunction.

With these injections, it is always best to have them done when you are well as they do cause some immune system suppression.  I have had my worse cold/flu illnesses within the first few weeks after an injection.  The reason why I say they should be done when you are well is also because the injections, through suppression of the immune system, take the body longer to fight and recover from infections.  The precise way the injections suppress your immune is through the reduction of inflammation comes a false signal that all is well/healed and the body drops its vigilance against infections.  I would hope that when you call to schedule an appointment that they ask you whether or not you have had an infection and/or dental/medical surgery within the past two weeks.  If the answer is yes, then you should wait until the answer to that question becomes no; otherwise the injections can slow the healing process and make the infection/illness worse.  

Please update us on how you are doing after the injections.  I hope that they are just as helpful (if not more) as the last round.  I am not familiar with the medication Versed but from reading your post, it sounds like it is a numbing agent.  They used lidocaine as the numbing agent for all of my past injections; however, this next injection is being done at a new facility as I switched insurances at the end of the year.  But definitely express to them before they begin that you were in a lot of pain during the injection process as the numbing agent didn't take so that this round is more comfortable for you.  

Wishing you the very best.

femmy :)

[kyleann3363]

I, too, have endured the epidural spinal injections. After suffering horribly for 6 weeks with unrelenting leg and hip pain that left me crawling and using a wheelchair to get around my house while stopping intermittently to cry I finally got my first injection in Sept. It was the miracle I needed to get me on my feet at all. Second one in Oct. left me feeling even better......but here I am 5 months later with pain that felt like I broke a rib for 2 weeks right into severe hip pain that is trying to get to my other leg like before. I cannot go through that pain again and I certainly cannot take off anymore work. I am the sole provider for two kids and I am a substitute teacher (no pay when you don't work). I am at wits end, pain medication does not really work; or what I have taken doesn't work. These weird pains started last spring when I started getting carpal tunnel syndrome so bad that each episode left me screaming and crying in pain when my hands weren't asleep, itchy or cold from lack of circulation. I can't help but think these episodes are all related.
I just finished my master's degree with a 4.0 GPA at 48 years old and I was ready to finally get on with our new and improved life and show my children that my hard work would finally eliminate our many years financial struggle where we have been crawling steadily, but slowly from being homeless for 2 years. Right when I was completing my degree is when my body started having other ideas. I am just devastated I am hardly working and we are still struggling. I want all this crazy pain to end.
Do either of you have any information about pain remedies or diagnosis that might help me. My doctor is an idiot and I think she received her medical license by  mail order and the medical staff is starting to look at me like I am crazy. I am so embarrassed to keep going to the doctor with pain in yet another area of my body I have always been very active and like to be active. The last 9 months I feel like I have lived in what my version of hell would be like and I am having a great deal of trouble bouncing back from this one both emotionally and physically.
Can you give me any ideas? Please help

[femmy29]

You are such a strong woman, mother, and educator.  My heart truly goes out to you!  You should be so proud of what you have accomplished in your life and struggles you have endured and ultimately conquered all in the name of love for your children.  

The pains you are experiencing sound absolutely relentless!!!  If you are crawling due to the degree of pain you are experiencing, you definitely need better care and more treatment options offered to you.  

Have you had an MRI completed yet? If so, what were the results?  If not, I would make that your first priority as having a diagnosis in hand opens the doors to more treatment options that could provide you with more relief.  If the last injection worked so well, could you schedule another injection in the near term?  Typically, epidurals are repeated every 3 months and it has been 5 months.  The injections start to lose effectiveness after about 6 weeks so 5 months is a really long time.

If you don't mind disclosing what medications you have taken and what you are currently taking along with dosages, that will help me and others help you better in that arena and offer valid suggestions.  I truly believe with the right set of medicines, you could be relatively comfortable without periodic injections.  I am going in for an injection more so because the pain down my legs is an annoyance that is painful but not debilitating.  Medication therapy has changed my life and many other's lives here as well.  You just need to find a compassionate physician that is willing to work with you during the trial and titration phase for optimization of the medications for maximum effectiveness.  Many doctors lack greatly at this skill and will throw a medicine at a patient and then demand they stay on it because they aren't getting anything else nor a dose increase despite the fact that the medicine is ineffective.  

