Long term pain treatment

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dkmi
New Member


Date Joined Aug 2012
Total Posts : 1
   Posted 8/20/2012 8:06 PM (GMT -6)   
I'm now 2 years into daily pain and roughly 24 years of on and off. As you might expect it has become worse as the years have come along. In 2010 I was diagnosed with spondylosis and had discs at c5-c6 and c6-7 removed and fused. However, the pain persisted (Left side, neck shoulder, collar bone. Mostly the left trap and base of the skull). We went through the normal routine of physical therapy, Vicodin regime, anti-inflammatory drugs, epidurals, facet injections, etc with no effect. A great deal of this is long term muscle spasms leading to a diagnosis of myofacial pain with an unknown cause. To top it off I am also have sleep apnea and continued excessive daytime sleepiness despite treatment.

So my question is to see if anyone has any experience or suggestions. Currently Vicodin usage is not overly high but has persisted daily for 2 years (but there are days when constant pain medication is necessary versus portions of a day). It's begin to no longer work. Anti-inflammatory drugs and Topomirate (headaches) are not options due to Kidney function sensitivity concerns. Gabapentin left me not knowing who I was on waking one morning and was quickly taken off. Currently my Dr. is talking about Suboxone as a long term Vicodin replacement, possibility of trying Lyrica, and nortriptyline (mixing in with Citalopram for chronic depression and Provigil for my inability to stay awake). Currently we haven't found the right cocktail of drugs.

And I've of course done all the other norms (chiropractic, massage therapy, etc).

So my question is does anyone have any experience or cautions with the above drugs? Anything else that I might point my Dr.'s at as options or other possibilities of trying. I know we are beginning the end of our current options now looking at long term on going pain management and physical therapy. Thanks...

Worthit
Regular Member


Date Joined Nov 2011
Total Posts : 212
   Posted 8/20/2012 9:27 PM (GMT -6)   
Hi and welcome to H.W. dkmi! This is the best place to find advice and support IMO! I cant offer you much with your situation but a moderator will get to you soon. Their really good here. Good luck and hope you can find comfort somehow so hang in there!!!
Alone we can do so little, together we can do so much
Call me Jimmy;-)

Cirrhosis,osteoarthritis,back,knee,hip, extreme flat foot,falling arches, hammertoe,out-toing and bone spurs(will be requiring major foot surgery on both feet). Had kidney tumor removed this spring. Hoping to be diagnosed with a good sense of humor ;-)

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 4994
   Posted 8/21/2012 8:57 AM (GMT -6)   

 

       Good morning dkmi!...Welcome to our chronic pain forum!

   There are several med's I do not see here...lyrica...Cymbalta..and of course many, many pain med's. Are you seeing a PM?...or is it the PCD that is scripting your med's? Also, I have seen good reports on the Suboxone treatment's...but it is my understanding that you have to be in full withdrawal, before taking it, and it takes a liscensed Dr to administer it.

     Again Welcome, and enjou the forum and it's members!

      SE wink


Moderator Chronic Pain Forum

Weekly Quote!

"If you trust Google more than your doctor then maybe it's time to switch doctors"

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 806
   Posted 8/22/2012 8:27 AM (GMT -6)   
Hi dkmi,

Your diagnoses are similar to mine. The cause of my cervical spinal issues is scoliosis, with degeneration from C4-T4. As I result I have a very similar pain pattern as you do: left side, from the upper to mid-trap as well as rhomboid. The doctor who attached Myofascial pain to my diagnosis gives me periodic trigger point injections. I've now had seven or eight sets of injections, with maybe two or three making a difference. But, the couple that did help, helped a lot. So, if you haven't yet tried this, find a doctor who does the injections, then prior to the appt, while you are in a fair bit of pain, try to identify spots in the trap muscle that are most painful, put X's or circles where the pain is (or get someone to do it for you). That way, the MD will know where it is best to inject.

Aside from that, three other suggestions:
1) ice. I find that it helps far more than heat.
2) get a "body back buddy" or similar stick. I have the "jr" whose curve suits me best. I'll put pressure on the tense muscles, and that can sometimes help.
3) traction. This, in particular, you might want to talk to your MD about, as I don't know its risks given your fusions. But an over the door home traction kit might be worth trying.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds:200mg Ultram ER daily, 2x 10mg Oxycontin daily, Oxycodone 5-10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

Gerasdoc
New Member


Date Joined Aug 2012
Total Posts : 2
   Posted 8/22/2012 8:51 PM (GMT -6)   
Suboxone is not generally effective for chronic pain. If your physician has not suggested a trial with a C2 opioid analgesic, you may need to find a different physician. I agree with the idea of trials of cymbalta, lyrica, and TENS.

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3307
   Posted 8/23/2012 12:56 AM (GMT -6)   
Hi DKMI and welcome to Healing Well Chronic Pain Forum, I am sorry you are having all the problems, but I think you have come to the right place, we sure can't cure you but we can give you our ears and listen to you, and give you support, and let you know your not alone in this!
 
I do have a question for you, I also have severe sleep apnea, you mentioned that it was not helping and you were still sleepy during the day. Did they tell you what type of sleep apnea you had? and what type of machine do they have you on? The reason I ask, is allot of time people are treated for just plain Obstructive sleep apnea,  and they also have central apneas, and regular CPAP will not usually work on Central apneas.  Allot of people that are on pain meds, have central apneas, because of the medications, also congestive heart failure can cause central apneas and upper spinal cord damage, and some neurological diseases or conditions.. Anyway I know it took them over a year and a half and six sleep studies before they got me on the right treatment to treat the central apneas. If you  have central or complex sleep apnea, you need to be on a ASV machine, Auto, Servo Ventilator machine they are specifically designed to treat central apneas. So before starting the provigil I would urge you to check ( if you haven't already) about the type of apneas you have and the treatment your receiving for it. Just a suggestion.
 
As for your pain in your upper neck and base of skull, I have the same fusions that you do, C5/6 and C6/7. I was suffering extreme pain in my upper neck and the base of my skull. I ended up having to have the articular joints at C3/4 fused  it was a posterior fusion of the articular joints in the back and they used rods and pins to hold it together. It did take care of the pain and head aches. You might have them check out your upper cervical spine. Just a thought, if they haven't already checked it out.
 
Again I welcome you to the forum, and I do wish you all the best and hope you can get relief soon!
 
White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

countrydad
Regular Member


Date Joined Jul 2012
Total Posts : 44
   Posted 8/23/2012 3:21 PM (GMT -6)   
I have similar pain problems at the base of the skull. I have a congenital fusion at C5/6 and a bulged disc at 4/5 now. I'm in PT, just got an at home cervical traction device and I just started on Vicodin as needed. I haven't found the right mix yet myself. I was doing well for a few weeks, but now I'm back to getting headaches and having dull pain/discomfort just about all the time.

All i can offer is moral support and well wishes to you that you find the right cocktail.
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