Pain wearing me down...any ideas what I can do?

[Spirit Moves]

Hi..I'm new here and hoping someone will have some ideas what I can do to at least take the edge off my back and hip pain...

It's been pretty bad for the last few day...really don't want to take meds or have any more injections...

Does anyone have some home remedies or any ideas that might help?

[shotspine]

I love your name and avatar. More info would help. What kind of pain? How long? What have you tried? Right now I'm suffering and not able to respond very well. I can suggest the simplest and most obvious........heat or ice, topical anti-inflammatory, topical lidocaine etc. Sorry, that's the best I can think of at the moment. If you give more info, you may get more responses.

Hugs and Best of Luck!

[Spirit Moves]

Hi shotspine... and thank you for posting...and am so sorry your not doing well. I was in an auto accident a couple years ago... plus I have autoimmune problems as well so I'm never sure what's causing the pain...

I've tried most of what you suggested the last couple of day but hasn't helped... I just want to at lease take the edge off...I was hoping maybe someone would have a new (maybe miracle) trick I could try.

Again... thank you so much for replying... you are so kind!

[shotspine]

Just a thought......I'm not going to get into all my problems now but my screen name should give you a hint. Anyway, the last few weeks, I've had terrible pain in my left butt cheek and hip joint. I already take pain meds but they weren't touching that pain. Went to Doc and he said it was probably bursitis and scheduled me for cortisone shots. In the meantime, I started taking my anti-inflammatory meds (they kill my tummy so only take PRN)....in about 2-3 days, that particular pain dropped a lot. I also used lidoderm patches. Between the two, I got very good relief in that particular area.

If you have any anti-inflammatory meds and the lidoderm patches, hopefully you will find the relief I did.

PS I honestly thought my pain was from muscle, not inflammation. I've been dealing with CP for years and I couldn't tell the difference in this case.

You may want to post over on Spinal Disorders also. This is a brand new forum so stick around.......it will get much busier as time goes by.

Hugs!!!!:)

[hummer]

Welcome to this place........

Do you have access to water for swimming or floating....?.....

I have a shattered spine.....four different places.....
In the water is the only place I ever find relief....gravity dissappears....I have no pressure on my spine.....I can stay in the water endlessly.....

There really aren't any tricks....are there..?....wouldn't we have found them by now...?...

How about a lite touch massage.....

When I can't stand it anymore, and I feel like I am going to snap....I lean against my husband, and he runs his hands ever so gently.....with the easiest of pressure....up and down my spine.....it seems to pull the ouch right out of me..........

I will come back and read this posting....because I am, as eager for some miracle trick, as any one of us must be......

Blessings on us all.......
Hummer

[shotspine]

Great to see you Hummer........

I like your therapy!!!!! As for the hubby's light loving touch, I can only imagine. My dog just can't get it, although I've sure tried to teach him.

Pool therapy.....absolutely. Sadly, I haven't done that in ages but remember it being the ONLY real relief for as long as I was in the water.

Magical tricks.....we'll all be waiting for that!!!

Blessings and Hugs to both of you!

[Spirit Moves]

Thank you Hummer... and oh my gosh you described it so well...I do feel like I'm ready to snap... the water trick... I'll have to try... I need some relief... even just for a bit so I can regain some of my sanity...

Thank you for the blessings shotspine... I so need them right now!

You both are so wonderful for understanding!

I'll be checking back here later also.

[janster]

Welcome!
It's damp, drizzly, and dreary here, so the pain level is up here too--I'm gonna wait to hear that magic trick too, k?

I use the old stand by: alternate heat and ice, and alternate Ibuprofin and Tylenol every 4 hours along with my regular meds and hope for the best.

That's about all we can ever do is hope for the best......

I hope your (and everybody's) pain gets better!

Hugs,
Jan :)

[JDPhD]

I use a myriad of pain management tools. I mentioned ginger to you in chat...and that helps some pains no matter in what form you use it.
Rest is important. I had to learn to say no, and to shut the world out at times...even when I felt I just HAD to get something done... nope. At other times it is distraction that helps...engrossed in a computer game or good book...if the pain lets you read.

