Pain contracts

Do pain contract really protect two parties?
Yes - 25.0%
No - 50.0%
Maybe - 25.0%
Are you serious? Of course they do. - 0.0%
Are you serious? Of course they dont. - 0.0%

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New Member

Date Joined May 2012
Total Posts : 2
   Posted 5/5/2012 12:47 AM (GMT -6)   
I would like to propose an idea for those of us with chronic pain. I am a 41 year old male with chronic back pain from a herniated L5 and nerve damage from it. I was recently booted from my doctors office for violating my pain contract, I will say that it was a clear violation. I was seeing my neurologist while working with the pain management doctor. I saw it as protecting myself in case my doctor left, if 86'd for a violation or any other reason they saw fit to get rid of me. In this case my doctor moved to AZ. I should explain my distrust of doctors; I spent 7 months diagnosed with bursitis and repeatedly asked for an MRI to check my lower back. Of course that did not happen, during the entire time we bounced from doctor to doctor being looked at like a crazed drug seeker. So in my best interest I kept the neurologist in my back pocket. It is not possible to work some days due to the pain so to keep income steady I figured I was doing the right thing. I admitted that it was wrong but was not given the chance to explain to the new doctor. I have since run out of meds and tried to see if my primary care doctor would help and that did not work.

It seems as if I have been black listed and have no hope of forgiveness. I in turn believe there should be a law voted on to do the same for doctors. My idea is to have a law voted on by the people; this law would require any doctor making a mistake to lose their right to practice, their license would be revoked the first time period! No second chance, no going back and definitely no chance to explain. Doctors in Washington are so scared to prescribe medication that they have no compassion for the patients they took an oath to serve. I think this is completely reasonable since they see it fit to do the same to patients. We even give people who break the law more that one chance but people like me are shown the door. Pain contracts should be called what they truly are; proclamation of obedience to the master. I know I made a mistake believing that I was looking out for my family but never thought I would be punished without any chance of forgiveness.

I am adding a poll with this post so please vote how you feel. Thank you.

Veteran Member

Date Joined Aug 2008
Total Posts : 3193
   Posted 5/5/2012 1:23 AM (GMT -6)   

I'm pretty tired tonight so I'll write more tomorrow... but I hear what you are saying in your message. Your experiences are kind of hard for me to follow right now.... It sounds like you signed a PM contract.... but then went to the neuro to get pain meds and so forth? I'm sure it's my exhaustion level why I can't follow things so much tonight, lol.

Anyway, I'll just share how I look at it all w/ my doctors. I don't mind signing a pain contract w/ my PM doctor.... saying that I'll only get meds and such from them. BUT, by doing that, I expect to be appropriately treated. That means looking at any new pain issues that comes up.... trying new/different pain meds, if needed.... exploring other injections/procedures and so forth. If those things weren't happening - I would explore looking for a new doctor.

Looking for a new doctor does not mean doctor shopping or breaking a pain contract. But if you do decided to switch care - and especially if you take medications from a different doctor... then, yes, that has broken the contract. Before I would do that - I would write my PM a letter, voiding the contract and letting him/her know I was moving on to a new doctor.

Don't know if that made any sense tonight.... The bottomline is - I don't like a lot of these "rules" and such either. But we are dealing w/ meds that can be abused and I believe that both sides have to have "something" that covers us.

More tomorrow. --Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Regular Member

Date Joined Jun 2011
Total Posts : 95
   Posted 5/5/2012 8:57 AM (GMT -6)   
The current painkiller abuse hysteria (thank you, media) has made doctors paranoid. For nearly three years, my family doctor prescribed me tramadol for lower back pain. Whenever I needed a refill, he wouldn't hesitate...until recently. But the last few times I've requested the medication to be refilled, he's made comments like "Are you sure you need it?". I've never given him a reason to believe I'm abusing tramadol, so I have to believe that his change in attitude is due to something I have no control over. I don't see a pain management doctor and hope that I never have to.

Veteran Member

Date Joined Oct 2010
Total Posts : 924
   Posted 5/5/2012 11:51 AM (GMT -6)   
This is an issue that troubles me greatly. I understand the PM's need to protect his practice, and that the fault lies with federal policy (and the media). But the OP's experience speaks to the lack of compassion for those in CP.

