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Posted 3/9/2012 2:01 PM (GMT 0)
hello everyone, so a quick background

I injured my back on deployment and when i got back to the states was never given the chance for a MRI. I recently got transferred to Korea and now that i had the chance went and saw a doctor. The doctor told me I have back pain syndrome or I have an unaligned vertebra. I started physical therapy about 2 months ago and it doesn't seem to be doing anything. The pain has gotten worse so I asked the doctor for a pain medication. Relentlessly he gave me Tramadol 50mg. I was told to take 1 pill when the pain gets really bad. So after doing this there was no relief. The pain got so bad the other day i ended up taking 4 pills = 200mg and absolutely no change in comfort. There are days where i don't want to do anything but lay in bed because it hurts to move (I also have Patella Femoral Pain syndrome in my knees) Just wondering if anyone knows of alternate pain relief methods or if they have any suggestions on medication that has worked for them because Tramadol hasn't.

Thanks for your time
Posted 3/9/2012 4:40 PM (GMT 0)
Hello...

Welcome to the board..... but sorry you are dealing w/ pain issues!

There are many other medications (other narcotics; muscle relaxers; etc) and many other things people here do to help w/ their pain.

The key is finding a doctor that will appropriately diagnosis you and treat you. Did you have an MRI to get your current diagnosis? Have you told the doctor that the tramadol isn't working? (If you haven't - I'd start there). You said he "relentlessly" gave you the 1x/daily tramadol - did he say why he was resistant to giving meds? Like I said - there's not only narcotics - but a good muscle relaxer will often help w/ back pain.

If you aren't making any progress w/ getting proper treatment w/ this doctor - do you have options to switch to another doc?

Sorry for the 500 questions.... but that extra info might help us to point you in the right direction. :)

--Tina
Posted 3/9/2012 6:09 PM (GMT 0)
Hi alwyas_working,

I take tramadol in a time-release form (Ultram ER --300mg daily). It helps me, but 50mg may not be enough for you. It also just doesn't do much for many people and for many types of pain. It is among the most mild opioids available.

In addition to opioids, another option would be muscle relaxants (as momtwo8kids notes). One question is whether your pain is based upon a nerve impingement or whether it is primarily due to tight muscles. If the former, ice may help and if the latter, heat.

Further, if the alignment can be corrected, then look into physical therapy and chiropracty. There are many quacks out there and so if you can get some referrals from others you trust, that may help you avoid some useless treatments.

Also, as momto8kinds notes, more testing is appropriate, including an MRI. If you haven't had a recent X-ray of your back, that should definitely be done.
Posted 3/9/2012 7:42 PM (GMT 0)
Welcome to the boards....Sorry to hear about your pain issues..

It's very surprising that they denied you medical care in between posts. What about getting a MRI in the base hospital now?

I come from a very large military family and they have all had great medical care when needed here in the states and overseas. My nephew was born in Italy:) But my brother was also stationed a year a long time ago in Korea.

(Yes...they have much room for improvement, especially with PTSD issues)...

Anyway...I also want to caution you that you say your DR. reluctantly prescribed you ONE Tramadol a day....

Is it written on your prescription that you can take up to 4 a day? If not...this can cause great issues with running out early, causing withdrawal if you take a lot one day and then none another...As well as if they do a drug test on you or a prescription bottle count....you won't have the correct amount of medication and this can get you released from care immediately. That would leave you with no medicine and a red flag on your records...

So...just trying to help that it takes time working with Drs. to get the appropriate tests, procedures, and amount of medicine prescribed by them...That you should always call them and let them know the one a day is not working well and not take it into your own hands.

Also, once the MRI is done...they will be able to see if you need injections or possible surgery....as well as the appropriate PT that will help and not cause more pain.

Dealing with chronic pain is all about building blocks...never just one pain pill...

In addition to what I mentioned, there are muscle relaxers, nerve pain meds, TENS unit, and many other modalities...

I know patience is hard when we are hurting...but unless it is emergent to warrant immediate ER attention...Drs have to work through any/all options to help see what works with us...