Chronic pain means your body isn't able to counter it on an ongoing basis,imo. I hope you review trying to find pain med that works for you. They have many newer ones that came out for MS but found that others can be helped too...

Watch your diet, as a healthy diet helps the body fight the pain...and if you have any type of arthritis pain, a poor diet can add to the pain.

Trigger point work/pressure helps me too... I use tennis balls to do this.

I would also suggest learning self hypnosis, as to be able to dissociate some from the pain is wonderful! (Which is a bit of what you do when you lose yourself in a distraction ;)
Hope you feel better soon!

[janster]

I use a myriad of pain management tools. I mentioned ginger to you in chat...and that helps some pains no matter in what form you use it.

S'cuse me! um...Hi!
Could you tell me about the ginger please? I don't go to the chat rooms at all, and I've never heard about ginger helping pain. I'll try anything. Thanks in advance!
Hugs,
Jan

[Jaye]

I used to be on the Parkinson's forum at BT1 a lot, now preoccupied with osteoarthritis in the left hip, left untreated too long, to be replaced in 3 more weeks--just so you have some idea--not the worst pain but down to the bare bone on both pelvis and femur, hardly enough pelvis left--you get it.

I can only offer a couple of spiritual things in addition to the excellent list above (and tell me about that ginger, too, please!). I assume everyone tries prayer if they're interested in it, including giving thanks for it because it helps us comfort others (you have to be majorly religious or nuts to get that far out, I guess).

I have read some Buddhist thinking by Pema Chodron, who teaches that we can fully experience the pain in order not to be afraid of it. I have tried this for short challenges like trying to get across a room, and have discovered that there is a finite limit to this particular pain I have, and so I don't fear it, and so it doesn't affect me as much (that's full of drugs, BTW).

I have just taken the first level course in Reiki healing for the purpose of easing my own pain. So far, in three days, it helps some, or at least restores some sanity.

Hope this helps, and thanks for being here.

Jaye

[Wittesea]

I have pain in my back and hip areas also. Mine is due to a combination of inflamation, muscle spasms, and a mysterious autoimmune problem that hasn't been named yet (the best they can tell me is that it is some sort of connective tissue disease).

I take meds, long-acting narcotics, short-acting narcotics, and daily low-dose prednisone for the inflamation because I can not take traditional anti-inflamatories like Advil, Aleve, and Celebrex. I also have Lidoderm patches.

The meds help to some degree, but not enough.

Some of the things I have found that does help my back and hip pain a lot is to always be aware of my posture, always be aware of how I am moving my body.... but the biggest help was making changes in how I sleep (body position, good pillows in the right places, memory foam mattress topper, a "comfort-u" body pillow).

If I sleep in a more comfortable position, I have fewer muscle spasms, and less inflamation - and less pain. When I first started experimenting with sleeping positions I kept finding positions that were body-comfortable, but that I had a hard time sleeping in because of a life-long habit of sleeping in bad positions. So, it did take some adjustment time to get in the habit of sleeping in positions that were better for my body -- but once I adjusted to the changes I felt so much better.

Hope that helps,
Liz

[JDPhD]

Sure, np. My story of using ginger the first time follows: On a flight to Boston some years ago, my pain med was ah-hem taken by the screener when my purse fell over on the belt... I didn't realize it had disappeared until I needed it at my brother's. SIL called her mom who said "ginger." The only ginger in the house was ground spice ginger, but she dumped a teaspoon of it into hot water and stirred. No, it doesn't dissolve well that way, but was enough for me to drink (like tea.) I hadn't even finished the cupful when the pain broke to manageable. The ginger held my pain at bay until I could replenish my prescription. (PS I no longer carry a purse! ) I do add ginger to any meal I can, also.

I've since found that many chronic pain patients chew on the root all day. Ginger in any form works, depending upon your pain (migraines too!) Gingerale, ginger snaps, ginger root etc. Good wishes! I hope something helps you too. TC. JD.

[jane2]

I think I keep trying things because what works for one person doesn't necessarily work for another. Sometimes abdominal exercises help my back if I can do them. If I'm to flared I can't do them. He helps but so does ice.

I do take painkillers and muscle relaxers.