I will look for your updates and provide additional info at that time.

femmy

[kyleann3363]

Femmy,
Thank you so much for responding and for the words of encouragement. I did have an MRI and I was told that I had a bulging disk and degenerative disk disease. I am not so sure this is the complete picture, however. Since my pain and numbness seem to hit me in so many places on my body, I cannot help but think there must be some sort of nerve issue going on. I currently take ibuprofen, and I am prescribed oxycodone(percocet) 7.25 (3.25 acetaminophen) and methocarbomal, but I only take them when I need to and they don' t really work either.

[femmy29]

I hope you didn't think I was ignoring your post.  I am not online during the week so I do apologize for the late reply.  Thank you for providing additional information.

I am glad that you had an MRI completed.  Sometimes a bulging disc can push upon a nerve and be the cause of sciatica or pain that shoots down your legs.  I would look at your MRI findings again and see if it says the disc is touching a nerve root.  For example, I have a ruptured and bulging disc at L4-5 and L5-S1.  The first one is touching the L5 nerve root and the second one is touching the S1 nerve root.  If the disc is touching the nerve root, it could be the cause of your symptoms.

Percocet is a great breakthrough pain medicine as it is a short-acting opioid.  I am also on Percocet as well and I take 2-3 per day, most days I only need 2 in the morning.  I used to have to take 7-8 per day but since my new doctor switched me from long acting Morphine to long acting Opana, I don't need to take as many as I have less breakthrough pain.  

I would like to encourage you to talk to your doctor about a 12 hour opioid medication as I believe you will have much better pain control.  Without pain medication, I can't walk very far as the pain is excrutiating.  It is even difficult to take a couple of steps (I know you know what I am talking about).  But I can walk just as well as any normal person with the help of the Opana medication.  

Another medication to try is Neurontin (generic is Gabapentin) or Lyrica (there is no generic).  I am taking Gabapentin.  It is anti-convulsant that is frequently prescribed off label for nerve pain.  It helps tremendously with the pain that runs down my legs.  

Lastly, you may want to try another injection in the near term.  I have very good pain control without the injections but the pain in my lower back is getting worse so I am having another injection on the 14th which I hope I can stretch for 6 months.

It is important to combine medications such as a muscle relaxer, anti-convulsant, anti-inflammatory, and anti-depressant along with the opioid pain relievers (long acting for baseline pain, short acting for breakthrough pain) and take them consistently every day to keep pain under control.  Combining medications creates a synergistic effect that more effectively reduces pain than if you take just one type of medicine.  Also, if you wait for the pain to get really bad before you take them, they don't work as well.

Let me know your thoughts on the medication suggestions and what your doctor thinks.  I had another MRI done on Tuesday and I found out I also have mild scoliosis, spinal stenosis, bone spurs, arthritis, and ligament thicknening as well as mild edema.  All of these pain causing issues are controlled primarily with medications.  And I believe that is a possibility for you too.

femmy

[martikadragoon]

I meant to respond and did but my stupid computer deleted it all. I'll post it all in a day or two.

[femmy29]

Ugh!!  I hate when that happens!!!  It is so frustrating.  It has happened to me a couple of times already too.  I totally understand that you don't want to go through all of that again right away.  I will look for your updates a few days from now.

femmy :)

[martikadragoon]

Hi! Kyleanne~ Im so sorry your going through such pain. it isn't fun at all and I can't imagine providing for 2 kids by myself. Talk to your doctor about effective pain management.

Femmy~ I'm a week out from my injections and feeling ALOT better. I woke up this morning with almost no back pain and got my boys up from bed, changed, dressed, and fed. I've been able to clean house and haven't been taking any pain medication other than excedrine and my neurontin and flexeril.
I went ahead and asked for him to do both sides this time when he suggested it. So 7 injections and this time my experience was SO much better!
The IV medication he gave me helped but didn't make me loopy and he REALLY numbed me up well. I had alot of pain for a few days but it's better.
I still have alot of pain at times but even having that is better than before and a heat pack takes care of alot of it. However... There have been a few times where there is twinging nerve pain in my back for a couple of minutes which hurts quite a bit and I'm thinking maybe it's from the injections.... there are 3 to the left, 3 to the right up to L5 and 1 in the middle at the bottom.

[femmy29]

Hi Cindie,

I am so glad that you had a better experience with the injections this round and are feeling better despite the nerve twitching you describe.  If it continues please bring it to the attention of the physician that performed the injections.

