Best Pain Medication?

Discussion in 'Fibromyalgia Main Forum' started by BeansMom, May 3, 2009.

  1. BeansMom

    BeansMom New Member

    I will be seeing a new doctor next week for my pain due to Fibromyalgia and Back/SI joint problems.
    I have been taking Celexa and Tramadol only for pain management. I've been on Tramadol for 3 years now, atleast 2 of them at the maximum dosage. For the past year, this medication has not adequately kept my pain under control - but I never had a doctor give me anything stronger. Which is infuriating. I understand the issues with DEA rules, legal liability, addiction, etc.. but it is an outrage that some doctors do not treat their patient due to this. /off my soapbox now!!

    I am hoping this new doctor will be willing to treat my pain fully and adequately. I would like to know for those of you on stronger medication, what have you found to be most beneficial and what you have found did not work at all. I have taken Lortab before (after an RF ablation) and it was pointless. Also have taken Demerol (after dental surgery) and I HATED it - made me feel very irritable and restless.
    How are pain patches? If the doctor refuses to give me anything stronger - what should I say? (By the way, have never had issues with drug or alcohol abuse - barely drink 2-3 drinks in a year)

  2. hatbox121

    hatbox121 New Member

    I also have FM and SI joint dysfunction and saw a pain mgmt dr. He also prescribed the tramadol and mobic. Have you tried mobic yet? It can be added with the tramadol without interactions. It's a NSAID. Have you done trigger point injections? Neither really help but no one including him and my rhuemy want to give me anything else. Loratabs are all the rage here but are usless to me and demerol just makes me nauseaus(sp?). I have done the Lidoderm pain patches. They were somewhat helpful for my broken ribs but useless for the SI joint(since it's so deep) and the FM(since I'd need an all over patch). I was given a moderate narcotic after having a extremly severe ear infection that helped with both but I can't recall the name at this point. None of my dr.s would put me on it long term due to the dependency issue. I'm like, "Hello. Unless you develop a cure for this, it's not going away." I have found that regardless of whether you have a history of drug abuse(I don't) and your tolerance level, no dr. I have found(other than one dentist) wants to give anything worth a dang. It's like if you even ask for something to control the pain you are a drug seeker, even if you'd rather not be taking anything at all. I also had 2 RF ablations, both sides, and have found they didn't help for long. My pain dr. is now contributing all of my pain to the FM and won't see me unless I break something, which is likely due to the osteoporosis. If anyone else has any input on how to explain that the drugs they are giving basically suck without seeming like you are a drug seeker, I'd love to know too.
    [This Message was Edited on 05/03/2009]
  3. BeansMom

    BeansMom New Member

    If you say "I need something stronger, this doesn't work" somehow you are seeking drugs. I'm seeking RELIEF.

    I've had numerous injections...trigger point in the spine and SI joint. Epidural injections, a nerve block, and RF ablation on my lower back --- nothing. It's not going to just magically going to go away, so why won't they at least let us live in some type of "normal" life.
    I have tried steroid packs, several NSAIDS, tylenol, muscle relaxers, anti-depressants, Neurontin, Lyrica, Lidoderm patches, topical relievers -- no relief.
    The tramadol is fine for minor, everyday Fibro pain. But when I'm in a flare or my back or SI joint is giving me lots of pain, it doesn't touch it. And I'm stuck at home thinking about how death would be a better option than having this pain all the time.

  4. Janalynn

    Janalynn New Member

    It's really hard to say what is the best pain medication because it's so different for everyone.
    I couldn't take Lortab at all. I would have what I called "spontaneous vomiting".

    Norco worked for me for a long time. Pain mgmt Dr. was the first to recommend Percocet - a little stronger that Norco.

    Of course, all of this is moot is your Dr. won't prescribe. How do you tell them - you tell them how your pain if effecting your daily life. I found that to be most effective.

    Tell them you're on a Fibro support board and many people have luck with Extended release medication "is that something you fell could benefit me?" Maybe he/she will start with something else, since you're coming from Tramadol.

    I hated the pain mgmt Dr. I saw and she even had Fibro. My doctor prescribes everything for me with no problems. When I'm having an extraoridinarily bad month, she doesn't mind if I have to ask for refill a couple of days early. I talked to her about it. She just said if I need it a week early, she'll need to send me to a diff pain mgmt Dr. because it means what she's doing for me is no longer working.

    There are many days where I only need one or two doses, which is WONDERFUL.

