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Where to put Fentanyl Patches for the best relief?
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Where to put Fentanyl Patches for the best relief?

Hi all,

I need some feedback, I use Fentanyl Patches (150 mg) for pain relief. I have Degenerated Disc Disease and it just seems that I cannot get the pain relief needed to manage my life.

So if you or someone you know uses these patches, where should or where is the best location to place theses patches???

My pain is from two lower discs in my back that are shot!

I also have Oxycodone for break-through pain, but I hate taking these drugs, I am going to a pain management group in the near future for hope that I can find a better way to manage this.

Any feedback would be appreciated...

Thanks, Oz
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Avatar_f_tn
Hi Oz,

I know what you are feeling as I have Severe DDD and have been on the Fentanyl Patches for 19 months now.  I'm on 87 mcg's evdery 48 hours and take Percocet 10/325 3 times a day.  I normally cut them in half but sometimes do need to take a whole one.

I was told by my PM (Pain Management) Doctor to place them on my upper back and switch from side to side with each new application.  I've been doing this for 17 months and they don't come off and the sweat doesn't effect them.  It's my understanding that this is by far the best place to place them.  It's definitely helped me to manage the DDD.

I hope that you will be able to get to a PM Doctor or Clinic soon as they can afford you several options to help you with your pain.  I've had tremendous luck with the RFA (Radio Frequency Ablation) where they "burn or kill" the nerves.  I know that it sounds terrible, but believe me it's not bad at all and I have mine done without any anesthesia.  I do have a very high tolerance to pain but it truly isn't bad at all. This has helped my Lumbar DDD (which is the most severe) almost 100%.  However, unfortunately, I have it over my entire back along with 5 bulging discs in the Thoracic as well as the Cervical areas.  That's what I use the Fentanyl and the Perc's for.  I wouldn't be able to function without them. :(  I don't enjoy having to use them either but it sure beats the other option of not being able to get out of bed in the mornings or being able to do anything at all!!!

I hope that you will be a candidate for the RFA and will be able to get the same results that I have from it.  I have been almost completely free from pain in the Lumbar area for 16 months now.  I'm hoping to make it to the 24 month time period!!  :)

I wish you the very best and hope that this information has been helpful to you.

Please keep us updated on how you are doing as I'm hoping to hear very good results for you.

I wish you the very best and will be looking for your updates...........Sherry  :)

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614661_tn?1267277524
Hi Sherry,

Thanks for the input, I have never heard of the RFA before, I will bring it up with my doctor.

Also, I think I have a mind or brain issue when it comes to pain relief from the patches.

The pain relief seems to work best when I put the patches right on my lower back where I have the bad discs! If I put them up my back I do not get the same relief. Am I just in such a state where my mind says I get relief here, but not enough when I place them somewhere else? But I will try the upper back on the shoulder blades and see how it works.

Thanks much for your feedback,
Oz...
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Avatar_f_tn
Oz, I don't know if it's a matter of your mind or not.  :)  I put them on my upper back because that's where my Doctor said that his patients have received the best results.  LOL.  I always listen to my Doctor as he has never led me astray as of yet.  :)


I hope you will ask about the RFA as it has worked wonders for me.  I was always walking stooped over and had such horrific pain down my legs and in my buttocks that it was hard for me to even be able to function.  I didn't even want to get out of the house as it was so hard for me to get in and out of the car.  :(   It has made a world of difference for me!!

I look forward to hearing from you again as you find the answers to your problem.  Hope it works for you.

I'm giving you a link to WebMD that will tell you all about the RFA.  Hope you enjoy it.

Here's the link:

/www.webmd.com/pain-management/radiofrequency-ablation

Good luck............Sherry  :)
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Avatar_f_tn
Meant to add that I will be out for awhile but will be back later today. so that if you have any more questions I'll be checking in.........Sherry
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Avatar_m_tn
Definitely try the process of killing nerves in your back to help. I've been through the process and basically they'll do novicaine injections two separate times at the same locations to make sure it works, then do the actual nerve burning. The nerves grow back after 6 months so you have to continue doing it, but it definitely helped me (3 degenerative discs plus 2 shot hips).