As for me, my condition has rapidly deteriorated since my last post here.  I have been experiencing severe sciatica at times in the right leg mostly but it has hit my left leg a couple of times.  The sciatica has been so bad at times that I have been walking with a limp and unable to sleep on my left side.  Wednesday is D-day for the injections and I can't wait.  I received a letter in the mail from my physician's office that said I will be receiving a combination of spinal, joint, and triggerpoint injections along with radio frequency ablation.  I think they are going to do something similar to what you had which includes starting a IV line.  The process is supposed to take up to 2 hours as the radio frequency ablation can be a tedious process as they burn a lesion through up to 5 branchial nerves near the spine and they have to inject a numbing agent near each nerve and then another needle that heats up to burn it.  The nerves are supposed to die within 2 weeks and it takes 6-24 months for them to grow back, and hence, cause pain again.  Some folks have had great success and the pain didn't return after the nerves grew back.  I have never had radio frequency ablation done before, have you?

I have also been told that I need surgery.  Specifically, a two level lumbar fusion of L5-S1 and L4-L5.  The disc at L5-S1 is completely dessicated and will soon flatten like a pancake and the vertebrae will begin to rub together.  I don't even want to know what kind of horrible pain that is going to bring.  I won't be having surgery this year I don't think unless it gets really bad as I just had surgery in December to remove my gall bladder.  But we will see what they say on Wednesday.  I'll update you after the procedure to let you know how I am doing.

I am so glad you are feeling a lot better and are able to do the things you enjoy.  I am hoping to get there too.  

femmy  :)

[martikadragoon]

No, I haven't had the ablation done before but I know that we're going to have to do something because the back pain is getting bad again. I go in for the follow up appointment this week.... It might just be the weather....we just got a cold spell out here and it's all lower back. Same side as before and I'm using heat, stretches and excercises, and prescription strength aleve along with the Neurontin but it was bad enough to keep me from sleeping last night and I'm having nerve twinges whenever I go from a sitting to a standing position.

I REALLY hope the combination injection/ablation works for you. Keep me updated!

Cindie

[namnam46]

Hi martikadragoon,

I haven't been able to be on since Setember because of neck and back problems but because of my latest RFA (Radio Frequency Ablation) in my cervical area, I'm able to sit and type again on the computer. :)

I hope that you will consider the RFA as I have had wonderful results with it. I've had it done twice in my lumbar area and the 1st time lasted for 20 months. Just had it redone and it's going strong again.

The one in the cervical area was just done last week and I go back on the 22nd of March to have it done on the right side of the cervical. So far it's working great on my neck and I can sit and type again. I've been fortunate enough that I didn't have to wait to get relief from the RFA as some do. Hopefully, you will get the same results.

I urge you to look into this procedure with your Dr. as I know how difficult it is with severe back problems. I have severe DDD as well as 5 bulging discs throughout my back.

Femmy29, I wish you the very best with your RFA and hope that we will hear of your wonderful results soon!!! I can tell you that it's nothing to be worried about at all and seems much more frightening before you have the procedure than afterwards but then it seems to be that way with every procedure that we have, doesn't it?  

Unfortunately, I wasn't fortunate to have any luck with the epidurals at all and so it was extremely fortunate for me that the RFA"s worked so well.

Wishing both of you the very best and will look forward to updates from both of you!!!

Best Wishes to you......Sherry  :)

[femmy29]

Hi Girls,

I went in for my procedure this morning and all went well.  I already notice a reduction in pain that is quite significant.  Sitting in my favorite arm chair has been feeling like a cactus but today I have been able to sit in it fairly comfortably.  There is some very minor pain but it is tolerable.  However, I think the lidocaine is still numbing the area so the pain levels I am anticipating to go up tomorrow and for the next few days until the steroid injection begins working.  The most fabulous difference is the leg pain is virtually gone.  There is a little bit there but not the shooting pains that have been slamming down my legs the last few weeks.

I did not have the radio frequency ablation done.  I found out they included that in my letter as a mistake but I told them I was interested in that as the pain relief lasts a lot longer than the epidural injection (6-9 mos vs 6 weeks and in Sherry's case 20 months!!!  That's fantastic Sherry!).  They said that at my 6 week follow-up appointment at the end of April we would discuss it more as a possibility.  

The sad news is that my MRI results were discussed and just by me reading them a few weeks back I knew the findings were bad and my PCP already said that I needed a spinal fusion.  My spine orthopedic specialist said today that the disc rupture is very significant.  He showed me the actual MRI films and at the L4-L5 level the nerve roots are slammed up against the spinal canal.  Add in the spinal stenosis and bone spurs and it was confirmed that I have quite a painful condition.  He said further that if I took my MRI results to any surgeon, they would definitely perform the fusion.  He said I need levels L4 through S1 fused and he said it is highly likely that over time the L3 disc will eventually blow from the additional pressure put on it from the fusion.  Then the L3 disc would need to fused and the L2 will blow and need to be fused...you get the picture.  They asked if I wanted to be referred to a surgeon and I told them no.  And they said there are still other more conservative treatments that they can try before having to resort to surgery.  They said it is best to exhaust all conservative treatments first before seriously considering surgery and I agreed with them 100%.