    I hope you have a great experience with this new Dr. and he/she is willing to help relieve your pain!
  5. lvjesus

    lvjesus Member

    I take take hyrocodone which is generic for vicodin. All my doc will give me is 5/500 (5mg of pain med, 500mg of tylenol) and I only get 30 pills a month with instructions to take 1/2 twice a day for pain. Thank God it works for me most of the time. I have been on it for several years and I also take elavil at night which is for pain. I know he would not go for upping me much, if any, because of the possibility for addiction, but I know I won't get addicted, that is not in my make up, and what I mean by that is that I quit smoking after 20 years cold turkey, I quit pain meds for awhile and my elavil and my klonopin, etc.

    If you research you will find that there is such a thing as an "addictive personality" which means some people are prone to it (and it is hereditary) and some are not.
  6. DemonFairy

    DemonFairy New Member

    My pain has gotten so bad that NSAIDs don't do much for me. If I had unlimited finances (I don't have insurance), my choice would be a Fentanyl patch and a breakthrough med. In the meantime, I take a pretty strong dose of Oxycodone w/ Soma for my back problems (herniated disk, surgery that wasn't completely successful, and now FM), and that seems to help me manage most days. I luckily have a pain management doctor who isn't afraid to prescribe Oxycodone. Also, if I could afford it, I'd get Oxycontin, as my second best to Fentanyl patches. Tramadol (or MS Contin or Dilaudid) does nothing for me. Mobic does nothing. Celebrex does nothing. I do occcasionally take Advil WITH my Oxycodone, as that seems to help it a little bit. If your doctor won't prescribe anything stronger than Tramadol, I would start looking for another doctor. I feel grateful for the pain management doctor that I have, but even luckier that my orthopedic surgeon will also prescribe Oxycodone for me if my pain management doctor won't.

    I prefer plain Oxycodone over Vicodin or Lortab, as I'd rather not add NSAIDs to my liver unnecessarily. I think plain Oxycodone or Hydrocodone is safer if you're going to take these meds every day. I don't want to overstress my liver. My body has enough problems as it is, so I don't need liver problems on top of it all. Fibromyalgia has ruined my life, but I don't want to ruin my liver on top of it all.
    [This Message was Edited on 06/09/2009]
  7. munch1958

    munch1958 Member

    I just completed some physical therapy -- went for the entire month of March - 3X a week. My first therapist was a 5 min drive away. She stunk -- didn't know how to fix the SI joint problem at all.

    The second was a 20 min drive away. She was located inside a chiropractors office. She was excellent. Knew exactly what to do. In about 3 visits she cleared up my SI joint problem. It all depends on the skill of the therapist.

    SI joint pain is very obnoxious. I was considering the RFA before I found this great therapist.
  8. BeansMom

    BeansMom New Member

    Going to see Dr. Joe this week.

    I don't have insurance either. When I left my job when I moved here (to NV), I declined Cobra b/c I was worried about the payments if I didn't find a job quickly here. Well, luckily I got a job quickly, but now have no insurance! And no one will cover me b/c of my back, fibro, endometriosis, and high blood pressure. So, I'm just going to have to self pay.


    I hope the visit goes well.
  9. italiano

    italiano New Member

    you sound like me.
    gentle hugs to you.
  10. ilovepink4

    ilovepink4 Member

    I have been lucky. My doc is a family friend and started treating me right before I got sick with Fibro. He gave me percocet for my back pain. I went through a series of treatments of steriod shots in between my vertebrae...they didn't work....then i got hit really hard with the Fibro that had been simmering for a few years.

    I use the fentenyl patch....100 mgs changed every 2 days...and I take 2 percocet every 6 hours.....on an average to bad day....i take less if the pain is less severe...

    i am bed bound /housebound most of the the (short) summers of Minnesota, I tend to feel better and can actually leave the house for short outings...nothing too physical...

    the pain meds used to help me be able to function better....but, the Fibro just keeps getting worse as time goes they keep me from crying, and from thinking of the "easy way out of this", and make it possible to take normal size breaths without it hurting too much...

    something that helps me that I use only works if I am not already a total phentermine...a diet drug...i took it for a while to help my very, very slow weight loss ....weight I gained from taking cymbalta.....the interesting thing is while it gives you energy because it is a stimulant, it really took the pain levels down.....

    a few years ago, I took a generic version of vivarin called Jet was summer vacation and I was having trouble supervising my sons because I was so ill....kept having to is supposed to be equal to 2 cups of coffee...i don't drink coffee or anything with caffeine normally so maybe it affects me more than others that do drink coffee BUT! it, too, helped my pain levels go down...

    it is interesting that something that stimulates you to feel awake must give you endorphins? that help with pain? i also remember reading here that some people take adderall for their Fibro so they could keep working.....adderall is a stimulant that is usually RX'ed for ADHD....interesting that some docs will prescribe it for folks with Fibro....

