Dr who don't like pain drugs

[Ariadne1925]

I'm surprised when I read on here how many drugs people take and the doses. I have fought to get better medication and was often the one suggesting the drugs while doctors have resisted. I was using butrans patches (20mcg ph), gabapentin, nortripiline and codeine but I've got down to just codeine and paracetamol as needed. I had surgery just over a year ago - lumber bilateral discectomy and laminectomy after three years of pain. I now have the SI and hip pain from pre surgery with tightness across the lower back, facet joint issues have been suggested with injections offered but I've refused for now.

I visited the GP as my pain is not controlled and the cycle of pain spasm and more pain is grinding. I have two small kids and a school run of an hour morning and afternoon. I do volunteer work two days a week but don't think I could work full time again. As often a day in the office equals the next day in bed. I'm not coping and just wanted to get more codeine per prescription as I'm running out just over two weeks after receiving the pills. I then get told I should be trying to reduce them and try regular paracetamol instead - I thought recently studies had shown paracetamol was useless. I had the pain clinic refuse to consider increasing doses or change to more effective pain relief too and a GP who said she 'didn't do drugs' and preferred physio etc. Nice but NHS physio is useless as they barely touch you and completely missed the slipped disc, even when pointing out I couldn't raise my right leg.

Why are doctors so against pain relief, it may be addictive but it's necessary and makes such a difference, when I have effective pain relief I feel almost normal again. I don't think being youngish and appearing healthy helps, another GP downplayed it until I stood, I could barely straighten my back it was so stiff. surely GPs should know how I look has no baring on the pain I'm feeling.

Anyone will a similar experience or tips on getting more effective pain relief. And yes I'm booked in for a private physio and looking at joining the gym/pool if I get the go ahead, already been recently and it helps but is no cure.

[teadrinker]

You sound really frustrated about not being able to manage the pain with the medication. I don't think there are many people in chronic pain who haven't felt this way.

Unfortuantely, I think you will find the reaction you describe to your requests for more codeine is quite common. It is a drug that can cause problems in a lot of people, even if it helps you.

But stick with the physio. Although it's expensive to go privately, I think it's something that can be worth it, because, like you say, the NHS physios are only able to offer you something very limited, usually because of how NHS physio is funded.

It seems that there is no one thing to help with chronic pain, and for problems like ours there often isn't a complete cure. For me it has been a long road of trying various medications and non-medication treatments. At the moment I am managing it with botox injections and regular walking as exercise, and doing the exercises from physio when I remember.

You've done well to get off the medications, and to aim to get back to the gym if you can. Would you reconsider the injections? I vowed I'd never have anything like that myself after a few unhelpful earlier attempts, but I was persuaded to try the botox and I am so glad I did. OK, sometimes the pain still flares up, but it's generally loads better.

Hope the physio goes well and things start to improve.

[Suzyhayes in reply to teadrinker]

What is the source of your pain and what part of the body do you have Botox injections. How long do they give relief.

[Hidden]

am the same 6 years nearly in constant pain and out all the meds iv been on none has worked and am still none the wiser and also have pain clinic for my 1st appointment in November .any idea what I should exspect ??

[Whimsicalangel in reply to Hidden]

I've had chronic pain for more than 20 years. Pain meds don't stop your pain, i have been through an amazing pain management program that is multidisciplinary. Meaning there are several parts to it- psychiatric, med, massage, exercise, biotherapy( which uses music and relaxation techniques)

Here's what helped me to realize that this was not going away and I needed to find a way to deal with this pain for the rest of my life.

I always hated when a dr. Says your just going to have to live with it, or it's just in your head.

To me that meant they didn't believe I was in pain. At any rate, to "live with it" , I learned to relax and know my limits. I learned to decide what was going to make it worse ,and was it worth the pain.

I learned that " it is all in your head", means that you can decide how much of your life you allow to be stolen by this. I decided , after much pain and suffering, that I wanted to live , in spite of the pain.

Those pain management clinics are out there, but for them to do any good, you personally need to make the decision that you want to be better and go for it! It's a long proses, an on going one, but well worth it. Don't give up

[johnsmith]

Pain relief attempts to switch off the nerves that register pain. It does not look at muscular behaviour that can make pain and discomfort worse than it need be.

Mental behaviour has a bearing on pain and discomfort. Mental behaviour can drive muscle behaviour which can make pain and discomfort worse.