As for the best place to put the patches, I've gone through a bunch. The recommended places are on your upper biceps/shoulders or on the upper part of your back/shoulder. The problem I have with this is that you can't stand in a hot shower with them there unless you block them off or you can cause an overdose from the hot water causing the medication to absorb WAY too fast. Trust me I passed out on my bathroom floor once from this. I switched to putting them on the insides of my biceps and even on the insides of my thighs instead. The only issue I ran into is I have sensitive skin and it caused a lot of irritation. I actually recently had to stop the patch because it was irritating my skin so much 3 weeks later you could still see a mark on the outside of my arms.
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614661_tn?1267277524
Hi all, Again, thanks much for all the feedback.

I will definitely look into the RFA thing. Well I put a new set of patches on last night, right on the L5-S1 location and have little pain this morning. This location seems to give me the best relief, but we are going to try the upper back with the next set. After all, is it true the the medication really tells the brain that there is less pain rather then affecting the nerves in the lower back???

I have the prescription written for changing every 48 hours. Normally they are written for 72 hours, but I found the 3rd day I have so much pain, they agreed to allow me to change them every 2 days.

Back in 2000 I had surgery mostly because I had a pinched nerve and they went in to scrape some bone away to relieve this. It took and I was great for about 5 years, then the muscle spasms started in on my back and my discs started to go bad. This was in 2005-2006 time frame. But from then til now I have developed the Back Muscle Spasms, DDD, a rotated left hip, a bad sciatic nerve on my left side, a dull pain down my left leg to the bottom of my foot and my left leg is thinner than my right. Also lost about 25 pounds while I have been on these meds. I just hate them with a passion...

Thanks for the feedback and I will be posting more when I think of other questions I might have, so keep it on the watch list and we can post regularly.

Thanks, Oz

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Avatar_f_tn
I, too,change mine every 48 hours, as I said.  I was having an extreme amount of pin on the 3rd day and my PM Doctor told me then that I'd be surprised at how many patients do have pain on the 3rd day.  I was having to take all of my BT meds on the 3rd day and not nearly as many on days 1 and 2.  When he switched me it made all the difference in the world to my pain.  I'm so grateful that my insurance, Medicare, pays for them to be changed every 48 hours. If it didn't I'd vbe in extreme pain on that 3rd day!!!  :(

I don't know your patches are affecting the pain depending on where you put them.  I've never had that problem with mine, but then eveyone's different!!  :)  

I meant to tell you that I take my long hot showers on the 2nd day when I take my Patches off before I get into the shower and I can take as long and as hot a shower as I want then.  On the other day I just don't take as long or as hot a shower as I would like too. :(  You can imagine that I really look forward to the day I change my Patch (which was today) and I really enjoyed my shower this morning!!!!  :)

Believe me, I have this post and your other on the RFA on my watch list.

Thinking of you and looking forward to our next posting...........Sherry  :)
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614661_tn?1267277524
Hi all,

Yes, the 3 day length does not work for me at all, I have the script written as every 48 hours. I did relocate my patches the other day and it was a complete failure. I put them on my upper back very near my shoulder blade. The first day was tolerable with Oxycodone but the second day I was in tears and we went with new patches back to the lower back where I get my best relief! I know that it does not make sense, but that's just how they work for me. I do not know what to say any more about the location...

I wanted to send a little update as I try to work with the VA and get an appointment setup for a nerve block. I did find out that the procedure mentioned throughout this thread as RFA is also known, at least by the VA, as a Medial Branch Block. If you Google Medial Branch Block you will see other names and what they are, there is just a boat load of information out there.

I will send an update as things progress.

Thanks, Oz
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5401369_tn?1367419574
My doctor prescribed me fluticasone propionate spray ie. Flonaze spray for the irritation of the patch. I know that it sounds crazy but you spray it on your skin and then let it dry and you apply the patch directly where you sprayed the medication. This stops any irritation you will have from the patch. I hope that this helps you out.
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