Sometimes the right better right chair to make a big difference. My back hurts really bad and the morning and went to set up its better, but it often wakes the up really early and keeps me from falling asleep so it's a problem, nevermind my worst pain is my legs keeping me from walking.

It's a struggle to find ways and not to aggravate the pain and I said to relieve it.

[dadsgirl]

JD ~

Thank you so much for that tip about ginger! I have never tried it, but I'm going to! I hope it works even half as well for me as it did for you!

Love,
dadsgirl

[Sherloc56]

I hope things get better for you soon. You will find a wealth of info here and some really great folks to boot!

I have hip and back problems too. Much like Wittsea. I have arthritis in my hip and spine and other things as well. My new doc put me on Celebrex, Flexeril, and Wellbutrin. Like you I am not a pill person. But I have to say after he crawled my @$$ about not taking my meds like I should I did it his way. I took them and boy did I feel so much better. I have since stopped them to see what the difference would be without them. Well looks like much as I hate it I am going to have to get with them again. The spasms get unbearable, my ankles, legs, and other areas are swelling again, my memory went to squash again too! So I guess he proved his point!! :rolleyes:

But as said, things work different for different people. The miracle I guess comes for us all in being able to keep our sanity through it all. By the grace of God and my belief in prayer I have pulled through some rough spots. We all manage differently. The support and knowledge that we can come to places such as BT2 helps us to realize we are not alone in this. So keep coming back! We are all here to help one another along and it helps with the sanity as well!

Sheryl

[Fancylady_2006]

Hi Sheryl,
I went to bed earily last night, so tired and worn out. I awoke at 2:10 am in bad pain that just won't let up. It's the left leg pain again. I wish I knew of a pain medicine that would releave me of some pain.My back feels like raw cutting pain this morning. I can't help but think some of this is arthritis type pain for I don't have it all the time. It has been rainy and damp and not much sun. My leg pain had let up and now for some reason it is back.

I was wondering if those pain patches would work on me.I can't take much in the way of pain meds. It seems all they give me is hydrocodone 10/650 or less. I have had other tablets, but I just itch and no pain relief.Perhaps more surgery is the answer to correct the problem but deep inside me, I don't think so. If only I knew the answer.I am getting surgery for the leg pain, but will that help, is the big question.
What are some of the reasons you all use pain patches anyway? Is there ever a time they don't work? I'm just looking for answers.
Blessings,
Billie:)

[Spirit Moves]

Thanks Sherloc and everyone!

I really enjoy reading how eveyone deals with this and all the suggestions! I'm doing a bit better... I'm not at the "ready to snap" stage anymore but still misserable... I know you all understand that.

Many thanks!

[Sherloc56]

I want to let you know I haven't forgotten you. I think of you all the time and wonder how you handle so many things. You are such a strong willed woman. I so admire you.

Isn't the surgery tomorrow for the leg problem? I hope it helps. I know you just had surgery and are barely recovered from that before you go again. You are in my prayers sweet lady!

Spirit I am glad to hear you are feeling better. Thats why we are here. We all know what you are saying when it comes to pain.

Sheryl

[jane2]

Most of us are quite a bit of heavy-duty painkillers and muscle relaxers and have tried quite a few things. That doesn't mean that it has to get to that, as many people get fixed by physical therapy and this cortisone shot. Usually you try the least invasive techniques and move-up. Get to a good doctor and a good pain clinic as well

There are two components to pain management and the most important is the hunt for the cause and cure. In your case it sounds like there are two problems-autoimmune and spinal. Sometimes cortisone shots can help spinal pain and physical therapy and that's all you need. Sometimes it requires surgery and sometimes you never get rid of the pain completely. Autoimmune problems are complicated and there are all kinds of drugs with all kinds of side effects. Seeing a good rheumatologist and a good neurologist and orthopedic specialist might help.

The other component is managing the pain while you are searching for a cure and if you don't get one. Usually start with the least invasive techniques like physical therapy. Many people I fixed by physical therapy or may be a cortisone shot in the spine are a few. They are trigger shots acupuncture and other treatments. Many of us are on quite a bit of drugs and that can help you get through the process of trying physical therapy and other treatments and sometimes that's the only solution you get, so it ends up being a permanent answer. The types of drugs that many people are on includes long acting opiates, muscle relaxers, anti-seizure drugs (for nerve pain) and antidepressants (that can help with pain not just depression).

