I haven't posted for a long time, though I do come on and have a read regularly. I find it very difficult talking about this stuff though, so I've not really found myself able to get involved in any discussions. I do have a question though, if you don't mind?
Up until a month ago I was on Tramadol, which I’d been on for a couple of years, apart from a month last summer when I tried MST morphine. It made me really depressed though, so I went back to the Tramadol. Increasingly though, I'd been finding that the Tramadol caused muscle pains all over my back (my main pain is on my shoulder and neck). The pain clinic said that Tramadol just causes muscle spasms sometimes and gave me muscle relaxants to deal with it but they made me depressed as well, so I came off them. Over the past six months the back pains has got a lot worse, as has the shoulder and neck pain, to the extent that it seemed like the Tramadol was no longer working. I wasn't able to cope with it any more, so a few weeks ago I reluctantly went on to Oxycodone. I started on immediate release Oxynorm (20mg a day then increasing to 30) but had real trouble with the side-effects - I was feeling completely out of it and kept ‘blanking out’, so my doctor changed me over to slow release (Oxycontin), starting 30mg a day, now at 40.
When I started the Oxycontin, I was taking 10mg in the morning and 20 evening, but I was still getting really bad muscle pains, like from the Tramadol, towards the end of the day, as though the morning dose wasn't enough to last through until the evening one. I thought the problem would resolve itself when I increased to 20mg morning, but the same thing happened.
I'm also on Fluoxetine for depression, and I was taking that in the morning, at the same time as the Oxycontin; I started to wonder if the Fluoxetine was somehow inhibiting the Oxycontin because I got more relief from the evening dose than I did from the morning one. So I've moved the Fluoxetine to last thing at night to see what happens. The muscle pains have improved a bit, but I'm now much more wiped out by the Oxycontin than I was - I feel completely spaced out, exhausted for most of the day. So it does seem like the Fluoxetine was somehow interacting with the Oxycontin.
But what I don't understand is
1) why I feel so completely spaced out all day now (I didn't used to feel that way all night) and
2) what the muscle pains really are?
When the pain clinic said it was the Tramadol causing muscle spasms, I kept asking if it was because I was becoming dependent on it and they said no. But when I changed over to the Oxycodone, the pains were much much worse and I did some reading that seemed to suggest it was basically because I was withdrawing from the Tramadol (indicating that I was dependent on it). But then why am I still getting the pains now, on a drug I’ve only been using for a month? I know they're similar, but even so, I don't get it.
I don't know if any of this makes any sense, but if anyone can shed any light on it I'd be really grateful. (And sorry for the mammoth post - there's probably a much quicker way to explain all this, but the meds are turning my brain to mush!)
Thanks very much
I have been a spectator for so long..Now it's time to participate.......
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/ 30 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night..Glipizide 10mg. 2X in the morning
Lantus 35 units at bedtime with Solostar Pen
How interesting - for some reason, I wasn't expecting to hear that other people found the same thing - I thought it was just me!
Whitebeard - my GP and pain doc both say just 'muscle spasms' and blamed it on the Tramadol. It tends to be in 3 bands - between my shoulder blades, across my mid back and across my lower back. Usually it's one or two of these bands at a time, but during the changeover from Tramadol to Oxycodone, and when I just stopped the Tramadol altogether last year, it was all three. I don't get muscle spasms or that kind of muscle pain anywhere else. My 'main' pain is in my left shoulder but it radiates up to my neck, across my shoulder blades and over the top half of my chest and back. Like many people, moving any part of my body can trigger pain in these areas. I also have trapped nerves in my back & neck that caused headaches and nueorological disturbances.
I'm afraid I don't know what 'charlie horse spasms' are, but I guess I'd describe the back spasms as the muscles feeling really really tight. It's like they're constricting from all directions though, not just one way, and it's not a sharp crampy pain, it's more low frequency than that (very different to my shoulder pain). I never used to get it before I started the Tramadol, but unfortunately the shoulder pain becomes too unbearable for me to go off my meds for more than a day, so it's difficult to say if it's still there without them, because I never get them out of my system.
Thanks for any advice you can offer
Chronic Pain Moderator
-Stress is when you wake up screaming....and realize you haven't fallen asleep yet.
-What if the Hokey Pokey really IS what it's all about.
-Is it time for your medication or mine?
-Underneath it all....I'm pretty much naked.
Thanks for all the replies guys, I appreciate your support. I talked to my doc today and he wants to change me onto Targinact (Oxycodone & Naloxone), though I think he's just randomly trying stuff in case it works.
A friend of mine who was on Fluoxetine for ages suggested to me today that it might be that that's causing the spaced-out thing, rather than the Oxycontin, because she had a similar problem, though not nearly as bad (and she wasn't on pain killers). Doesn't explain the spasms though. My doc's only idea was that my back is just very weak because of my limited movement, but that doesn't explain how it can come and go regardless of what I'm doing.
I'm going to try taking the Oxycontin a couple of hours after the Fluoxetine tomorrow, to see if that helps (usually they're the other way around).