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Kyphosis

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Posted 2/27/2013 7:50 PM (GMT 0)
Hi-

I'm a 40 year old female and I haven't posted on this website for the last couple of years. I posted about chronic pain in my left shoulder that I couldn't get a diagnosis for. I saw many specialists, had several MRI's a bone scan, etc. Pretty much everything was ruled out and I was just left with the diagnosis of chronic pain. I ended up being prescribed several medicines including oxycodone, klonopin and gabapentin. I have been on this regimen for a couple of years now. I took a break for quite some time and just kept taking the meds with really no answer as to why I had the pain or whether it would ever go away.

Recently, I found a chiropractic and pain rehab clinic. This chriropractor sat down with me and looked at my xrays and MRI's and actually gave me a diagnosis. This is after several years of everyone telling me that the MRI's and xrays revealed no reason for my pain. He told me I have cervical spine kyphosis. This is when you loose the normal C curve that your c spine should have and it's straight or has a slight S shape. I also have two cervical spine bulges. They are minor but according to him, they are enough to cause the pain I  have been in.

I have been having weekly adjustments and in the same clinic they also have massage therapists. So once a week I get an hour long message to work out all the terrible muscle spasms and then adjustments and also some traction. It is the first type of treatment that has actually helped me instead of hurt me.

Getting a diagnosis has been wonderful. But it is still scary to know that this may be a life long condition in which the only thing I can do is control the symptoms. I have stayed on the medications my PCP prescribed and continued my weekly massage and chiro adjustments.

I think my biggest issue right now is my PCP. I had to go through hell and back with them to get on my current medication regimen. I was accused multiple times of taking too much medication and asking for refills too soon. Every time I was able to prove that this was not the case. It has been very hard. But this PCP has been the only one so far to at least prescribe to me.

Since being on the meds, I have been able to resume at least most of my daily activities. They have allowed me to work, to take care of my three year old daughter, to take care of my home and to be a wife to my husband again.

My biggest problem at this stage is now that I have my PCP on my side and they trust me now (as well as signing a drug contract) is that it is very difficult to discuss the possibility of discontinuing one or all of my medications to get a good feel for what my base line pain is without the medication, especially now that I have a diagnosis and I am receiving the right kind of treatment. She just doesn't want to talk about it. I get the feeling that with her it's an all or nothing situation. If I want to take a short break, they'll pull them from me completely and if the short break reveals I still need them, I will not be able to get them back. When I bring it up, she skirt around the issue and says things like "it's like taking insulin away from a diabetic".

So I'm basically here to just see if others out here have kyphosis and what experiences they have had. But mostly I need to find out how to educate myself on how to determine what drugs are helping me and what drugs are not helping me. And how to best communicate this to a doctor that doesn't want to talk about it. I've heard of people cutting back or quitting for awhile only to find out they still need the meds. I would think a doctor would be well versed on this sort of thing. Isn't it my right to make sure I still need my meds? Even with cutting back, I still get really severe symptoms..most likely because I'm dependent on the drugs...but without a break how will I ever know the difference. I know cutting back should always be done under direct supervision of a physician, but what happens when your physician is not open to this?

I hope this makes sense. I'm just really confused. I don't want to put drugs into my body unless they are helping and improving my quality of life...I'm willing to take the drugs as long as they are helping me...but when is enough really enough??

Posted 2/27/2013 10:05 PM (GMT 0)
Well...

My guess is that the increase in relief you feel, is a result of everything working together.

Her analogy makes sense. If you stop the meds, your baseline for pain relief will be gone, and you'll have to work that much harder to get it back.

If you're getting severe symptoms from cutting back on the meds, its probably because the meds are keeping your pain at a certain level while this new treatment is like a booster.

Our first reaction is always to try and get off everything once we start to feel better, but usually doing that will just make us take 10 steps back.

Unless there's a serious problem caused by the meds, I would stick to them. If you want to try taking less a day within your daily limits, thats something to think about. Ie if you take 3 oxycodone a day, try only taking 2. That way you can experiment without having to give up anything.
Posted 2/28/2013 11:39 AM (GMT 0)
I have mild thoracic kyphosis from vertebral fractures in the last couple of years. The worst of my pain is covered by the meds I take for my CRPS - I think the kyphosis pain alone for me would not require high level pain meds as yours does, but I can certainly relate to the spasm issues - without weekly massage and mobilisation work with my physio, my pain I'm sure would get out of hand.

I think Lexi has given good advice about experimenting with dose. My dr gives me guidelines that I can work between, so I can increase my dose (for me, OxyContin) to a certain level for a certain period of time without consulting him if I need to, or taper back on my own if I don't.
Posted 3/1/2013 10:02 AM (GMT 0)
I see the Drs point in this. She has been treating you for years as a chronic pain patient. Cp is just as the name states,chronic in nature. Now after years of her treating you in that capacity,documenting whatever was necessary to substantiate why she as a PCP has took the high and aggressive roads in meds and used the last ditch efforts to bring you a better quality of life.

They really,really hate it when this happens an we stroll in and say wait!! Maybe I'm not really a chronic pain patient after all.

I can also as a CPer who went out on my own and found things that worked for me to bring down those levels of pain and as stated previously I was given some control in how much how often I could take the meds.

I cut back on them until I knew that was the best I was getting. Approached my PM Dr and said this is what I'm currently taking and have not needed more meds in awhile. They rewrote for the proper amounts and I've managed with that for 4 yrs.

My dose cut in half on my LA med and eliminated the B/T med altogether.

You can lower your dose yourself and play around as not many Drs are going to be angry over less only more without their knowledge.

Good luck

Vickie

Post Edited (nvrthesame98) : 3/3/2013 1:23:24 AM (GMT-7)

Posted 3/1/2013 2:15 PM (GMT 0)
I agree with Lex on this.

Having a disability that causes chronic pain myself, it's a battle finding the right combination of medications to manage the pain. If you go "cold turkey" you're also once again going to have to go through hell and back to get your meds back if it turns out that you do need them.

From my experience of numerous medications, if you want to cut back, do so slowly and with caution. The pain is probably coming back, not from withdraw or being dependent, but the chemical balance of all the drugs sort of...working in harmony with each other.

I would be careful on how you approach this. Your doctor probably doesn't want to change anything out of your best interest and probably her experience with other patients, knowing that it will bring your pain back.

Another way to look at this would be, do you really want all those fights with your doctors, proving that something was wrong, and your PCP, getting the medications and proving that you do need them, to all be in vain?


- Rainy/DD
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