    I really hope that you get some help with some pain meds....the amounts of pain meds that I take have been the same for about 5 years....i would not be here if I didn't have something to take the pain is too , ah, painful...
  11. italiano

    italiano New Member

    I really appreciate those comments. I was wondering if the fentynol patch helps with the all over pain through your body. I have not gone for injections because the doctor said my pain is too widespread and not pinpointed enough for steroid inj.
    great feedback and I will be trying many things in the months ahead...have to find something to get this pain down. So sorry you are housebound. i live in FL with all this beautiful sunshine but can't enjoy it one bit.
    thank you so much. ( a gentle hug)

  12. DemonFairy

    DemonFairy New Member

    Yes, Fentanyl patches work for all over pain. The patch is just another way to slowly release the pain meds into your body. It doesn't matter where you put the patch, the medication gets slowly and steadily released it into your bloodstream. It's not like lidocaine or something, where it works where it's injected or placed.

    If you get the Fentanyl patch and you spend time outside in Florida, where your body gets heated up, it can make the drug release faster, so you need to be careful. I imagine Florida doctors should be aware of that fact, so your doctor would (I hope) warn you.
  13. ilovepink4

    ilovepink4 Member

    Yes, the patch is great for all over pain....i don't have that burning pain behind my knees like the tendons are being stretched too much...and it takes down that flu like pain...

    the pros are that you have constant steady pain control without the ups and downs with oral meds......

    the negatives are.....cost is high if you are paying for them....i need to buy covers to hold them on(i use tegaderm clear $3 each...and i use one every other day).....i can't make it the three days that the patch is supposed to last so my doc had to write my RX for enough patches for every two days of replacement....

    i have faint scars on the top of my legs where I wear my patch....

    i can't go in hot tubs, saunas or put a heating pad on that spot....the heat will make the patch overdose youl.....i don't think the Florida heat would hurt you...i lay out in July in MN with isn't the same as florida but nothing bad happens....

    I don't even want to think abou tthe hell I will go through if I have to wean off these patches...i can feel withdrawals if i get a "wimpy" sometimes wears off a little soon and i will get dizzy, nauseaus, pain gets worse....THIS IS MY WORST CON OR NEGATIVE IS THE RELIANCE I HAVE TO THIS MEDICINE!!!

    BUT! the pain I have when I have overdone it, isn't like it was before the patch....also, i have days where I don't have to take my percocet more than twice in a day...

    If I had to do it all over again, I would STILL go on the patch.....Even though I listed all those negatives , I love the fact that I don't have the constant up and downs of relying on oral pain meds....most of the time you are waiting for your pain meds to work, or you are waiting until you can take the next dose...

    i would do some research online besides people's opinions....and look into the withdrawal part because I have heard bad things about that...

    [This Message was Edited on 06/10/2009]
  14. italiano

    italiano New Member

    Those insights are so helpful...honestly. I can't thank everyone enough.
  15. Janalynn

    Janalynn New Member

    For those of you who have been on the Fentanyl patches - is this the step you took after trying an extended release med? - or did you go right from short acting meds to the patch?

    It's good to know about them helping everywhere - that was my concern or question as well. I guess I'd been thinking they were like the lidoderm/caine patches that help that one area. I thought my goodness, I'd have patches covering my legs, hips, forearms!!! =)

    I am fortunate enough to have been given a long acting med and also something for breakthrough. It really does make a difference.
    I agree though, it feels like my pain is getting worse. It went from being mostly my legs, - then to my arms on really bad days, now my arms are often in pain with my legs. I asked my Doc "am I going to keep getting worse" (in tears) and she said she honestly didn't know.

    I am sick of taking medication - or meds that don't work sometimes, but am thankful there is something that can help SOMEWHAT! I literally do not think I would function at all - or want to.
  16. BeansMom

    BeansMom New Member

    Well, saw the new doctor a total of three times now & really like him. I just told him how awful I've felt & how hopeless I am. My 2nd visit, he prescribed Methadone (low 5 mg dose) and said to take it when I feel a flare coming on (as it works best BEFORE you get in too much pain) and it has worked awesome!!
    My last visit with him, I told him how grateful I was to him. I am actually back to doing pilates (not too much), swimming, and having more physical ability to walk more, do more around the house, stay later @ work, etc.. The only thing I wish I had now was more energy...I still feel really tired a lot. I loved taking Cymbalta, as I felt "refreshed" upon waking for the first time ever...but my insurance denied it for fibro (even though it IS FDA approved for Fibro...only one of three or four drugs that are...go figure) & now since I am cash only, I can't afford the Cymbalta anyway.

