Best drug therapy for nerve pain

[BusyGrl]

When I started seeing a pain manager for chronic leg pain last fall, she said it was nerve pain without doing any diagnostics. She put me on morphine, and I've had ups and downs with it. Now I am considering going back to square one by weening off of morphine and seeing what my pain level is. It is almost a year since I had L4-5 spinal fusion, and I hate the side effects, costs, and stigma that go with taking this class of drugs.

Has anyone tried this? What was your experience? My reasoning is that I could get a maintenance prescription for hydrocodone, which was working just fine for me before. I am pretty sure I need a maintenance drug, but morphine has always seemed to be overkill and not worth the weird side effects. I wonder why they are so OK with prescribing morphine and not lesser drugs like hydrocodone. I always heard it is because you need more and more, but don't you build tolerance with morphine, too?

My only issue with hydrocodone is I can't sleep on it, so I'll need another drug. I am also expecting her to say no for some reason as it seems every time I get a combination that works, someone takes it away. I was using morphine plus Ultram and she made me choose one. I chose morphine and I'm not happy with my choice. Ultram wasn't enough when I was using it before the morphine, and I've read about some risks of seizures and maybe other things with it.

Comments?

[BusyGrl]

Thanks for your response.

Today I decided to wean off of morphine and try Ultram for a few weeks. My PM is willing to work with me, so that is a very good thing. She said hydrocodone isn't good because of the Tylenol, like you said, and I am sure she would be willing to help me try low-dose oxycontin or something else if this doesn't work. Thanks for the suggestion.

It is probably wishful thinking that I will find the pain level has subsided by now. I am grateful that my PM doesn't hang me out to dry like my PCP. You never know how bad the treatment is out there until you experience chronic pain.

[sandee1818]

Your doctor must have her own reasons for the choices she has given you but in my opinion a PM would be much more apt to prescibe hydrocodone or something in that class minus all the tylenol. the issue she has with the hydro may be the tylenol content. talk to her and really make yourself clear that you need pain control but consider morphine overkill but the ultram wasn't enough. There are plenty of choices in between the two.
I think maybe a low dose oxycontin say 10mg with a break thru medication would be a good middle. But it is up to her and you as you should have a say in your treatment.
If you feel you don not then it is time to find another doctor. But do not expect other docs to be so forthcoming with the pain meds. They tend to start you on a low dose and not morphine right away.
Keep us posted and if you have any more questions please ask:)