The long acting a short acting opiates do a lot to keep the pain under control. Of course, they do causes dependency and they do have side effects. If you can get by with liddoderm patches that's better. Special compounding pharmacist can put lidocaine and other drugs in topical ointments, so you can get to spots that the patches don't get to that well.

There are many autoimmune diseases and for some of the more serious diseases like Lupus or MS, there are some very heavy drugs that can stop the progression of the disease or help with the symptoms. They do tend to have side effects although they usually start with the ones with the least side effects.

It's a process of figuring out what works for you and that could include rest or exercise or specific exercise or a better pillow or better chair. Hopefully you'll get an answer but if you don't it's a lifelong process of, making the pain is bearable as possible and reducing it as much as possible so that, you have as much of a life as you can. It's about adapting and there is life after chronic pain, so hang in there and keep looking for answers.

[Fancylady_2006]

Sheryl,
My surgery isn't until October 24. I certainly am not over this one yet. I'm 3 1/2 weeks post op and even tho I have a while to go, it won't be long enough. The new surgery I will have soreness 3 to 4 weeks. I can't even pick anything off the floor yet. It gives me the willies just to think of this other one. If I wasn't alone it would help. I'm fairly sure I will have someone come in at first. As I am planning on moving about that time. I don't know how to get things done. They didn't like me lifting now and the other one has the same instructions. Why I said I could do it, I don't know.

Doc acted like it is important to have it fixed asap. Sheryl you would do the same if you had no choice. That's what happen to me. I do wish my husband and I could of counted on good family support,but it didn't last long. Some treat me awful now and won't even speak. Worse yet thet are my neighbors.
Just call me hurt,
BC

[frank]

Pain sufferer since 86, sinus pain (I can feel headaches, and they are not this). Some thought they are also migraines and cluster, but positive they are neuropathy. "mild" narcs since then, "heavy" since 94 almost continuously. Therapies that have had some effect for me:

1. counter pain. Push a ball point pen into the muscle between your thumb andindex finger (either hand). Continue until the pain from it is really intense. Surprise, your mind is distracted for a few minutes to weeks.

2. Heat packs. Get really hot, put towel between, with enough folds it does not burn your skin- but just barely. visual and feel the heat soak into the head until it reaches the back skin on head (also works on back and any other muscle or skin pain).

3. cold packs do not work for me, they merely increase and prolong the nerves, but other people say they work like 1, above. Trick is to go through the pain threshold you think you have- when it seems like it will overwhelm you, it suddenly goes away.

4. Hot Jacuzzi. Trick is to get in while it is hot, then add hot water (slowly) until it is at maximum heat you can take. Take a cold drink (NOT alcoholic) and keep hydrated for half hour at least. The stronger the jets the better.

You've noticed- above tricks are to experience another sensation that is much more intense than the ordinary pain. The more intense the better, and BELIEVE it is more pleasurable than ordinary pain (yeah, I know it sounds masochistic, but its not, and if it works why do you care? Using psych speak- are you more invested in your pain than curing it?).

5. Reading a book, engaging in a lively argument on a subject you CARE about, accomplishing a task you can lose yourself in- do it WHEN you don't feel like it, not when you do. Make a habit of doing this at the times you don't want to. Key is habit- your mind should automatically turn to these things when pain begins to take over your mind, just like you automatically perform all the steps needed to tie your shoe, just without thinking consciously about it. In fact, it is a habit when thinking about makes it more difficult to do.

6. Find a mental activity that does not require movement. Songs are good, listening to tv that actively engages your mind, learning new things, come up with your own list. Scream with every bit of energy and emotion you have in your body, not just the "I hurt" grunt. (Be warned- my wife put me in the Stress [suicide] Center for doing this all afternoon. But it was good to meet people who really hated themselves.) Or even (this sounds crazy) take the time to shut everything else out, then feel every part of your pain, and the sensations caused by the pain (some people say concentrating on their pain makes it go away!) This should not be habit- instead it is something you give yourself permission to do rather than "more" pressing things at hand that seem to pressure you. In fact, taking care of that pain is probably your most important job- if not, you're probably not on this site.