So they injected steroid medication into the epidural space at the L4-L5 level.  All of my other injections were at the L5-S1 level.  However, the nerves at L4-L5 are the most pinched so I am hoping that I will get more relief from them targeting the major source of the pain.  They did 2 epidural shots laterally on each side to hit both of the nerve roots.  Very uncomfortable procedure as you both know.  And the pain down my legs after the procedure took my breath away!  There was a long walk back to the car and I had to stop like 20 times when the pain really hit my legs hard.  A guy driving one of the courtesy carts at the hospital saw me limping and struggling to get to the car and gave me and my family a ride to the car.  I was so RELIEVED and GRATEFUL for that little golf cart...LOL!

Sherry: It is great to have you back on MedHelp.  I am so glad the RFA is really working for you and you are more able to participate in the activities you enjoy.  I look forward to talking more with you in the near future.

Cindie:  I am so sorry to hear about the increased pain you are dealing with right now.  Definitely express the difficulties you have been experiencing at your follow up appointment.  I know you are trying to not have to take opioid medications so there is a great anti-inflammatory gel you should ask your doctor about called Voltaren Gel.  It is much more effective than Aleve (I tried it in place of taking of Aleve and it worked better for the pain as you apply it right to the back versus Aleve having to go through the stomach and a smaller amount finally reaches the back as some point).   I am on very strong opioid pain killers and they weren't touching the nerve pain that was shooting down my legs.  I think Neurontin is a great medicine for nerve pain.  I take it as well.  The dosing goes up to 3600 mg per day and I have read that other chronic pain patients have had a lot of success at higher doses.  I take 1200 mg per day and may consider talking with my doctor about a higher dose in the future depending on how things go.  Please keep us updated on your condition and I hope they do something at your follow up appointment to ease the pain.

femmy

[martikadragoon]

Sherry~ I've got my follow up appointment tomorrow and will ask my doctor about RFA. My pain is about the same now as before my 2nd round of injections which really stinks... I'm having shooting pains whenever I try to pick my kids up (they're in the 30lb range)

Femmy~ So this may be long so I can explain all I do for my back....

I actually DO use Voltaren Gel. It helps some but at this point that only offers temporary relief for mere minutes.... same with the Naproxen 500mg.... I've got Lidoderm patches also but those don't do crap.

My doctor said I'm on the maximum dose of Neurontin as it is...1200mg 4x a day...
It definitely helps with the nerve pain. I've noticed though that my pain inceases exponentially when I toss and turn at night and heat packs only work the first few times I use them unless I use it... wait a couple days thru pain and then use it again as hot as I can handle it. My muscles tighten up badly and I'm taking Flexeril 10mg 3x/day and can NOT take Soma as I was addicted to it at one point and refuse to take it again.

Any ideas on anything else I can ask the doctor about?

I'm doing my excercises as well. Hubby asks everyday if I'm doing them. My primary doctor has me on pain medication~ Nucynta 100mg 3x/day but I'm gonna ask my pain mgmt doctor to take over completely for my pain mgmt instead of relying on my primary to do it.

I plan to change primaries as he just hands pills out sometimes. My stepdad was a patient of his and OD'd.... :/  (stepdad was an a**... and I don't regret his dying as it was due to his own actions)

[martikadragoon]

ALSO~ for both Sherry & Femmy~

Do you guys handle your own meds or does someone else handle them for you?

I know doctors suggest having a family member admister meds.
For me, simply because A) I've got an addictive personality and family on both sides w/drug and alcahol (alcohol) problems and
B) it's easier... Dh handles my meds and we keep them in a lockbox.  It seems to work for us. :o)

[Tuckamore]

I think there are several conversations going on your thread!!!

I just wanted to tell you that I am delighted that the injections continue to be benifical. We are all different and respond differently to procedures and medications.

It's not usual that others "handle" a person's opiates... but there is no right or wrong. What ever works for you is the right way. Personally I would not be comfortable with someone "handling" my medications. We had another poster some time ago that had a relative manage her opiates also. It worked well for her due to past addiction problems.

