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Posted 8/17/2009 3:38 PM (GMT 0)

Hi guys

 

I haven't posted for a long time, though I do come on and have a read regularly.  I find it very difficult talking about this stuff though, so I've not really found myself able to get involved in any discussions.  I do have a question though, if you don't mind?

 

Up until a month ago I was on Tramadol, which I’d been on for a couple of years, apart from a month last summer when I tried MST morphine. It made me really depressed though, so I went back to the Tramadol. Increasingly though, I'd been finding that the Tramadol caused muscle pains all over my back (my main pain is on my shoulder and neck).  The pain clinic said that Tramadol just causes muscle spasms sometimes and gave me muscle relaxants to deal with it but they made me depressed as well, so I came off them. Over the past six months the back pains has got a lot worse, as has the shoulder and neck pain, to the extent that it seemed like the Tramadol was no longer working.  I wasn't able to cope with it any more, so a few weeks ago I reluctantly went on to Oxycodone.  I started on immediate release Oxynorm (20mg a day then increasing to 30) but had real trouble with the side-effects - I was feeling completely out of it and kept ‘blanking out’, so my doctor changed me over to slow release (Oxycontin), starting 30mg a day, now at 40.

 

When I started the Oxycontin, I was taking 10mg in the morning and 20 evening, but I was still getting really bad muscle pains, like from the Tramadol, towards the end of the day, as though the morning dose wasn't enough to last through until the evening one.  I thought the problem would resolve itself when I increased to 20mg morning, but the same thing happened.

 

I'm also on Fluoxetine for depression, and I was taking that in the morning, at the same time as the Oxycontin; I started to wonder if the Fluoxetine was somehow inhibiting the Oxycontin because I got more relief from the evening dose than I did from the morning one.  So I've moved the Fluoxetine to last thing at night to see what happens.  The muscle pains have improved a bit, but I'm now much more wiped out by the Oxycontin than I was - I feel completely spaced out, exhausted for most of the day. So it does seem like the Fluoxetine was somehow interacting with the Oxycontin. 

 

But what I don't understand is

1) why I feel so completely spaced out all day now (I didn't used to feel that way all night) and

2) what the muscle pains really are? 

 

When the pain clinic said it was the Tramadol causing muscle spasms, I kept asking if it was because I was becoming dependent on it and they said no.  But when I changed over to the Oxycodone, the pains were much much worse and I did some reading that seemed to suggest it was basically because I was withdrawing from the Tramadol (indicating that I was dependent on it). But then why am I still getting the pains now, on a drug I’ve only been using for a month?  I know they're similar, but even so, I don't get it.

 

I don't know if any of this makes any sense, but if anyone can shed any light on it I'd be really grateful. (And sorry for the mammoth post - there's probably a much quicker way to explain all this, but the meds are turning my brain to mush!)

 

Thanks very much

 

Posted 8/17/2009 4:01 PM (GMT 0)
Im not sure if I can answer your question I'd just like to add that I find that when I just have my oxycodone 30mg they make my muscles in my upper back feel very tight and spasms all the time. I thought it was my imagination but since you've posted this its made me think.

I feel for you.
Posted 8/17/2009 5:30 PM (GMT 0)
I thought that my upper back pain was just a normal progression of all of my back problems. I just thought that it was "bound to happen". Now I am wondering if it's the oxycodone 30 mg. immediate release I am taking. I have severe lower back problems and DDD along with spinal stenosis, and perm. nerve damage. I have had 2 back surgeries including spinal fusion at L5-S1.

Does anyone else have these spasm problems due to oxycodone? I had an EMG a few months ago and they told me that my muscles "fire" all the time with no rest....

Me.
Posted 8/17/2009 6:13 PM (GMT 0)
Bandit 07

What does your Doctor say about your muscle pain? Is your pain localized to just a certain area? or is it wide spread and all over your body? Also your muscle spasms, do you have them when your not taking any medications? are they limited to only your back? or are they all over? Hands? feet? legs? arms? or what? And are they cramps and charlie horse type spams that knot up your muscles or are they just tight and uncomfortable? You need to really observe all this and write it down and then take this information to your Doctor. There are allot of things that can cause muscle pain and spasms and you need to be checked and maybe have some tests run to find out the cause of all this. I do wish you well and hope you can get some resolution to your problems!

Good Luck to You!

White Beard
Posted 8/17/2009 7:19 PM (GMT 0)

How interesting - for some reason, I wasn't expecting to hear that other people found the same thing - I thought it was just me!