7. Choose to talk to your family or support staff. Find out what they see in you and how you are coping, what problems they are having in school or work, what triumphs they have had. If you are not totally into it, take notes so you will remember it later- but you will find that the concentration of notetaking will become automatic when you talk to these most important people.

8. Buy a relaxation tape, and use it first when you are feeling relatively good. Get good at it, then start using it when you have some problems, then build up to really bad times, but you now have a basis of believing that it helps.

9. When you have that belief, start trying self-hypnosis tapes. Remember, you must believe what the person hypnotizing you is saying- and in self H, that person is you. Maybe take a course in hypnosis in a classroom setting. When you see a 98 pound gal laying with her shoulders on one chair, and her feet on another, but her untoned stomach is supporting a 200+ man, you will really begin believing there is something in telling yourself not to hurt. Then experience posthypnotic suggestion. You will tell yourself it is not GOING to hurt: and believe yourself. Talk to someone who was in serious war situations, tell them why you need to know what the human will can do, and they will open up with stories they stopped telling other people because they were not believed.

The above are related to the mind's ability to control what it feels and does, but don't despair if it doesn't last forever; you may get longlasting relief, but it may be limited to a couple weeks: isn't that a couple weeks you wouldn't have had otherwise? It can still be effective in acute situations with several hours relief which is enough to handle some breakthrough pain. However, only Peter Pan and Tink can fly, and no amount of willpower causes you to grow a sixth finger.

10. Forgive everyone. Anger and agitation multiplies pain, and you can't afford the energy required. Especially forgive your close ones, and find reasons to believe that they did not mean to hurt you in anyway. They have the most power to prick your ego into reacting. Decide right now that what you initially feel is an insult is really not intended that way, and it is silly for you to react to something that is not intended to hurt you. If you are really hurt (someone intentionally tells you that you are not meeting their expectations and they are disengaging from the relationship in some manner), consider whether their expectations were real or fairy tales, whether you caused it or it was only perceived in you, and if you did cause the hurt (yes, they are almost always acting from feeling hurt themselves), what can you do to change your actions. And if they insist on going entirely, let them go. Loss is part of life, but hanging on forever is not. Living organisms grow. Decide (DECIDE) now to live.

11. Every day, concentrate on doing at least one thing for your close persons that will please, surprise, gratify, etc them. If you do the same thing everyday, you have not concentrated. This will give you a real sense of accomplishment (which tends to crowd out the worst of pain) and seeing someone you care about happy will plant a good feeling in you. (PARENTAL ADVISORY: If you don't believe me, explain why someone who is at first grossed out by oral sex can get really into it when they see the pleasure in their partner?)

12. Think about the world around you realistically. It is not terrible just because you feel chronic and/or acute pain: it is not wonderful just because you feel good. What is different is your perceptions of some of the same events. Everthing has something of good and bad in it. A death means no more pain, but it also means loss of what good that person spread on others. Even the worse evil actions are countered by people who show that they will not be controlled by evil. Therefore, look for the good in your pain, as well as all the things you know to be bad. Do you have more patience now? Can you empathize with other sufferers? Can you help someone because you know what they are suffering, and what they will suffer? Would it have helped you to know somethings others have learned from their experience with pain? Then, USE the good you have found.

13. Find some peace in believing that what you are going through will ultimately contribute to your growing as a person, instead of destroying who you are. If you cannot believe that, consider why you cannot. Is it because you don't want it to be? What is causing that destruction, and what can you do to construct something good?

The above will generally be thought of as "spiritual" bandaids. I think we are all spiritual beings, that choose to love or hate, but our spirit. True, while here we are spirits bound to human bodies, and all of the limitations they impose, such as pain. But if you believe love, or hate, or sacrifice or any other such is real, then you believe in spirits. These things have no mass, no velocity, no gravity, but they really change this world. And isn't that the definition of a spirit? And if there is a Spirit that is so powerful He can speak worlds into existence, even me, but tells me He loves me, wouldn't He give me rules that make my existence work to the better? (Bet you can't imagine what my religious leanings are!)