The important thing is you've found some pain releif and the process for taking your medications is working. Both good things! :o)

Peace,
~Tuck

[femmy29]

Hi Cindie,

I had forgotten that you are taking Nucynta for pain.  Are you feeling any significant relief from that medication?  There are a lot of folks that said it did not work well for their chronic pain.  But marycarmel who posts here a lot was only on it for a little under two weeks as the side effects were intolerable and after discontinuing it she now has a significant reduction in pain that may be permanent as it is believed the medication reset the sympathetic nerve.  I am not sure what other types of opioid medications you have tried in addition to Nucynta, if you wouldn't mind sharing.

You definitely are on the max dose of Neurontin and it sounds like it is helping more than anything else you are taking right now.  I would definitely stick with this medication since it is so effective for you.  I've noticed that both the Voltaren Gel and naproxen don't help for extended periods of time that is for sure.  And I have tried the lidocaine patches and lidocaine ointment and both offer pain relief that is very short in duration.  But the lidocaine injections that they use during epidural procedures work so much better!  I guess it is because they inject it deep under the skin and tissues.

I have tried Soma probably about 12 years ago and it didn't work very well but I believe it was a really low dose and I asked for it to be increased and my doctor told me no (my pain was very poorly treated in my early twenties I believe due to my age).  I am also taking Flexeril.  I took 10 mg 3x a day for over 7 years until here recently I decided to taper to 10 mg 2x a day as after I started the Opana, I began getting these brain twitches/zaps throughout the day and could feel at night that I wasn't breathing for brief periods...very scary!  Once I bumped down on the Flexeril, those scary side effects stopped.  I have noticed a few times that my muscles would tighten up in my back more than they have in years but those instances of muscle tighteness are reducing.  I also take Valium for pain and muscle spasm.  Valium is a very potent muscle relaxer even though its primary use is for anti-anxiety/panic disorder.  5 years ago, I started off on 5 mg at night and as I started to take stronger opioid medications, my doctor reduced the dose to 3 mg.  I take 2-3 mg a day right now, usually 1-2 mg in the morning and 1 mg at night.  I noticed that the valium works a lot better than the Flexeril for muscle tightness and spasm but take the Flexeril away, and muscle tightness returns so I think taking the two together produces a synergistic effect.  Additionally, triggerpoint injections may be helpful in relieving the muscle tightness you are experiencing.  Have those been offered to you yet?  I haven't had them yet but I am looking to try them in the future.

The shooting pains when trying to switch sides really makes me mad and it wakes you up too!  I noticed that there is still some shooting pain down my left thigh when turning to sleep on my left side but I was able to at least get to that side last night...usually I just give up.  I would say that you are definitely experiencing symptoms that should be able to be controlled better (i.e., shooting pains when changing the side you sleep on and shooting pains when picking up the babies).  The RFA may be the treatment that will work for you as Sherry said the epidurals did nothing for her pain but the RFA worked.  So I would talk with your doctor about RFA when you see him this week.  I have read that there also nerve block procedures your doctor can perform.  They inject a numbing medication with an opioid medication into the spine or joint versus a steroid medication.  I am going to be looking into these too.  I am willing to try pretty much anything to get the pain levels down and I know you are too.

I think it is good that you acknowledge the tendency for abuse in your family and that you might have inherited that trait.  So, having DH administer your medications isn't a bad idea.  I do manage my medications myself but I know of many that hand those responsibilities over to one of their loved ones.  I think both approaches are definitely okay.  That's crazy your stepdad was given enough medications to OD on...very scary!  But it does happen unfortunately.  There seems to be more treatment plans out there that mostly involve undermedicating or overmedicating the patient with less cases in the middle.  I would say my treatment plan is more toward the middle but I wish I had a little more leverage as I still experience periods during the day where I am in significant pain but have used all the leverage I have already unless I take my evening dose of meds and hurt later in the evening so I end up suffering during the day instead.

I do plan to do some more research on what other treatment options may be out there.  If I find some new things, I will be sure to let you know about them.  The one other thing I can think of is perhaps trying a different opioid medication.  A 12 hour extended release medication could provide you with more control over your pain and if pain breaks through the extended release medication (as it typically does), you would take a short-acting medication like the Nucynta or Vicodin or Percocet or one of the various other short-acting medications for breakthrough pain.  There are many different types of extended release medications out there and they produce much less euphoria than one might expect as they provide a constant level of medication in the bloodstream versus a big ramp up and then a big ramp down like the short-acting medications.  To name a few of the ER meds: MS Contin (Morphine ER), OxyContin, Nucynta ER, Opana ER, Fentanyl, BuTrans.  I was on MS Contin for about a year before switching to Opana ER and before the MS Contin I was on short-acting opioids only.  I have Percocet for break through pain, which isn't helping much anymore.  I plan to talk with my doctor about a different breakthrough pain medicine as he only wants me to take a max of 3 per day which hasn't been very useful to me.  I do hope that the injection will reduce my need for breakthrough pain medicine but it will only be temporary.

