Posted 3/14/2013 1:39 AM (GMT 0)
Sorry for your hurt back..
You are a bit backwards on the med situation with at only 30mg of MSContin as your ER but 40mg a day of Oxycodone as BT pain.
I would speak with your Dr. and just let them know you aren't getting good coverage of pain during the day. My PM usually raises the ER medication so then I barely have to use any BT meds except when on a really bad day.
If you are using your Oxycodone 4 times a day, every day....then you really don't have an actual Breakthrough med for a spike in levels.
I am on 3 times a day of 30mg of MSContin. My BT is 5mg of OxyIR to take as needed. I get all the way up to 8 if I need but never go there as I take the lowest amount possible to have for days that I have greater pain.
May I ask what the diagnosis is of your back and when your last MRI was and looked at by a Board Certified Neurosurgeon or Orthopedic surgeon?
Someone with truly chronic pain should be on a comprehensive plan of treatments to help keep the pain at a manageable level.
Just some of the things I do are daily exercise (walk 1.4 miles every day), stretching, yoga, aqua therapy, physical therapy, TENS unit, ice, heat, acupuncture, massage, injections, steroids, biofeedback, counseling, eating well and maintanint a healthy weight, and absolutely no smoking as this is now proven to dehydrate discs in our spine.
Then there are other medications like an actual muscle relaxer like Flexeril, Robaxin, Skelaxin, Baclofen or Zanaflex. These work specifically for spasms.
For nerve pain there is Lyrica, Neurontin, or Cymbalta. This is where an opiate does not really work for muscle or nerve pain so it's good to have these on hand to take for that type of pain.
With all the modalities I use and after 11 years and many surgeries including 3 spine fusions.....my pain is about a 5-7 daily. This is acceptable and reasonable to me because I try to stay on the absolute lowest amount of opiates and medication as possible. I haven't changed my dosages in over 3 and 1/2 years.
So, to answer your question is that it really boils down to how long you've been on those dosages and what else do you do for your pain both medically and non. Is there anything surgical that could possibly help to lower some of the pain?
The best thing to do is just approach your Dr. with what you are able to do each day and what you aren't able to do. Write down what "type" of pain you have and when is it highest and when is it lowest. Also write down all you do to help keep your pain levels on your own.
This way you are letting your Dr. know you are part of the team and are willing to do whatever it takes to have the pain at a manageable level. Just make sure you discuss with him about reasonable pain levels as we aren't going to be at 0 ever again.
The main thing is showing them that you aren't only wanting/expecting opiates to solve all your pain issues. So, it may be as simple as adding in a muscle relaxer or nerve pain med, or get you into a PT program or do some injections...
Let us know how it goes...