However, I don't want to see laws written regarding pain contracts as I doubt that they would more than another mechanism to come down hard on abusers. It would, however, be interesting to see what would happen if a denied patient sues a doctor or clinic for refusing to take him on as a patient. There is something called "public accommodation law" that has been used to fend off various forms of discrimination, ranging all the way from denying non-whites access to restaurants and hotels to requiring casinos to allow card-counters to play (the courts didn't agree in Nevada, but did in most other states).

I don't know if it has ever been tried, but I wonder if there's a chance that that law could help the OP? I suppose consulting with a GOOD lawyer in his state would be worth a (long) shot.

In my own case, I have a pain contract, but am without a copy. So, I don't recall what I can and cannot do. I thus err on the side of caution and call my PM regarding any medication that has to do with pain prescribed by another doctor (from Naproxen up). I also tell my PM everything I have taken during my appt -- e.g. I have an old bottle of opana we tried a few years ago and now and then I take one to see how benefits vs. side effects pan out.

One thing that still bothers me are the urine tests. Again, I understand that the PM is trying to protect his practice, but I see it as more like malpractice insurance, which he should be paying for rather than charging me. The tests are not germane to my medical needs.

One suggestion to the OP --- go back to the neurologist and ask him to help you find a new PM. If the violation was minor enough, then he might. Otherwise, find a new GP, state that you've had this ongoing pain and that you don't want any meds, but need to find the diagnosis. It might take a year, but in time, maybe he'll be able to get you to a new PM
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: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

New Member

Date Joined May 2012
Total Posts : 2
   Posted 5/5/2012 1:56 PM (GMT -6)   
I am a little more calm now and will explain a little better. For momto8, during the time that I was following all instructions things were fine. Once I told my doctor that the 3 to 5 other monthly appointments he wanted me to attend was not possible things changed. He wanted me at PT, pain psychologist, group therapy and god knows what else, once he understood that my family gets all of my time is when they decided I get less consideration. I explained that my pain level was a sustained 5 to 6 daily and requested an increase in methadone, he increased the gabapentin that already proved to make me sick at higher doses. Basically screw you pal, so the nice man moves on and the next doctor decides that I broke a contract with her. I have 2 years left to reach 20 at my employer and when that happens I can risk another surgery. If I do that now and it goes bad then I run the risk of being medically removed with no income.

Everything I have done was in the interest of being able to provide for my family. I started being looked at like a seeker, finally got redemption showing my pain is real. Then my doc doesn't like that I don't have time for only them, then he leaves I am back to a lowlife addict seeking drugs. In a mere 2 weeks everyone I have seen or talked to says basically I am screwed. The part I don't understand is how they can sleep at night after seeing me hobble out of their office. My blood pressure has been dangerously high and they still just let me go! There are around 10 pain specialists in the area and most are at the place I was booted from. I effed up and get it, there is nobody reading this that would not do the same for their family. I have to be able to work, even if in so much pain that I cant talk without breaking down. I want these doctors to feel the same pain I have mentally and physically, then I will poke around and ask them how it feels. Doctors do not deserve 2nd chances if chronic pain patients don't.

Regular Member

Date Joined Oct 2009
Total Posts : 175
   Posted 5/5/2012 3:12 PM (GMT -6)   
I certainly understand your frustration. These contracts seem to go only one way. I have never had to sign one but have heard a few horror stories about them. I also would like to see these contracts challenged in court when the doctor does not fulfill his or hers end of the contract. It's about time that doctors are made to feel more responsibility toward their patients. I have heard some many stories of doctors forgetting to fax in scripts for patients and consider it no big deal. That type of incompetence should have consequences. I wish you all the best and hope you can get things straighten out.
Chronic Back Pain, Anxiety, A little Depression, Left foot problems...foot growing in length and big toe growing out sideways, Osteoporosis,11 surgeries total..right foot twice, right knee 3 times, right elbow, throat/neck, spinal fusion, left elbow, left knee, currently deciding on whether to have surgery on left foot.
Meds: Oxycodone, Oxycontin, Clonazapam
Birthday July 18th
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