I hope I didn't write too much.  I just really wanted to provide information on all that I know is out there for management of chronic pain and what has helped me over the years.  Please do let us know how your appointment goes this week.

femmy  :)

[namnam46]

Martikadragoon:  I sure hope that you will be a candidate for the RFA.  If you are I know that you will have great results. There is nothing worse than having back pain that is relentless and never lets up.  I had totally given up when I lived in TN and thought that I would have to live with the pain and the 5/500 hydrocodone that I had been on since 2003 but was no longer effective but better than nothing.  Then moved to AZ & was sent to pain management. (I'd been offered that option in TN but was under the mistaken idea that it was only for physical therapy.)  Was sent to the best PM Clinic in AZ and the rest is history.  My Dr. suggested the RFA after the very first x-ray as my DDD is severe.  I was petrified about doing it but had complete faith in my Dr. After my first side was done I never had another pain down my legs or in my back.  I didn't have to wait 2 weeks for the results it was immediate although some do have increased pain during the 1st 2 weeks after then it goes away. I just pray that you will be able to at least try it. I'm keeping my fingers crossed for you. :)  I'm hoping that you get a positive answer for trying the RFA tomorrow!!

As far as the medication goes, I've always handled my own meds.  Like Tuck, I wouldn't be comfortable letting someone else handle my meds for me.  That being said, if I did have an addictive personality, I wouldn't hesitate to have my daughter handle them for me. The important thing is that you get the relief that you deserve and don't have to continually put up with this chronic pain that you are having to endure!! You need to do what is best for you and don't worry about what others think or might say. I think that you are a very intelligent young woman to handle this the way that you are. Since I'm old enough to be your Grandmother, I can tell you that I'm very proud of you for knowing that this is what you should do to protect yourself from what might happen because of the addictive behavior in your and your families background.

I think that one of the problems you have is your age, as you know most Dr.'s are very hesitant to give out very strong pain medications to a young person mostly because, once you reach your maximum dosage, where do you go from there?  It's a real problem and they want you to hold off as long as possible or there will be no where for you to go with your meds.  It's a real problem for the younger generation.  This is one time that I can say that I'm very happy that I'm 65 so that I can get the type of relief that I do.  Otherwise, I wouldn't be able to walk. I'd be stuck in bed for the rest of my life!! I'm on Percocet 10/325 4xday and Fentanyl 87mcg's. That combined with the RFA's is what makes me be able to function and get out of bed.  That's why I'm hoping that you will be a candidate for the RFA so that you can function once more as you used to (or at least as much as possible).

There is one thing that you might ask your Dr. about and that is, possibly, switching you from the neurontin over to Lyrica. The neurontin was making me very sleepy and so we tried switching and it has worked.  Since you've been on the neurontin for so long and have increased to your maximum dose, it might be worth a try to see if you can get even more relief!!  :)

Femmy:  So glad that you are having relief from your injections. I hope that they continue for you and eventually  you can get the RFA that will, hopefully, give you a much longer acting relief.

I wish you both the best of luck & I will be thinking of you both.

Looking forward to all of your updates.........Sherry  :)

[martikadragoon]

Femmy~ it helps a little with the pain but not enough... the side effects really stink, itchiness, forgetfullness, inability to concentrate...

the pain mgmt doctor today said he wants me to do physical therapy only and won't persue more injections and won't give me anything else for my pain.  He feels I've exhausted ALL of my options and believes only in conservative treatments for someone my age (like you mentioned...) his words were that "He has to babysit me and make sure he doesn't do any harm with medications"...bull

My PCP is the one who started me on nucynta and I don't take it very often due to the side effects.
I was getting a medication called klonopin which is like a long acting valium but need to stay away from it for similar reasons to the Soma... I'm too at risk of dependancy for things like that.

Sherry~ Age is an issue with my PM doctor... it wasn't when I went to the PM clinic in Loma Linda during my 2nd pregnancy... I'm going to try the phyiscal therapy and HOPE that it helps.
A huge issue is that none of my tests really show a definite explination for my pain, only small things that can cause some pain.

