Types of Pain Management Doctors

[Lilkim703]

I recently went to a pain management doctor for the first time.  I was nervous because of the stories I have read on this website.  I had a thoracotemy in March 2005 and have been experiencing chronic pain at pressure points in my upper back and shoulder blades ever since; also, I have small lung collapses that make it hurt to breath in my upper back and chest.  Anyway, part of me was hoping to be prescribed some type of pain medication to help ease my discomfort, but I am a CPA and I would not function at a high level if taking mind-altering medications.  I also knew that tapering off of dilaudid after surgeries was never fun.  The place I went is an "Anesthesiology Associates" that handles pain management.  I found out in my appointment that they do not prescribe narcotic pain medication but will prescribe muscle relaxers.  The practice focuses on injections, physical therapies, massage, electrode therapy, etc.  I was able to get a couple pressure point injections on the left side of my upper back and it felt much better than my right side throughout the day.  As a result, the doctor suggested botox injections for my pressure points because the other injection worked well.  Now, to my point - has anyone had the botox injections?  If so, please share your experiences.  Also, when going to a PMP, is there a way to determine ahead of time whether they are the kind that prescribe painkillers?  I am currently very happy with the way this is going - no drugs, no surgeries - but if it does not work as I am hoping, I am curious to know how to figure out which practicies would consider prescribing medication if deemed necessary.

[tanglewood]

Hi Lilkim,

    I've never had the botox - but very curious; will look forward to your comments on them. After reading other's posts it seems it works for some, but not all - probably depends on the doctor hitting the right exact spot. I've had the epidural injections and they helped at first, but then I got to the point where they didn't help any more. If you have to go with pain meds, maybe a synthetic narcotic like Tramadol would work for you? Good luck with the botox injections - I hope they work for you.

[Tuckamore]

Hi Lilkim,

You are correct that Botox is a neuromuscular blocking agent. Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves. The effects last about three to four months. It's the same toxin that causes a life-threatening type of food poisoning called botulism. It is used more often cosmetically. It is used on the face to produce a temporary "face lifts."

You are also  correct that the OTC patches can be effective. I use a heat one, the most expensive and it lasts and lasts. Of course nothing "cures" the problem but a little relief is good. I have tried the lidoderm patches and have not noticed any change in my pain.

I will be very interested to know how this works for you. We all learn form one another. Have a great new year and please keep in touch with us at MedHelp.
Peace, Tuck

[Lilkim703]

Thank you all for your comments.  I am scheduled to have the botox injections on Jan. 9 and I will report back on my results.  Botox is a neuromuscular blocking agent, so theoretically, injecting it into trigger points will reduce pain for a 3 - 4 month period.  We shall see about that.  

I have gone about three years without prescription pain medications (except Lidoderm patches) and I have no desire to go down that path unless all else fails.  Knowing that nothing I have tried so far has yielded much relief forces me to consider that pain meds may be in my future so I wanted to understand the intricacies of the "pain doctors."  Random note:  If you have used Lidoderm patches and they sort of worked a little, I recommend over-the-counter Johnson's & Johnson's Back Plaster as an alternative.  It keeps my back warm and loose all day long.  

[melo64]

Hi lilkim~
I have had the botox injections for pain control and they did not seem to make any positive results. I think the steriod injections helped me more so than the botox. Of course the steriod injections are only for inflammation and are temporary. I have everything done and been given just about everything to help control my neck and back pain. Currently, I'm back to the Fentynal patches and anti depressents to help with my pain and yeah, it seems to help for a little while then I'm switched to another type of opiate. Believe me I am scared come the day that I no longer will be on anything but I don't see that happening in the near future. I think my pain dr. prescibes the narcotic type meds. when all else fails. I was even told that I may never be pain free and that I just have to accept where I'm at. I had a failed cervical diskectomy with plating and have never been pain free since that surgery. Now I'm told that the upper disk and two levels below are herniated because of the surgery that I had. Ask me if I'm going to go through this again? ! I don't like the fact that I'm on narcotics but if that's what helps alleviate some of my pain, so be it. But it ***** because of the side effects. Everybody is different and some may not have the same reaction or opinions about the meds. If you current dr. does not prescibe those type of meds. he may refer you to someone who does. Let me know how things go for you

Melo64

[sandee1818]

I have heard of botox injections for pain and have heard it has helped some people. I would get all the information I could before taking this step though. I can give you a couple sites if you would like that has information on it.
I see you went to a anesthesiologist and some do pain management but it is best to find a pain management clinic/doctor.
Remember when you find a PM doctor your hiring the person who will control your pain so you need to fell comfortable with him/her and the options they give you. I think your doing the right thing by trying to find a way to handle the pain without narcotics. You may need to go that route eventually but its best to try all other options first. Most doctors do this anyways. If you do end up taking pain medications remember that is only a small part of chronic pain control.
Most pain management doctors do offer medications as an option for chronic pain but as I said make sure you discuss your expectations and have him/her go over what options he/she can offer you before you decide on one.
We tend to take our doctors for granted sometimes and they are the ones that helps us control our pain so as I said make sure you choose the doctor who is right for you.
Good luck and have a wonderful new year!
Keep us posted and let us know how things are going.

[Ghilly]

When you go to a PM doctor, your first visit is almost always spend in consultation with him or her.  So use the time to tell them how against the use of painkillers you are, and tell them that if it's all the same to you, you would rather try alternative therapies.  If they are not well-versed in working with other methods of pain control, ask them if they can refer you to a PM practice that does.  You don't have to do anything you don't want to do, so take the time to find a PM doc who is going to work with you the way YOU want.

Ghilly

[jollyman069]

i have never heard of botox injections for pain control...my pain mangemnet dr is a anesthesiologiost and he perscribes me narcotics for chronic back and leg pain, i have 3 herniated disc and already have had one back surgery.. i gues if you want to check out the dr before you go you would have to ask questions..i know that is sometoimes hard to do because of the stigma that is attached to chronic pain patients as drug seekers. but the botox is different i am curious on how other MH family is going to answere that one..good luck and keepm us informed on how it is working