lower back and head pain

[randykb]

I am getting very close to my wit's end in my pain management issues. I will attempt to list everything I've tried and then ask some questions that I hope someone that has the same issue(s) will be able to answer. I do understand that because this is a medical related issue, any responses will be regarded as such and I will see a doctor regarding any suggestions that may be presented to me. I will start with some background and then present what the issue(s) are. My problem started when I had an almost fatal automobile accident in 2006. As much as I like to talk about it nowadays, I will try to keep it short and to the point! :) I had to be extricated from the vehicle after it hit a power pole. Fortunately my vehicle was the only one involved. According to the EMT records I was able to obtain, they thought I was already dead or dying and they flew me to the hospital in a helicopter. They had to perform brain surgery to remove pieces of plastic from my brain. I was put into a medical coma for 4 days and then I was transferred to a rehabilitation hospital for care. For about the first 2-3 weeks, I had no memory of my past and that included not knowing anyone including my wife. I was hospitalized for about 3-4 months and I started regaining (fortunately) my memory and had gotten it mostly back prior to being released from the hospital. I was ‘rushed’ back to work (mostly due to insurance issues) and that's the continuation of my story. I am currently on long-term disability since about Sept. 2008 because of my current pain issues. I have had problems with extreme pain due to headaches. I never had migraines before and several doctors I have seen regarding the pain have all agreed that they aren't migraines. I have also had issues with lower back pain but most doctors don't want to address that issue (I know it's my fault because I could press the issue) and they would rather concentrate on the head pain. The head pain is actually worse so it does need to be addressed. I have had a couple of MRIs and I have been to a pain management clinic but they haven't helped. The pain management clinic kind of made things worse for me because they were preaching anti-narcotic propaganda to my wife (you’d think they would be open to any pain management techniques) and she is/was anti-narcotic anyway. Trying to keep this 'story' as short as possible, I have been taking  Hydrocodone with acetomeniphene (10/325 MG) (generic Vicodin) since about Feb 2007 for the pain. Doctors of course, don’t like to keep prescribing it because it IS a narcotic. My main issue right now is that the Hydrocodone stopped relieving the pain in about late 2008. It still has SOME pain relief because the pain is not UNBEARABLE yet, but I feel it will become that way soon so I need some advice on different medications, obviously something with more pain relief. I am also open to any advice from 'experienced' pain suffering people. I don't know what medications are currently available, but some that I found are: Oxycodone (which offers higher MG than the hydrocodone that only has 10MG as the highest dosage), fentanyl TD (which I think may be too strong) and there are several generic forms of  oxycodone. Although it is my desire to be pain free in my head and my back, I also don't want to take something that would be stronger than I really need. I do need to mention the fact that I have a high resistance to pain medication. That's why I feel that advice from people that are familiar with the various drugs and have already had experience with them could help me avoid some issues they might already be familiar with. Thanks for any help and/or advice you can provide for me. I'm also interested in hearing other methods of pain management others have tried.

[ryder100]

For most of people first thought is comes to back pain relief medication. And while there are a  manager  of prescription medications that will cure back  pain,  they are doing  none  more than masking the symptoms  alternatively  of  attempting  the underlying  source  of pain. Medication should be employed sparingly and under the stringent supervision of a medicinal professional. But it should in addition be your last vacation resort for back pain relief. Use over-the-counter pain medication for back pain support to help you military discomfort while you work to alter the underlying reasons for of your back pain. for more information visit
http://www.americanpainfl.com/

[randykb]

Thanks for responding (your two cents are worth more in this forum). I actually saw one of my doctors Thursday and he wrote a script for me to see a specific DR at a different pain management clinic. I am up for it because I need so much help! I looked at their website and they mention lower back pain but not head pain. I also noticed that my DR had written 'evaluation for a pump' on the script. I have tried looking it up but there is so much information on it that it's confusing. Most of them mention 'morphine' pumps. Is that the only kind of pump available? I would appreciate anyone that could give me more information on the types of pumps available. I feel a morphine pump would be too much but what do I know? :)

[katarina777]

I personally think that oxycodone is not a good solution at all because it is so  very, very short acting. narco works for a food 4-6 hours but ocycodone only workd for about  2-3.

