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Long acting not working for all pain issues

I am taking 15MG of long acting oxys for my knee but when I have to walk it does not help too much and I have to spend the rest of the day with my knee burning and trying just to get it comfortable which is pretty much useless. I am also taking gabapentin for RLS which has started giving me side effects of feeling depressed and somewhat suicidal at times but when I don't take it my legs keep me up almost all night and then when my legs are twitching and jerking it aggravates my knee so then I have two types of pain to deal with at night. I do not want to increase the gabapentin since the side effects are getting worse and the anti depressants are making me very groggy and tired all day and have no emotions it feels like any more. Now on top of that my cortisone shot that I had last year for my trigger finger has worn off and the long acting pain meds DO NOTHING to help this pain in any way shape or form. I don't want to take another cortisone shot since it gives me high blood sugars and that makes my RLS and neuropathy pain worse for a couple weeks. Does any one think I might be better off taking a short acting pain med instead of a long acting one that does not seem to help everything? I can't take NSAIDS due to ulcers and gastroparesis amongst other stomach problems from years of indulging in alcoholic beverages in my younger not so wiser age. Any ideas so I can talk to my PM Dr. to keep my pain under control and still be able to have some sort of normal life. I miss the simple things of just walking my dogs, grocery shopping or talking a casual stroll through the mall to get some exercise and see other  people besides my family due to the knee pain that will follow  after a short walk even through the grocery store. Thank you in advance for your advice or suggestions.
2 Responses
7721494 tn?1431631564
Common standards of practice include using two opioid dosing types -- long acting medication to control baseline pain, and immediate release medication to handle breakthru pain.

Perhaps you need both?

I suggest that you keep a pain diary during the month to document your pain level vs activity to demonstrate your need for breakthru medication.
Avatar universal
Here's the "big secret" that nobody has/is/will ever say out loud: pain medication does NOT kill pain.

Opiate pain medication causes euphoria, and it is the euphoria that makes the mind "not notice" the pain so much.

When a person has a pain or issue that responds to Advil (sprained shoulder, or whatnot), and they take an Advil, the pain *truly does go away.* (Of course, lots of times the pain doesn't totally go away, but often, it does!)

So, it is safe to say that in certain circumstances, Advil "makes pain go away," and it "kills the pain."

Conversely, opiates do NOT kill the pain, or make it go away. If you are expecting an opiate to do that, you'll be 'expectin' for a long time! Opiates do something to the mind (scientists don't truly understand exactly what's going on -- they have all their fancy charts, and theories about 'opiate receptors' -- ever seen one? LOL), causing the mind to "not focus too much" on pain. Any kind of pain -- physical and emotional and mental.

That is why, when you ask someone that has just taken an opiate if they still feel the pain in their arm/leg/shoulder/back/whatever, the truthful answer is, "yes, I feel the pain.... but it doesn't bother me as much."
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Avatar universal
st. louis, MO
317787 tn?1473362051
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