E R meds

Hello everyone,

I have asked my doc several times about possibly taking an extended release pain med due to the fact that my pain is pretty much constant. Well he usually tries to deflect the question to something else and doesn't really give me an answer.

I have bulging disks & arthritis which affect my lower back, hip & pelvis, leg & groin area. I have fallen several times due to my right leg being weak or because of severe shooting pain down the leg. I currently take high blood pressure meds, Plavix for 2 coronary stents, Zocor, and 2 5/500 hydrocodone a day for pain.

Several times the doctor has tried to push Tramadol, I tried it and while it was useless on pain, it did for some reason help with depression. I guess my question is, can you take an extended release Tramadol and also take hydrocodone for a breakthru type pain. I get little relief from 5mg hydrocodone but my thinking is is it possible the combination of the 2 could possibly help me. I was also on Prozac for about 8 months but I think it made my mood worse.

Any thoughts would be greatly appreciated. Not really wanting to take Tramadol but if doctor will not give me a more potent E R just looking for something to help

Hi Tziggy & welcome to the forum. Sorry to hear that your dr is not taking you very serious concerning your pain. However,in reading one of your other posts you were talking about having a pinched nerve. With that being the case even if the dr did increase your pain meds it still would not have much effect on your pain. Narcotics have little effect on nerve pain. Have you ever been tried on any of the nerve meds such as Lyrica, Cymbalta or Gabapentin just to name a couple? Most of the time you have to be on these meds for a while to know whether they are helping or not & also to get you on the correct dose.

Are you seeing your primary care physician or pain mgt dr? If you are seeing your primary care physician that is another reason he is keeping you on the lowest dose he can. Just about all primary drs now refer their patients to a pain mgt dr because of the new guidelines in place for rxing narcotics. New guidelines & rules for drs dispensing narcotics to patients. Drs now, no matter what kind of practice they are in, are really strict & this includes pain mgt drs. They are all afraid of losing their license to practice medicine which makes it difficult for us.

Glad you decided to join up & wanted to welcome you aboard. Keep us posted n how you are doing. Take care......Susie

Thanks Susie,

I see my PCP, he had mentioned at one time Cymbalta, at that time I was on Prozac. Being that I am currently receiving Medicaid, the state that I live in try to throw people off after 6 months and you have to fight to get the coverage again. So it's a constant roller coaster of coverage and non coverage. I believe the Dr didn't want to start Cymbalta and then I would lose coverage and not be able to afford it. I had bad experience with pain management and would prefer notto do that again LOL. But anyway, thanks for the advice

Hi Tziggy...welcome to the boards...

I just wanted to add that there is a huge difference between some pain "clinic" where there are Drs. just shuffling people in/out within 10 minutes and handing them prescriptions of opiates...

There are many wonderful, reputable, Pain Management Doctors who are both Board Certified AND Fellowship trained in Pain Medicine. Thankfully this is the type of Dr. I see.

He is trained using a multidisciplinary approach to chronic pain which includes everything from exercise, physical therapy, injections, acupuncture, to medications.

I'm sorry that you had a bad experience with a "pain clinic" but please don't write off the entire aspect of Pain Management. For me, just as I went to a Board Certified Neurosurgeon to do my cervical spine surgery, I want to go to the most qualified and specialized Dr. in chronic pain.

I would make sure that you have seen a great Neurosurgeon as well to make sure that you aren't a candidate for surgery right now.

As Straydog mentioned, most of us with any type of spine issue is on some type of nerve pain medication as opiates just don't work well for that type of pain. As well as a muscle relaxer....there are many choices for these as well from Flexeril, Robaxin, Skelaxin, Baclofen, and Zanaflex.

You mention that Tramadol helped with your depression....then I would talk with your Dr. about being put on some type of SSRI antidepressant as Tramadol is known to have certain properties that act like this type of med.

I sought out counseling for about 6 months after my divorce to continue to work on all the issues that come with having chronic pain. It is completely normal and most everyone with chronic pain ends up with having symptoms of depression. So it's just as important to take care of this aspect of our health just like we do the physical.

Being that you are only on a low dose of the Hydrocodone each day, this may be why your Dr. is not ready to move you to an ER med. The usual next step from Hydrocodone is to move to Oxycodone like in Percocet or even OxyIR which is plain Oxycodone (short acting) without the acetaminophen.

Obviously I'm not a Dr. and just going on the steps that I have taken with chronic spine pain/surgeries.

I just really recommend trying to find a reputable Board Certified PM in your area that is willing to treat you as a "whole" and who knows that treating cp involves using as many modalities as possible. There are so many other ways to be treating your pain in addition to any medications..

Keep us posted..