14. When pain is really unbearable, and all self remedies have come up short of putting it back into its place, turn to someone else. First, try a massage therapist, or chiropracter (with care) or D.O. who can administer to you. I credit a nurse masseuse with saving my life when I was in hospital, all the therapies had been tried, and my numbers continued to accelerate the wrong way. She used healing hands massage, and it was from that point my stats turned around. I also credit a D.O. with a specialty in adjustments who showed me that I had shut down the sensors in my back (severe curvature) and I needed to feel them to know how to correct the problems. After that, I intentionally forced my back to straighten up in the right ways, to the point that when a new doc does a back xray, the first thing he says is "Did you know you have a severe scoliosis?"

15. You all have doctors. If you don't believe in your doctor, find one who does instill confidence in you. I know the drill: you stay with someone because he (alright- or she) is familiar. But the familiar is that you have no hope things will turn around. You must want the help more than the (comfort?) of staying with things that are so bad you do not know if you can go on. Don't be afraid of hurting the feelings of the doctor: they are taught not to feel personally about their patients on any level (think of doctors who unthinkingly do this to their wives or husbands anytime a problem pops up), and they may really want to be relieved of having to see their failure time and again (remember, they don't think of your loss, only the blemish on their ego of not succeeding with you).

16. If you believe in your doctors, try therapies they suggest with the expectation that they told you that because it has helped someone else. Nothing is worse than trying something with the expectation it will not help.

17. Know your individual chemistry. Medicine is now finding that drugs that help someone will not be as effective on someone else because we each have unique chemistry makeups. The majority of human beings may have a chemical process that makes oxycodone more effective at treating pain than hydrocodone, but the minority is sizeable. I personally have opposite effects on a large number of drugs. If I know it, I can advise doctors who are in ER's, or substituting for my regular doctors. I know someone who lived and worked with dying, wasting hip bones for many years on Ultram: I found it to be worse than water. Know where you fit in in the spectrum.

18. Start with anti-inflammatories. In most chronic pain cases, there is an inflammatory component. In smaller words, pain can cause swelling, which then also adds its own pain to the mix. Don't assume an NSAID is for autoimmune problems, and get depressed when it works. But don't despair either if the NSAID is not totally effective. You may need something that prevents the nerve transmissions.

19. If you need synthetic or real narcotics, don't get into the "I'm violating the Just Say No campaign." You are different, and you don't have to apologize. It is hard enough to convince a doctor that his patient needs narcotics, and if he gives them to you longterm, he feels he can easily justify them to the DEA (I've been on the inside- this is no small fear for most doctors). So don't dilute their effectiveness by delaying taking them until the pain is really established, or making yourself feel bad for taking something that makes you feel better. You are a good person for taking care of yourself so you can help the ones around you who are most effected by your pain.

20. On the other hand, give up liquor, especially if you are on any heavy medications. By way of background: I had never drunk alcohol (when a kid, they swabbed my arm with overpowering alcohol, then stuck a very dull, used needle into it every week- it is a sure fire cure for demon rum). But one night the pain had been so bad so long I poured the cooking rum into a two cup measuring cup, then added some punch mix. I tried to sip it, but couldn't get it near my nose, so I downed it in one long drink, not allowing myself to breath. What I found was that instead of deadening my pain, it moved it farther away from me, kind of like I was feeling it across the road. I drank a gallon of water (yeah, I also measured it out) that night, and didn't wake up with anything I recognized as a hangover: little wonder, my sinus pain was throbbing to push any other sensation out of my mind. I know from conversations with fellow pain partakers, we have all tried (some harder than others) to deaden the pain with the legal sedative. But when you add it to prescriptions, your absorbtion may be poor one day (little interaction) but instantly effective on others, interacting to terrible extents very quickly. To avoid aiding suicides, I will not tell you the drugs, but there are pain medications that when taken with alcohol may do nothing one time, but cause complete respiratory cessation in under six minutes. Because it is a sedative, you may simply drift out of consciousness, not awake when your breath stops. Unless someone recognizes the problem within three minutes, AND gives respiratory therapy, the ambulance will not arrive before brain death has occurred. DO NOT stop your pain by adding even small amounts of alcohol to prescriptions. It will cause even more pain than you bore to those you leave behind, whatever the status you think your relationships are in.

