The good news didn't last

Hi guys. My lower back pain is severe again. My 40mg a day OxyContin is not keeping me comfortable at all.

I met my Dr last night and he gave me 30mg each 12 hours but it was not enough in the day. He did not want to try another kind of drug. I took that today and I'm still in pain. I'm in bed now and feel really low. I have 20mg IR Oxycontins for flare ups but these are not helping either. I hope it's just a bad month.

I doubled my dose of the 30mg ( I used to do this with the 20mg and I spoke about it with my dr) So, on the 60mg I have some relief.

Have you had the odd severe pain month? And then go back to your 'normal' horrible pain level?

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  • I find a cold compress for 20 mins helps a lot with that lower back pain.

    I have one that fits into a vecro type belt- so I can walk around or sit back with it on.

    Good luck.

  • Thanks. I tend to respond to heat. I'm using the old hot water bottle right now. Just like at the very start of my pain - many years ago. I will look into getting a belt to hide it under my coat in the winter. I'll try anything right now!

  • Morning .sorry your pain has got worse again. I don't know what is causing your lower back pain but usually staying in bed, lovely though it seems, is not a good plan.

    You need to keep things moving. Pain medication alone will not help long term. You perhaps need to be looking at the cause and working on protecting your back. This means establishing very good core strength and back muscles, looking to your posture and the way you move.

    If I have got this wrong because you have a condition that prevents it then ignore me. But otherwise exercise is crucial. Once this crisis period is over then starting Pilates or something similar is important. If your back is having problems this early ( just looking at your photo) then a regime like Pilates is for life.

    Otherwise the dose of opiates will just go on increasing until they cease to be effective.

    Am I right in think you are taking 60mcg a day , modified release ?

    Dee

  • Hi. It took 3 years to get to this dose. I'm now taking 60 mg OxyContin each 12 hours with 20mg oxycodones for flare up. I also need tramadol as that seems to cover an area if pain the OXY does not. I'm really upset that this is gapping to me. I'm43 btw.

  • You really need to see a pain consultant, you are taking well over the equivalent of 200mg morphine which is a massive dose.

    What is the cause of the pain. Rather than something just masking it can it be treated or reduced with injections or blocks etc ?

  • I did not want to risk an injection in my spine at the time. I may think about it now that things are quite awful.

  • I agree with tou about the Pilates. As soon as this crisis is over (if it ever calms down) I'll start!

    I was looking at books last night. Taking a Class on a regular basis will be difficult to maintain with my moods.

    When I'm low I won't go and when in high I'll do too much and cause more pain. I often get these high moods where I walk about with my posture up right ( I feel very powerful and become agitated and quite arrogant) and it puts extra pressure on my spine. When the mood calms down I'm left with the pain I caused from over activity. It's a circle we can't stop because my meds don't control my bipolar effectively .

    My psych is good after 7 years but my moods change so fast, we can't stop them / treat them quick enough. It's up to be to notice when I become unwell. Often the actions of walking about like that ARE the symptoms that something is wrong. My daily mood stabiliser does not control sudden major shifts in mood. I try so hard. Thanks for giving a s--- about me.

  • Any idea what is causing your bad back? You seem so young to just go on this high dependency pain drugs. I suppose with your other condition it might be hard to keep going with Pilates or Alexander technique classes but they are very good if you have a bad lower back without any obvious cause for it. I use those lower back belts, a bit like weight lifting ones. They keep the back kind of in place, offer support and keep it warm. Just cannot do it continuously as it would become too much of an dependency and then weakens the back. So I do it on and of. My issues are somewhat different as there is a known cause and I am going for nerve denervation later this month and am hopefull for relief there. Hope you find relief soon. Take care.

  • The Mri shows nothing. It seems to be facet joint overloading. Physio says this. I'm willing to try anything but movement has become so painful.

  • They say the bad back is caused by overloaded facet joints. Still they don't explain what this means.

    I think the back belt is a great idea. I could act a an aid to remind me when I'm high that I need to take it easy. I say that now but I think when I'm high I will feel restricted or even feel like the pain is not

    that bad and take it off. Or feel too important and powerful to wear it.