DH asked me if it could have anything to do with having a low tolerance to pain and I told him that I doubt it because I can handle a migraine, or with my skin disorder...when I scrape my skin and it tears or blisters badly I can handle that.
Currently our pastor comes to the house to just do counselling with me regarding many things including medications. We are working to where I can handle meds correctly when I have to do it myself.  idk.... my problem in the past has just been that I don't want to deal with hardly any pain sometimes. I've had to change that to where I decide I can handle SOME pain and get my level down to a tolerable number..... It's been tough all around.

I'm hoping that physical therapy helps but if it doesn't then I'm not sure what to do...

[femmy29]

Hi Cindie,

This news is discouraging but don't lose hope!  Your pain management physician's decisions are mind boggling to me.  I don't understand why he would stop all of your other treatments and pursue physicial therapy alone.  It has been shown that a combination of treatments are best for chronic pain.  Not one type of therapy at a time but a multitude of therapies plus medications provide the best benefit.

Physical therapy has not worked for me thus far and I have been through it three times.  I tried physical therapy again back in January and it seemed to make my pain worse.  This therapist was stretching my legs all over the place and kept rambling about how flexible I was.  Little did I know what damage was being done underneath because the pain was well masked with pain medication at the time.  I can't say 100% that the therapist increased my pain but shortly after that therapy session, I began to experience worse shooting pains down my legs EVER in my life.  Granted my MRI results are much worse than they were 5 years ago and it could have just been increased pain waiting to happen but who knows how I would of felt if I never let her test my flexibility like that.  My point is, just BE CAREFUL in physical therapy.  If something doesn't feel right and causes you pain, STOP doing it!  I will probably be sent back to physical therapy myself in a couple of months as my spine orthopedic specialist said that he wants me to try physical therapy again after my injection.  I really don't want to go back...honestly.

Klonopin is very similar to valium but I understand your concern about the abuse potential of the medication.  Could you have your DH manage the Klonopin for you?  He could administer it to you at night so that you can sleep better.  It sounds like you have a great awareness of any addictive tendencies and are working towards self administration of your medications.  I understand you have addictive personalities in your family...my father is an alcoholic.  I have always shyed away from alcohol and now I never drank it because of the fatal reaction it can cause with the Opana ER I take.  I don't know...I am not seeing the addiction potential in you through your writings.  I believe that with your faith in God and family, you can responsibly handle meds like Klonopin.  It is unfortunate that the medications that work the best for pain have a higher potential of abuse.  I am not telling which way to go, it is just hard reading how much pain you are in and that your family needs you.

When I was 25 (just 6 years ago, I am not that much older than you), I was in a lot pain during pregnancy at the time.  After I had my son, I was in constant agony...couldn't do much of anything.  I fought and fought and fought with the doctors to help me.  Continuously went in their offices in tears explaining that I couldn't play with my newborn son and had trouble taking care of his basic needs.  It took 3 or 4 office visits and finally at the age of 26 I was put on Tramadol and valium.  Before pregnancy, all they would give me was Flexeril and Motrin 800 (which ate a hole in my stomach and I had to discontinue that).  I was on Tramadol until I was 29 years old which is when I switched to Vicodin and then a year later, Morphine ER w/ Percocet for breakthrough pain and at the beginning of this year, I was switched to Opana ER w/ Percocet for breakthrough pain which has worked far better than anything I have tried before.  I do worry about my tolerance but I also know that my son is now 6 years old and I already missed out on so much already, I don't want to miss out on any more.  I would rather have issues with tolerance and poor pain control when I am older after my child has grown up.  Then if I need to suffer, I can.  But I feel that I need to be as active as I possibly can right now to show my son that I love him and love spending time with him.  That is why I don't understand why doctors treat younger women so badly as far as treatment goes.  You have so much to live for right now...there is no time for suffering with pain.  Your kids want and need you!!  Therefore, I recommend that you NOT give up!  If you need to find another pain management physician, find one.  If this one thinks that he cannot help you anymore, then it may be time to move on.

I know it is hard without a detailed diagnosis that corresponds with your symptoms but it was the same with me at first.  Most of my pain was in my thoracic spine in the early stages (I had no low back pain back then).  My MRI only showed a tiny disc protrusion in that region with a bony bulge.  But I persisted and kept demanding better care.  And I think you need to do the same.  Have you been evaluated for fibromyalgia?  Your sensitive skin issues made me think that you could possibly have this condition.  Have you been evaluated for SI joint dysfunction?  Tuckamore has this very painful condition and she had a hard time getting it treated at first because it is very hard to diagnose and doesn't display any visible signs of trauma as other conditions.  But SI joint dysfunction does cause sciatica.  My spine orthopedic specialist thinks that I could possibly have this condition as well.  Sometimes a steroid injection into the SI joint alleviates a lot of the symptoms of SI joint dysfunction.