21. Even heavy, longterm doses of narcotics can be taken with little effect on health if you follow your doctor's precautions and orders closely. You can get into trouble if you do not have one doctor doing all the prescribing of pain drugs. It seems attractive to be able to get doses larger than one doctor feels comfortable with by getting drugs from two doctors, but it is a recipe for attacking your health. With larger doses, you need different precautions, and maybe even other prescriptions to counter side effects. In addition, you can kill the golden goose by making both doctors distruct you if you are found out. Getting something now is not worth leaving yourself with nowhere to turn later (and don't forget, doctors talk to each other about patients).

22. Talk to your doctor fully, and fill him in on anything related to the pain. Do not exagerate, but also do not take the he-man approach. The doctor needs to know where you are at, and have been, to medicate you correctly. If you do not give him this information, do not blame him when your pain is out of medication control. That means if your pain is out of control now, make your doctor aware of that. They will probably not be able to give you more drugs while you have a script in effect (again, the DEA looks at that very closely- and yes, your doctor has been audited several times, and many times if he is a pain specialist), but they may have the ability to give you breakthrough medications when your scripts come up for refill (yes, that is an incorrect term as far as the DEA is concerned- by law, narcotics cannot be written for a refill).

23. After narcotics, your doctor can also look at medications that block nerve impulses. I am familar with Norontin and Lyrica. Some anti-depressants have an effect that relieves chronic pain, such as some doses of Effexor and Prozac (no, they are not saying it is all in your head). It has been found that the ability of nerves to get impulses to the head is dependent on other factors than blocking the opoid receptor sites with narcotics. Other drugs are in testing that may block the impulses from getting into the chronic pain system in the spine. These can still have side effects, but these effects are felt by fewer patients than with narcotics.

24. It is also possible to inject some narcotic or steriod into the tissue surrounding the conducting nerve, which will deaden the pain without getting into the blood system at levels that cause the unwanted effects.

25. Finally, surgery can, in some limited cases, crush, remove, deaden or otherwise prevent the nerves in the pain area from functioning. This can last forever, but contrary to earlier thoughts, nerves do regenerate in areas of the body other than the spine and brain (at least, doctors now think that- who knows what the real truth is). The side effects of surgery must be weighed against the possibility that relief will be felt. On the other hand, some doctors who treat chronic pain believe they have seen cases where the simple act of touching a nerve that is not normally touched will cause nerve transmissions that are felt as chronic pain from body parts served by that nerve- in other words, cutting and moving inside the body may excite pain from nerves that had been left alone. There is no precise measurement of how many times this occurs in surgery since some doctors refuse to believe it.

I'm sure I'm talking to medication veterans, so the bottom line on medications is take them if needed, and tell your doctor what he needs to know to decide what you need. Some doctors refuse to believe pain can be so bad (except in cases of gunshots or their relatives) as to require narcotics at some or any levels. Some do not want the attention of the DEA and refuse to do anything that conventional doctor wisdom says will cause them to be audited. Some doctors have been indoctrinated into the current JCAHO model that says pain is a condition that doctors can address, and must inquire after it, and then treat it effectively, but without catering to addicts. If your doctor will not treat your pain, or rules out alternatives, you need a second opinion, or a different doctor. Yes, from experience I can say that getting a new doctor attuned to your conditions is not easy, but staying with a doctor who ignores your symptoms is worse. Not many statements can be made as absolutes, but in my humble opinion, that one comes close to it. A good doctor is looking for alternatives to treatments he has already decided on, and if he is not conversant with new procedures or meds, will become familiar with them or bring in a doctor who is.

The one sentence answer to your question of "What can I do?" is to look at everything you have done so far, try them again, and go to the next step wheneever anything does not work. In gentlest, kindest, most sincere terms, you will feel better when you feel you can do something, and stop listing what you cannot do.

I hope and pray this is somewhat helpful to you- it has at least taken my attention to helping you and off my pain!