Aa
can medication cause pain
I have been on pain management for 10 years I have (with help from Dr) been able to reduce the amount of pain meds after a nerve ablation to c-spine I have noticed I can go longer without the need but when I try to reduce I get very worn down and achy can long term treatment create hypersensitivity to the nerves and how do you fix that? would like to be able to cut down more thanks taking morphine sr 30 and hydromorphone 4mg
Thank you jerry I thank you for the information withdrawal is awful I have been their twice both by poor Drs. glad I found my current Pain Mgmt. Dr. I am looking forward to reducing my dependence and learning what to expect thanks
Absolutely! That is called "hyperalgesia," a real phenomenon!
However, from posts I've read on this forum, hyperalgesia appears to be used as an 'excuse' a number of times -- by some physicians who are not wanting to prescribe opiates (i.e. creating an irrational fear).
But hyperalgesia is real!
You can't 'fix' it, but you can moderate it by taking extended "drug holidays" (LOL -- easier said than done! And.... I wouldn't use the word 'holiday' ... maybe HELLiday haha)
Hyperalgesia is not permanent. It's just the body trying to normalize.
However, from posts I've read on this forum, hyperalgesia appears to be used as an 'excuse' a number of times -- by some physicians who are not wanting to prescribe opiates (i.e. creating an irrational fear).
But hyperalgesia is real!
You can't 'fix' it, but you can moderate it by taking extended "drug holidays" (LOL -- easier said than done! And.... I wouldn't use the word 'holiday' ... maybe HELLiday haha)
Hyperalgesia is not permanent. It's just the body trying to normalize.
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Opioid-induced hyperalgesia (OIH)is one of the most understudied aspects of opioid research.
OIH has been studied mainly in rats, however, it's also been demonstrated in post surgical settings by nothing an increased sensitivity to response of c-fiber nerves (the nerves that are responsible for chronic pain), under heat stimuli. I don't want to go into any complicated neurobiology here. If you're interested seach this site for c-fiber pain, I've written extensively about chronic pain vs. acute pain (carried on largery, mylenated alpha-delta nerve fibers.)
These studies on humans have been limited to less than a dozen and involve only opioid naive patients.
Not one study on OIH has been performed with humans receiving chronic opioid therapy (COT) that has rendered them physiologically tolerant to opioids. Yet, an arbitrary limit of 200mg / day morphine equivalent dosing is now a standard of care in the US, and millions of pain patients on long-term COT are suffering because of it.
What you are feeling is hyperalgesia associated with opioid withdrawal. I would notify your doctor of your other symptoms and ask him to wean you more slowly. especially from hydromorphone (Dialudid) which happens to be one of the strongest morphine-like opioids in our arsenal against pain. Hydromorphone is thought to be twice as strong as heroin, although so-called equal- analgesic tables that compare the efficacy of the various opioids provide rough estimates due to tolerance, metabolism, clearance, and other factors.
Talk to your doctor and report your withdrawal symptoms. Slowing your weaning will help you cut down your pain while at the same time, reduce symptoms.
Let me also advise you that medial branch block neurolysis is not a cure-all for neck pain. There may be other sources of pain contributing to your cervicalgia, so ask your doctor about physical therapy and other modalities for treating your pain. I find that RFA or radio frequency ablation removes only 50% of my pain, at best. I still have pain from foramenal stenosis, spinal stenosis, and chronic myofascial syndromes. As for now, I still require opioids to treat these other modes of pain, but without RFA, I'd be in pure misery.
Best wishes in getting your pain under control.