Whitebeard - my GP and pain doc both say just 'muscle spasms' and blamed it on the Tramadol. It tends to be in 3 bands - between my shoulder blades, across my mid back and across my lower back. Usually it's one or two of these bands at a time, but during the changeover from Tramadol to Oxycodone, and when I just stopped the Tramadol altogether last year, it was all three. I don't get muscle spasms or that kind of muscle pain anywhere else. My 'main' pain is in my left shoulder but it radiates up to my neck, across my shoulder blades and over the top half of my chest and back. Like many people, moving any part of my body can trigger pain in these areas. I also have trapped nerves in my back & neck that caused headaches and nueorological disturbances.

I'm afraid I don't know what 'charlie horse spasms' are, but I guess I'd describe the back spasms as the muscles feeling really really tight. It's like they're constricting from all directions though, not just one way, and it's not a sharp crampy pain, it's more low frequency than that (very different to my shoulder pain). I never used to get it before I started the Tramadol, but unfortunately the shoulder pain becomes too unbearable for me to go off my meds for more than a day, so it's difficult to say if it's still there without them, because I never get them out of my system.

Thanks for any advice you can offer

Bandit

Posted 8/17/2009 7:46 PM (GMT 0)
You're not alone, far from it. Over the past years I've had similar axperiences; muscle aches and spasms in regions that you wouldn't expect them. The explanation was in my case quite simple. I'll try to explain in general terms.

A person's movements are a precise sequence of muscle movements. Now when we are in pain, we tend, usually invariably, to "spare" the part of our body that aches. E.g.: When your left leg hurts you're going to switch most of your weight to your right one. In "sparing" one part, we often overstress other parts. We also screw up the minute sequence of muscle movements, usually without even realising it when we "spare" our aching body parts.

The solution was very simple in my case, though it took a while: try not to "spare" the aching parts by performing all actions as if you don't have any body ache at all. Initially this will increase the pain of the part that is actually injured as it is no longer being "spared", but after a couple of months all the other aches ans spasms might fade away. This was the case with my body. I was even capable of quiting all painkillers (although I still take morphine, but that's not for the pain, that's against diarrhea).

Might be worth a try.
Posted 8/17/2009 10:30 PM (GMT 0)
I know that when I take my oxycodone 30mgs I hurt much more, then with a patch on, I dont hurt at all anymore since starting the patches again, that I had used a year or so back. but it seems like I know its definetly the oxycodone, because somedays I'll feel worse and have to take more right? just like everyone with CP, well it seems like the more I happen to take the worse my muscles hurt and tighten and knot up. So its a really easy identification of whats making my back hurt worse, I just find it strange that a narcotic pain killer is making your muscles hurt. because most people relax when taking the narcotics, which I do, very much so, but its afterwards of the initial umph of medication release, about 2 or 2 and a half hours after taking it I start to hurt in my back already, and like I said, like I take 3-30mg ones at a time, so 90mgs at a time, usually 2 - 3 times a day, well I can tell the difference in taking 2 doses of 90 vs 3 doses, I hurt CONSIDERABLY more with the third dose to the point whre Im only getting relief for that first 2 hours or so then start to hurt so its almost better to not take it and tough it out
Posted 8/18/2009 12:21 AM (GMT 0)
Wow Bandit, that's a lot of Oxy. I'm going through multiple fusions and I get 5mg for breakthrough on top of 15mg MScontin twice daily and am also having dramas with muscle spasms. usually 10mg Oxy will knock the pain on the head for a few hours but its amazing how quickly you build a resistance to it and I tend to go through it quickly as I have to take 2 to get relief. I to was on tramadol for a long time but it fuzzed me out way to much and it also messes with your serotonin, hence the emotions going nutso (mine certainy were)..That's an interesting idea that the narcs may be causing the spasms - food for thought? I recently started on muscle relaxants as the muscles spasm like crazy and contract to protect the joints and I think in some cases a lot of the pain comes from the spasming, not the fusion! managing the pain killers and other meds certainly blows IMHO