    One plus to the pain led increase is it is slowing down my moods a little as its a bit sleepy. Have good day.

  • Yes, I suffer with Degenerative Disc Disease and what you’re describing is typical of the pain that I suffer with.

  • My mri did not show this. I think I have an issue with my nerves.

  • Hi, after my spine op I was left with a gammy leg and back pain. Both at times really high, as in 10 out of 10. Had facet joint injections for my back which helped a bit and these are the fore runners of nerve denervation which I will be going for in about a week or two (unfortunately he wants to do it in 2 goes rather than 1 due to the amount). Hoping that will help for my back, leg is something else. I read somewhere on here about licodaine infusions for bad pain that does not respond to anything, maybe that might be something to think about too?

  • I can talk to my dr about this. He said the next step is the pain clinic and asked me if I wanted to go, I said your the dr. He said I have enough to deal with. My moods etc and trying to stay well. Why did you need surgery on your back?

  • I had a badly herniated disc. Had issues afterwards and am now at the stage I described above. To get the treatments I described I would ask your GP to refer you to a pain specialist as he/she will be able to do all of them. Maybe stay with your Gp for your other issues and that way he can sort of make sure you don't get conflicting meds although the pain clinic specialist should know it too. Pain clinics often include psychologists in their treatment plan which again might be beneficial?

  • I had a better day today. I took 10mg less than the day before. I did less but didn't need extra BT meds. For now, the DR was right to see how I go with this new dose. Have good week. (I doubt he will like it when he finds out I actually need double the dose)

  • This is the first time I have written to this community. Although I do regularly post on other ones. I have been suffering with sciatica for years. And this has meant I have had to combat the pain with ever increasing pain medication.

    I take ibuprofen 400 Mg 3 Times Per day and Co-dydramol 20 Mg 4 Times Per day. But in recent months this has not even scratched the surface. And the pain can go one for days. I started having problems with my knees 6 months ago, and last month have started having server pain in my shoulders. My GP has done extensive investigation into these new problems including MRI’s and X-rays. He has also started prescribing Tramadol 100mg up to four times per day when required. I have a number of Co-mobilities that have effected various parts of my body. So have to monitor how the ever increasing number of medications I take can and does effect my body. I take up to 19 different prescribed medications. And hate that I have to rely on so many painkillers. Especially as their effectiveness becomes less and less over time. I have now been referred to see a Rheumatology Consultant to see if I am developing arthritis. I feel like a 90 year old sometimes, but I am just 53. I hope you can relieve the pain your suffering. No one who hasn’t had Back and joint issues will understand how much pain and over extended periods of time, can effect someone’s quality of life.

  • Simon, I started on tramadol and have also kept it. This drug seems to work more on the nerves as its related to antidepressants in its action. You may find that 200 will help at a time and my GP said I can always take 300mg as a dose. You may need morphine later and then there are other options if you still have pain. No need to suffer in this day and age.

    I have had a better day today and think inhale a better dose. Wish you well.

  • Hi Simon, after reading your post I wondered if lidocaine infusions would be beneficial in your case. I sometimes wonder about them for myself. They seem so beneficial for some people who have all over body pain that they can come of most if not all their medications. It seems a process that involves a number of these infusions over a certain time span. Just a thought.

  • Thank you for your advice. I will wait to see the Rheumatology Consultant in December. Once I get a diagnosis of this newer pain. Then can plan how to deal with it.

  • Good luck

  • Thank you.

  • The colder it was the worse it was,mornings were always a nightmare.They call these flareups ,,episodes,,ive been hospitalized due too these episodes that lasted a week at a time 🙄 not pleaseant at all.

  • I think that's what this is. I had 2 days where I could not go out to get my food. I stay in bed trying not to move! I had other days where the pain was bad but not the deep ache that I can't cope with at all.

    When that deep ache starts, I take as much OXY as I can get away with. On those days I reached over 120mg per day.