I also personally do not like fentanyl. it also matters how often and for how long you have those headaches because fentanyl is around the clock relief and you may really not need or want all that extra medication during the night.  Personally, I also do not like the way it makes me feel although the pain relief is incredible. but it causes me to become dysphoric, as in the opposite of euphoric and I really feel slowed fown and medicated. With narco, for may of us, it's more like a drug that fives you energy and you can function great on it? but narcotics can also make headaches worse because they somehow increase the pressure in your head. For that reason you may want to try something totally different like Fioricet, which is a combination of tylenol or aspirin in conjunction with butalbital and caffein. It is sometimes also combined with codeine but here I was specifically thinking about the butalbital that often really works for headache sufferers and it's a barbituate. It's mostly appreciated by people who get migraines buit also tension headaches, and it's just a good drug, I think.

For the backpain, and even also for your head, i would also give physical therapy a try. i used to think they were a waste of life but I changed my mind on that. Especially the ones that use pilates; it made a huge difference not only with really all of my body and specifics of my body but overall wellbeing.

So much for my two cents!

[ryder100]

You are better competent to get your discomfort under manipulate when you are relaxed. Fear and anxiousness originate from the asleep psyche so it is needed to tap into this mental supply in rank to get the support that you need. You can observe yourself finishing the opening or you can use other images to lead you to relief.

[randykb]

I appreciate your responce and will try to keep the forum updated if something changes. I actually have an appt scheduled with the rehabilatation DR that helped to 'make me better', (knowledgewise) during my hospital stay after my recovery from the 2006 MVA (which by the way. it was also a sports car, a BMW roadster convertable and I really miss that car! :) ) I will look into the TENS Unit and ask the Dr about it tomorrow. As far as the medications, I don't look for them to cure my pain, just make it more bearable. I'm trying not to expect too much. I have tried biofeedback in the past but it was not because of pain. What I did find is that I really can't control my body in any fashion. Thanks for the advice and I will keep looking for more! I listed the medication possibilities because I wanted to be prepared to discuss it with doctors when I had someone hat might listen to me.

[TrayCee]

"Oxycodone is no longer available without acetaminophen"

Roxicodone

[Tuckamore]

Hello Randykb,

Welcome to MedHelps' Pain Mangement Forum. I am sorry to hear about your traumatic MVA. I too am a victum of a MVA. My sports car was hit head on by a loaded dump truck and I also had to be extricated and Med Flighted. I did not have any head injuries. I spent 6 months in the hospital. I understand the trauma of that experience alone.

Do not regard any suggestions I may offer as medical advice, they are personal opinions only. There are no physicians on this site and I am not an expert.

There are multiple medications that you and your PMP can select from. Which works best for you will most likely be trial and error. All of our systems are different as our our responses to medications.

To my knowledge Oxycodone is no longer available without acetaminophen. The dosage will be similar to hydrocodone.It is considered a more potent drug and you may want to begin there. However it is more widely abused than hydrocodone and your PMP may be reluctant to prescribe it. I am only guessing I have no idea how your PMP prescribes.

You may benefit from a longer acting or slow released pain medication. That will avoid the peaks and valleys that one can experience on the short acting medication. Yes Fentanyl is a jump especially if your pain is basically controlled at this point with hydrocodone. Chronic pain patients usually do not achieve freedom from pain. It is not a realistic goal. The goal of Pain Management is to make the pain tolerable and return us to a realistic functioning level.

Have you tried bio-feedback? Some ppl find it helpful. A TENS Unit may also help with pain reduction in your back. Acupuncture is another method that others have tried with varying degrees of success.

Rather than listing medications that are possibilities I think you are better off to discuss this with your PMP. He knows you and your pain better than I. Others will post with their suggestions. Best of luck to you. Please keep us posted and let us know how you are doing.

Take Care,
Tuck