Muscle behaviour has never been looked at by medical consultants so medical consultants do not examine for muscle behaviour problems or help patients modify muscle behaviour to reduce pain and discomfort.

Physiotherapy on the NHS tends to be one size fits all which is not helpful in many cases.

Yoga teachers can help with muscles. Alexander Teachers can help you re-train the use of your muscles to help reduce pain and discomfort. McTimony Chiropractic can help remove muscle spasms which generate pain and discomfort.

Meditation and mindfulness can help with studying yourself to see what makes your pain and discomfort worse and what helps reduce pain and discomfort. Emotional reaction to pain makes a difference to how bad the pain and discomfort is.

Hope this helps.

[Calceolaria]

I find docs are only too keen to write a prescription, depending on what you are asking for. Opiods are heavily censored mostly. Its just not true about paracetamol. The study was about acute, not chronic pain but even so, paracetamol works well on such acute pain as headache. Why have you refused injections? These could be a marvellous help for you. I'm waiting for mine, tons better than having a system full of drugs, affecting every organ.

[Steve49]

Hi.

That's great that you have managed to come all off your meds.

As all off my meds seem to not help me much, I have decided to look at what makes my Pain worse.

Currently we (Me & Med Team) are only looking at trying to treat the "Symptoms"

Surely we should be treating the Cause's\T riggers !!!!!!!!

I have managed to pinpoint mine !!!!!

1: Physical.

&

2: Emotional.

That's the "easy bit"

Now the "Hard Part" ???????

1: The Physical Part, Keep off my feet "Works Fine"

Mind you I can't stay in Bed for the rest off my Life !!!!!!

2: The Emotional Part, I need to become a "Hermit"

What about my Family !!!!!!!!!

It looks like I'm "Dammed if I Do & I'm Dammed if I don't"

Steve.

[Hidden]

Lucky you, a forward thinking GP who has researched pain and is not being influenced by the prescription payouts from drug companies. You have a gem!

I have only had 2 lots of 8 weeks of painkillers in 14 years by choice. It's not been easy, but I too am against painkillers (worked in the NHS for 15 years and have seem the long term effects), so until I desperately need them I will stay away from them.

There's things like operations to consider. By constantly taking painkillers, you build up a resistence to them, and need stronger and stronger ones. Eventually you become a legal addict and the pain you feel at this point is not pain from your body but pain from withdrawal.

If you are on maximum pain killers everyday, and need an operation, it's a bad day when you have to remain aneathetised because they can't give you more than you are already taking, and what they are giving you is not helping the op pain.

My first port of call these days is a sports physio. They are not afraid to touch you. They use a variety of therapies to suit your body at the time. They understand pain and it's pathways, and will give you helpful exercises to do at home.

Your GP is right in that alot of the pain we feel can be treated by physio as it is compensation pain, not directly caused by the injury, but as a reaction to the injury. (Twist your right ankle, you limp and the left knee takes more weight and strain. Untreated, the left hip might join in, then the right hip, the lower spine, and neck).

Another pain we may have in chronic pain is a trigger. This is a spasm in the muscle fibres, and can sit there pain free until it's triggered by other pain in the body. This pain is felt in a different location to the actual spasm. I have several in the deep muscle if my buttock which when firing off gives me sciatica, dull ache in the kidneys, bowel disturbances depending on which one it is. This pain does not respond to medication.

Then factor in the brain trying to make sense of all this information, it creates more and more pain, because it recognises an injury and it needs to stop the body moving so it can heal. That is the primary function of pain, to let you know something is wrong and to stop you moving until it heals.

The sports physio works by peeling away the layers of compensation pain, locates the triggers and can show you how to treat them yourself (accupressure). Then you are left with the original injury which at this point may be pain free. You might discover that all your pain is a reaction to thecoriginal injury.

The NHS physio works on the injury pain, which might cause more compensation and trigger pain.

As for your lifestyle, you could see if another parent could help share the school run, so you are doing it less.

Work, there are plenty agencies that can help with retraining and plenty on line agencies that offer remote working from home. I'm with people per hour,

Elance but they pay in $, but there are other ones too. Some employers are happy for you to work from home if the content is not sensitive. There's a high % of chronic pain people in the craft industry, because it's your own business so you can set yourvown work hours, but also because you can get into the zone, it's a great distraction therapy.

And John Smith is spot on with muscles.