  • Ive been there and its nothing short of a living hell.I always found a hot shower,or a hydrotherapy pool.I go to hydrotherapy 2x a week ,live in the water when its summer.

  • Only just discovered this forum but reading your posts has made me realise how bad pain can become. I've dealt with a mystical pain in my literal ass, both side to be exact, for the last 6 years. It's only ever gotten worse and it's now impossible to sleep. I've had 2 trips to physio and now waiting for Rheumatology appointment in December. Pain started after I broke a leg, weird I know, possible due to having never recovered from the weakness in one side... Anyways I've not relied on drugs, had a period of 2 months on Gabapebtin at 300mg a day then triple that which didnt help much. Should I go back to pain management to try something else ? When I exercise I always go too far, is it better to build up strength doing walking daily ? Any advise is good at this point. Just to cover the basis, my issue is with sitting too long, desk based job in IT so difficult to avoid..

    If this is the wrong post then any other posts someone could recommend ?

  • Hi. Pain can be a surprise, just when you think you have it under control. I would suggest you buy a book on Pilates. Anything will do. Always build up to anything you do. Keep moving as much as you can but if it causes pain, take a rest. You need to ask your dr about what is the next step. Only they know your history. Good luck!

  • 20mg or immediate release oxycodone is both a lot in general and compared to your background so should be a lot more helpful then it is. Please check it isn’t oxycontin as per your post.

    It should be oxynorm or also called shortec.

  • Wow I’m shocked your GP is prescribing so strong medications at such a high dose, with nothing showing on an MRI. Clearly you are in pain and an answer needs to be found - and further investigation is probably the first step. So I think the pain clinic will help. However there is no doubt that they will want you to reduce the oxycontin or even stop it all together.

    Opioids can actually make pain worse - called opioid induced hyperalgesia. Also they can damage the endocrine and immune system and reduce testosterone production.

    So in an ideal world hopefully they can find the cause of your pain, treat it and allow you to reduce your oxycodone.

    You might think I’m hypocritical as I’m also on oxycodone. My GP also prescribed 120mg in 2012. Through denervations, physio, psychology and a pain management program my daily oxycontin is 40mg and OxyNorm instance release is 10mg up to 3 x a day so 70mg.

    I have a host of left over effects from using oxycodone in high doses for over 5 years.

  • My fear is the pain clinic will stop my OXY and I will be left in so much pain I will have no option but to end my life. I have been to physio for a year and it helped a little but j feel it was more to do with the massage relaxing me. We all know stress can cause pain. I think the reason the dr has not sent me to the pain clinic is because of my bipolar and personality disorder. He understands how much pain I'm in. I don't g rotting that effect where iPods cause more pain yet as I was fine for 3 years on 40 OXY a day with BT meds. I went to A and E at the start when I had no pills and they gave me nothing!

    I walked out knowing I would have to plan my death. It was after showing my dream a pain chart and pointing to no. 8 as a daily guess....that he got it!

  • Oxynorm is my instant release. (Oxycodone). OxyContin is my sustained release at 60 mg in the morning. I need to take my BT meds at night as he has not given me anything for the night. It was 30 each 12 hours but it was big enough so I doubled it up as I did with the old side of 20 to make 40'each 12 hours.

    He knows I do this as we talk about it. However, he never puts this info on the prescribed label. It still says take one (30mg) each 12 hours. When I'm taking 60mg and he knows it. Not sure why he does not want it on the records!

  • I hope you are okay. I completely understand you are in severe pain and you need help.

    If you have suicidal thoughts please tell friends and family as well as your GP immediately - and if you feel you will act

    On them please go to Hospital.

  • As I have these thoughts often, and my risk is so high, there is little they can do. Last year after I started planning my death after reading a book on the subject, it did get to a stage where it was clear I was struggling when I have away my fav things, like paintings I did etc. My psych have me the right meds at the right time. It took many weeks to get like that. These thoughts I have now are more impulsive, it's not likely I'll do anything right now. Thanks for asking.

  • Well I wish you all the best and I do care.

  • I care too. I'm here if you want to share. Not much I've not faced. 😎

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