I certainly feel for you
Posted 8/18/2009 2:07 AM (GMT 0)
I'm not a doctor, but it sounds to me like you have a whole new thing going on with muscle problems. But I will add in that once (a long time ago, about 4 years) I was taking oxycontin 20mg 3 times a day with tramadol for breakthrough, 2 50mg pills every 6 hours, and I went through 3 bottles of 120 pills nonstop (of course taking them as prescribed) cause my pain was really bad. Well I ran out of them and I thought no big deal, I had a doctor's appointment coming up a week later and I thought it would be no big deal to wait til then to get another prescription for the tramadol. Well about a half a day after running out I hit BIG time withdrawals with the tramadol eventhough I was still taking my oxycotin. So even with oxycontin in my system, I still had severe withdrawals from the tramadol, and if I remember right, I did have some body aches, but mostly I had sleeping issues and anxiety, it probably would of been worst if it was for hte oxycontin, and that lasted about 4 days til it calmed down enough to where I could ignore it. But that was just from taking it for a couple of months, but you said you where tkaing it longer then that, so maybe it is withdrawals. But truthfully I really dont know what to say.

If I where you, I would just keep being persistant to the doctor and letting them know whats going on, maybe you need a diffrent muscle relaxer, one that wont cause depression. It's alot of trial and error with these meds, as most of us know. Just like antidepressants, we have to sometimes try several til we find one that works without horrible side effects, I know it took me over 10 years of antideppresants and pain meds to find the right combo. I always think I'm weird, cause I find the best pain med for me is Suboxone, better then all the other ones I've tried, and cymblata is the only antideppresant that doesnt make me feel like clawing my skin off. So just keep letting hte doctor know, they've got to eventually figure out that the tramadol has nothing to do with it, and if it does, then just time would take care of it.

I also hear lots of bad things about tramadol, I even heard from lots of people that withdrawals from it is worse then any full narcotic pain med out there cause tramadol is kinda an anti-deprresant also in the way it effects the body, I would do lots of research on tramadol, their's several websights out there where people list the side effects they had from all kinds of prescription meds, so maybe you should start there and see if other epople had this muscle issues also. well good luck.
Posted 8/18/2009 3:36 AM (GMT 0)
Yeah look I feel I have to say my bit about Tramadol...

I was put on that for quite a while and it was really the first of the heavier type of painkillers that I was prescribed..I found it to make me very foggy and stoned at first but as I built a resistance to it, up went the intake. But it also messes with your serotonin levels as well. I had depression at the time and taking a Tramal would lift my mood also. Being youngish (21) I really had no notion of withdrawals and all that (thought that was only in the realms of heroin addicts etc....how wrong i was) I was just happy that the pain levels were down a bit, even though I didn't like how stoned I felt and how my mood would go up and down depending on how and when i took the Tramal.

My usual Dr packed up and moved away one day without informing anyone. When i went in to the drs to get a script refill the dr that had taken over her patients refused to dispense it to me, said i was taking to much and that if i really did have AS and had managed to get in to see her from (from a mobility perspective) I obviously wasn't in that much pain to require such a heavy painkiller and basically accused me of drug seeking behavior. i thought bugger it, made another appt with another doctor (wasn't for another week) and left.

The withdrawals started that afternoon. I wont bother describing it, there are plenty of other posts detailing it. you just have to experience it to know. lasted for 5 days. but the real bugger about it was, as i described before with how it messes with your serotonin levels, once it got out of my system the depression that hit me was, in a word, hardcore. as far as I know other painkillers don't mess with your serotonin levels like Tramal does, but a lot of people have seizures and everything because of it.

When I saw the new doc he told me that Tramal withdrawal is just as bad as full blown heroin withdrawal, with the added plus of the depression that comes with it.

Just my opinion anyways, but I certainly would think twice about combining tramal with antidepressants, or even taking tramal in general. There are better and safer options out there than that - I fully agree with Kitty - talk to your doc about your concerns and keep at it

Sorry about the long rant by the way
Posted 8/18/2009 8:19 PM (GMT 0)

Thanks for all the replies guys, I appreciate your support. I talked to my doc today and he wants to change me onto Targinact (Oxycodone & Naloxone), though I think he's just randomly trying stuff in case it works.

A friend of mine who was on Fluoxetine for ages suggested to me today that it might be that that's causing the spaced-out thing, rather than the Oxycontin, because she had a similar problem, though not nearly as bad (and she wasn't on pain killers). Doesn't explain the spasms though. My doc's only idea was that my back is just very weak because of my limited movement, but that doesn't explain how it can come and go regardless of what I'm doing.

I'm going to try taking the Oxycontin a couple of hours after the Fluoxetine tomorrow, to see if that helps (usually they're the other way around).

Bandit

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