Don't get me wrong, physical therapy may help but don't give up the pursuit for other treatment options.  I know how much you want to be a active mommy for the two little ones that you have right now.  Don't let any doctor kill you dream of living comfortably while you are young!

femmy

[martikadragoon]

For sleeping I'm going to have a sleep study. My pastor is a former addict of prescription medications himself. You may not see it in my writings but I've done some stupid stuff with pain medications like Klonopin that I"m not proud of.

You asked about Fibromyalgia, no I have't been evaluated for it but my mother was diagnosed with it and my PCP wanted to test me for it about a year or so ago. I didn't do it because I don't want to know if I've got it... My mother uses that reason ALL the time (I have a flare up..etc) and it drives me nuts even tho I know she really does get flareups. I feel she's using it as a convenient excuse sometimes.

Right now I've gone 2 weeks without any opiate pain meds, just Naprosen, Flexeril, Neurontin and Volataren jel on occasion and have managed to function kindof ok. I still have days where I'm in pretty bad pain though.

My pastor said that most likely once I undergo a sleep study, if I need it the doctor will put me on something that REALLY works, unlike ambien where I need to take 30mg just to get 2/3 a decent nights sleep. Im back off of the Trazadone (3 to 2 to 1 every 4 days.. so that I don't deal with withdrawals). Apparently he had to do the same thing....

Thanks about the info on SI joint disfunction causing Sciatic pain... I DO have sciatic pain but it doesn't travel down my leg. If I bend over for any length of time then stand up I have sharp nerve pain shoot down the back of my right hip area. He did an injection near the area I think when I last had the shots.


Cindie

[martikadragoon]

So I'm wondering if the spinal injections just took longer to work than 2w or if some of what I was dealing with was rebound pain when I stopped the pain medicine because I definitely feel better than I did 2 weeks ago.

I'm still getting up early due to back pain but as long as I take something to help me sleep I'm able to get a few hrs of much needed sleep.

I've cut myself down from 10mg 3xday flexeril down to 10mg 1-2x a day and from neurontin 1200mg/4xday down to 900mg 2-3x a day and off the trazadone completely as of 2 days ago.
Personally I'm proud of myself and think that I'll stick to this level with the medications. I've been doing ALOT more housework and playing with the kids and think that doing all that has been strengthening my back muscles more which helps the pain more.

What do you think?

[femmy29]

Hi Cindie,

I think it is both: Rebound pain from ceasing opioid pain medication and also from the spinal injection.

As far the spinal injection taking longer than 2 weeks to work, that is highly unlikely that it would take that long to reap any benefits from it.  You should have noticed a reasonable drop in pain after 1 week and perhaps a little more relief 2 weeks out.  I think what could have happened is they injected the medicine inaccurately.  I have had a couple injections that barely did a thing and it was frustrating as I had been waiting for the injection for 1 1/2 months to help reduce my pain and when it didn't, I was very disappointed and felt let down when the injection those couple of times didn't reduce my pain.

I am glad to hear that you are feeling after ceasing the Nucynta.  Increased pain is part of the withdrawal symptoms from opioid medications so that could have been causing the increased pain too.

It is so nice to hear that you are up and able to do things with the kids without a lot of pain, that is such a blessing!  I do believe that strenghening your core muscles gives your back more support.  

If you are able to reduce the pain meds, both opioid and non-opioid and still function, I think that is wonderful!  I recently decided to reduce my flexeril dosage from 3x a day to 2x a day as it was reacting wildly after I started taking the Opana ER such that my head was always feeling ready to explode!  I think we all need to find our comfort level when it comes to medication and it sounds like you are doing that.  

Also, there are steroid injections that are injected directly into the SI joint...if this relieves your pain, typically doctors diagnose the pain as being related to SI joint dysfunction.  If the pain just runs down your hip, it is more characteristic of SI joint dysfunction as the pain that runs down the legs are directly traced back to a pinched nerve root in the lumbar spine.

I think your approach is great and I hope you continue to get pain relief with your new medication dosage.  As always, please keep us updated on how you are doing and feeling.

Wishing you more days with less pain.  Have a Happy Easter!  :)

femmy