Hope you come back to update us soon..
Posted 3/9/2012 10:59 PM (GMT 0)
hello again,


Momto8kids- i didn't get an MRI for the diagnosis or at all for that matter. The doctor took ex-rays of both my knees and back and said they came back normal so there was no need for a MRI. He said he was hesitant on giving pain medication because there were so many addictive types that he didn't want to risk the chance. This was so recent I haven't had the chance to tell the doctor that the Tramadol isn't working but I Just moved to a new base in Korea so I will have a new doctor and was told by the pt that i am going to be put on electro stimulation twice a week. The problem the doctor said with medicine is finding one strong enough to work but will still allow me to function properly at work for 9 hrs. So I will wait and see what the new doctor says on Tuesday.
Posted 3/10/2012 3:12 AM (GMT 0)
Hello and welcome to the chronic pain forum. I am sorry that you are having such a time with pain and then not getting much in way of good care from the treating dr.. However, you are not the first one to get crappy care out of a military dr, others here have had the same experience. I had my own problems with them and had I continued to listen to them my daughter could have died. Fortunately, I had enough sense to know something was seriously wrong and got her to a civilian hospital in time. It is so frustrating when drs do not listen to the patient and just ignore what is being said to them.

I do hope when you see the new dr next week you can get one that will listen and try to help you. You mentioned going to PT and getting E-Stim, that works pretty good too, helps with muscle spasms and helps reduce the pain a little. Hopefully it will give you some relief.

Please let us know how the appt goes next week and keep us posted on how you are doing. Take care.
Posted 3/10/2012 7:25 AM (GMT 0)
Hi and Welcome~

It sounds like you're in a real bind. I live where there are several military bases within an hour's drive plus a VA home so I've talked to many folks who are under their medical care (Tri-Care I believe). Anyway, what you are saying sounds very familiar about not getting the medications or diagnostics you need. Just my opinion here but of all people who should be helped with medical problems I personally think that the men and women in our military should be at the top of the list. Sad thing is that the doc you had is touting the old lines about addiction, yadda, yadda...

These folks need to read the research that's been done in the last couple of decades instead of relying on old medical myths that don't hold up to scrutiny any more. Yes, the meds we're talking about are addictive but the rate of addiction among those with chronic pain is so small ... less than 1/2 of 1%! ... it's not worth fussing over. Don't get me wrong. We all need to be aware that narcotic medications are potentially dangerous but they are appropriate when used responsibly. I can only compare the dose you were taking to what I take and a few others I know of but IMHO that's a very low dose.

Please do talk to your doctor about everything that goes on concerning your pain. In fact the best thing would be to keep a pain journal. There's a link to a free one you can download in the Chronic Pain 101 thread at the top of the page. Make some copies and fill them in daily with information about your pain level, etc. Then each and every trip to the doctor take it along and insist that he/she reads it while you wait. They will not only see that you're serious but can also see the patterns and intensity of your pain. It can really wake up your medical team.

Good luck and keep in touch...
Chutz
Posted 3/10/2012 9:09 AM (GMT 0)
I hope your appointment goes well on Tuesday. Really let the doctor know of your pain... and that the meds aren't working....

Take good care... and let us know how things go!

--Tina
Posted 3/10/2012 11:11 PM (GMT 0)
Always working.

I too injured myself while I was in the military......though its effects didn't truly manifest until December 2006 while on my Kosovo deployment. I truly empathize and sympathize that you are going through all this (been there).

In my response to patrict on another post today, I told my back story so feel free to check it out. However, what I can tell you from my experience is that military doctors UNDER TREAT. In fact, I was made to believe physical therapy could "solve" my issues. In some respect I do think it helped, but the injury still got progressively worse over time.

You NEED an MRI. Can you make a request to get sent to Landsthul or Walter Reed to get a full evaluation over the course of a few days?

As for medications, I truly wish you the best. Nucynta which is what I'm on is very similiar to tramadol, only its about 3 times the potency (like tramadol it has both anti depressant NRI action and opioid narcotic action).....however its a sechedule II. It does however have a lower abuse rate than many narcotics so perhaps your doctor might be willing to compromise there? Nucynta causes very little drowsiness and while it does affect your mood, its affect on your motor skills while noticable are less than that of most narcotics. You can also ask to be put on a low grade narcotic like hydrocodone and ask to be put on an adjuvant like Cymbalta or Lyrica. I'm not a doctor and this is just my grainofsalt advice for you.

Have you discussed this with you XO and company commander?
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