    Thanks to DemonFairy first for your helpful words & referral to my doctor back in the winter!! And also thank you to everyone who always provides insight & tips & experiences. Hopefully one day there will be a CURE for this...or at least drugs that work 100% :)
    Best wishes & hugs to everyone
  17. DemonFairy

    DemonFairy New Member

    I saw Dr. Joe last week and asked him if he remembered a new patient coming in a few months ago from a referral from a message board. He didn't (if you want, next time you see him, you can tell him that Nancy referred you from the Fibro message board), but he thanked me anyway. I knew that he would be helpful for your particular pain med needs. He's willing to let you try just about anything within reason, which is one of the things I'm most grateful for. I hate doctors who think they *know* what pain med will be right for everyone. Not everyone feels each medication in the same way. Some people think MS Contin is great, and for me, it sucks and does nothing, no matter what the dose. So, any doctor who thinks they can know what our bodies will react to in the best way, are full of it. I don't even know what my body will like. I expected to get great relief from MS Contin and was sorely disappointed. But, I know it does wonders for other people, so everyone who needs pain meds needs to try more than one drug, unless they hit on the perfect drug the first time...which is pretty unlikely.

    By the way, the Methadone totally exhausted both my partner and myself (fell asleep sitting up in the bathroom...more than once, and for a couple of hours at a time - it was awful), so some of your fatigue could certainly be attributed to the Methadone. Let Dr. Joe know about the fatigue if you think it's Methadone related - there are some meds that he can prescribe that might help counteract it a bit. I have a prescription for Dexedrine that I got when the Methadone was wiping me out. Unfortunately, I react poorly to anything that speeds me up, even caffeine, so the Dexedrine didn't work too well for me. But, it might for you.

    It's funny, I was just talking to my partner about talking to the doctor about referring you right when I signed on to the board...and there was the update from you! I'm so glad that it's been a good match for you. He's a good doctor who really wants to help, and he's pretty good about getting suggestions from his patients about things they want to try, not just trying to force the same medications on all of his patients.

    It's ridiculous that your insurance company refused to pay for Cymbalta. If/when you get insurance again and they try to not pay for it, see if the doctor's office can convince them to change their mind. It's approved for the disease that you have, so they should pay for the drug. Have you looked into any of the prescription assistance programs? Maybe you could get Cymbalta through one of those.

    I'm glad Methadone works for you because it's a great drug for the cost. Unfortunately, I had bad bladder side effects from it (something they've never encountered from anyone else - the drug company rep was incredibly nice) and had to quit taking it after a month. It was too bad considering the month's prescription was only $13, compared to my Oxycodone, which is $165. Ptooey on my bladder!

    Even though I'm having trouble controlling my pain issues these days (stress, stress, STRESS!), I'm SO glad to know that I was able to steer you toward someone who could help you. I wish I had unlimited funds (I'm in the process of applying for disability and also filling out all of the prescription assistance paperwork) because I'd love to not be limited by my finances.

    Thanks for the update! It cheered me up tonight.
  18. pitoune

    pitoune New Member

    I just wanted to add that many people with FM do have a very low tolerance to medications. I'm one of them. I was put on the Fenthanyl patch many years ago. Only used the one patch and ended up in the intensive care unit at the hospital for over a week and it was only a 25mg patch. I have tryed so many medications in the last 17 years that I can't remember many of the names of the meds but I was on Demerol for over 6 years, got wean off of them by a specialist and they put me on Morphine instead because of the damage the Demerol can cause to your liver.

    I use the SR Morphine twice a day and take 20 mg Statex Morphine for breakthru. It's still not helping with the amount of pain that I'm in most of the time. I do have to tell you that on top of my FM, I also have 8 herniated discs and have been in an electric wheelchair for quite a few years now. I'm finally going for more test on September 14 and I'm hoping they can fix some of those hernia that are caused from DDD and I hope to be able to get off all of my meds. I know, doubt it very much but so tired of living off of pills all the time as I don't have any quality of life anymore.

    I also did get cortisone injections in my spine and trigger points and that didn't do a darn thing for me. I've heard good things about the Cymbalta but I'm afraid to try something new and end up in the hospital again.

    Good luck with your new meds and so glad you like your specialist. That's a bonus.

  19. steach

    steach Member

    Your doctor should do a complete physical to determine how much pain you are having in your body. After that, he/she may start you on something new, which may or may not work for you; each individual tolerates medications differently.

    Your doctor should do a complete day-to-day history to find out what your activities are right now -and- what they used to be.

    It is difficult to say what pain med. is best for you without being a doctor. Good luck.

  20. hannahfaid

    hannahfaid New Member

    I am currently taking morphine sulfate (MS contin) 30 mgs twice a day and Percocet 10/325

    for breakthrough pain.. I usually take the percocet with the morphine 2x a day then I will take

    one during the day if I start hurting before my next dose

    Fortunately I have a good pain dr.. Doesnt talk much, but if I tell him somethings not helping

    he doesnt give me a hard time..

    I am also on flexeril (10mg) I take at bedtime or if I need it, I will take it during the day