Skip to content
Paracentral Disc Protrusion
sjlnv posted:
I am only 27 years old & have recently started have sever back pain.(I am a wimp!) I went to the Dr. & she put me on Vicoden & Ultram. I am scared to take the ultram & she told me to take 4 vicoden a day. I am only taking 3 with meals. I feel very loopy as it is, but am stil having pain. Am I on the wrong meds? I have now been on Vicoden for 2 weeks. I'm very scared about getting addicted. How do I know that I am okay & not addicted to the drug?

My MRI tells us that I have a moderate left paracentral disc protusion at the L5-S1 Level, which effaces the left ventrak surface of the thesac and the left nerve root exit zone. Also a annular buldging disc at L-4

Do you have any idea what this means? I am being referred to a Neuro Surgent, so I'm very scared about this. The Neuro surg that I am being referred to is so busy that it will be about a month before I get in & I don't want to be worried for all of that time. Any suggestions will help!

Thanks so much!
cweinbl responded:
"Sjlnv," why are you afraid of addiction to pain medication? Have you experienced a prior addiction disorder? Are you aware that a large body of research reveals that between 1% and 3% of patients taking narcotic medication for chronic pain become addicted? Why fear addiction when your chance of being addicted is minuscule? Of course, if you have been addicted before, or if substance abuse is prevalent in your family, then perhaps you should pass on it. Otherwise, you have no reason to fear addiction.

I've been using some of the most powerful narcotics available for almost 30 years and I've never felt any addiction tendency at all. I've encountered many people who have also been using powerful opiates over many years and none of them have had a problem with addiction. Perhaps you have been misled about the chance for addiction associated with pain medication. You might also benefit from some brief research into the difference between addiction and dependence. Addiction is a disorder in which patients steal medication, purchase it illegally, take more than they should, run out too early and obtain medication from multiple physicians. Since the chance of that happening to you is between 1% and 3%, isn't it a risk worth taking? Why not obtain the comfort that you deserve?
freedom1960 responded:
The fact that you're worried about it makes me think there's no reason to worry about it. If you want to make absolutely sure you won't even become dependent, which, as Charles said, is so different than becoming "addicted" you can just make sure that you go without the medication when at all possible.

When I first started taking narcotic pain meds, I too, had the same worry about addiction because I wasn't educated on the difference between addiction and dependence. I just made sure I went two days in a row every week without any pain medication, which I could actually do quite easily at the time because my condition hadn't progressed to what it is now and I could take them as needed. Now I take them as scheduled and am just fine being dependent (not addicted) on them.

I am wondering why your doctor gave you Ultram on top of Vicodin? Is the Ultram for day and the Vicodin for night? He doesn't have you taking both at the same time does he? Personally, I think Ultram, or "Tramadol" if it is generic (and if I got that spelling right), is a pretty useless drug, to me, for pain, and I can't take it because it causes a "speed" effect on me (and about everyone I've talked to-like drinking 4 POTS of coffee), to the point that twice, before I knew it was the Ultram doing it, I ended up in the ER with A-fib and they had to shock my heart back into rhythm.

Now, don't let me scare you into not taking it should you need it or if you are already taking it, because I have the weirdest constitution my doctors have ever seen. I'm allergic to this drug, I need extremely high doses of that drug, and this other one just gives me the trots,etc. LOL

But I am still wondering why you are prescribed both medications? Just curious. Were you to try one and if it didn't work, the other? Or the night and day thing? Like I said, just curious. I think they should do more trials on Tramadol myself, as for me, it is a dangerous drug. But then I got that constitution thing again. LOL

Good Luck to you!!!

freedom1960 responded:
Also, make surgery your last course of treatment. Surgery only helps in 50% of all spinal surgery cases. Something both Charles and I left out. There are many other treatments, like injections and pain management to try before surgery. Not all pain management means drugs either. There are many other options. Just make sure you check them out before you go for the surgery. And don't allow a surgeon to "push" you into having a surgery you're not sure about. And NEVER see a chiropractor! For anything! Especially when it is the neck that is involved.

I think I got it all out now. LOL Oh, you have a disc that is protruding and putting pressure on the nerve, which is where the pain is coming from. Normal people would say "You have a pinched nerve" or "A slipped disc" or something in that kind of language I'm sure you've heard before. But I by-passed neck and back surgery twice by using other treatments when surgery was suggested. I got Injections that didn't help, then I got a different kind that did. An anesthesiologist does these types of procedures. You can ask your PCP (your regular doctor) about these and if he thinks and anesthesiologist who does these injections is something you could look into. It would mean another appointment (hence, another referral) but to me, I'm so glad I went that way instead of surgery.

Good Luck!!!

annette030 responded:
I take 100 mg. when I wake up along with my long lasting morphine. It seems to make my meds last longer during the day. I take less hydrocodone/APAP. I have tried omitting it, but I notice the difference right away. I don't take it later in the day, because then I don't sleep at night. Tramadol is one of the meds my doc told me to try and see how it worked out for me.

It is just one of those things that works fine for some people, and doesn't for others.

Take care, Annette
jenius715 responded:
I dont mean to dredge an old post (or maybe i do since I am lol) but Ive been reading threads on the sight for quite a few days, and since I have some experience w/these two drugs, i thought Id finally get out of "lurking mode" and chime in.... Im also prescribed BOTH Ultram and Norco (almost the same as Vicoden, different strength)... And it is prescribed to take intermittently as it helps keep pain under control and helps other meds work longer. So I am prescribed 1-2 ultram 4 times per day and hydrocodone 4 times a day... I was told to take the Ultram, then two hours later take the Hydrocodone, then two hours later take the Ultram, etc..... So instead of taking EVERYTHING at once then EVERYTHING wearing off at once, you always have something there controlling your pain. Hope that makes sense! Im a long time Pain Pt, and also take a controlled release med w/these two meds. BUT I thought this might help you --- and this is one way to take them to get the best relief thru out the entire day. I also agree with the Annette- Ultram does an excellent job making my pain meds work longer, and on really good days, I can use ONLY ultram. Unfortantley, I dont seem to be getting those days too often anymore, WINTER kills me! I know many many many people say Ultram is 'baby aspirin' and things like that, but I am also someone who it works wonders for. You may want to give it a try if you havent already! Good Luck!

annette030 responded:
I totally agree with you. I have had a number of days lately where I have not taken any of my breakthrough meds except my ultram once a day when I get up. But I notice right away if I don't take it at all. It really helps make my long acting drug work better. I only take that two times a day now. I can't take the Ultram later in the day though, because it makes it too hard for me to sleep.

I think Ultram is one of the many tools we have for our chronic pain, and it is worth trying if you have never tried it before. Sure, some people will have a bad side effect with it, and they should opt for other meds, but many people will find it works well.

It is approved for mild to moderate pain, I would compare it to taking one vicodin with 5 mg. of hydrocodone in it for me. Other people will have other efficacy.

Take care, Annette

Featuring Experts

Peter Abaci, MD , is certified in anesthesia and pain management by the American Board of Anesthesiology. Dr. Abaci received his undergraduate educat...More

Helpful Tips

a confused patient
my doctors office called me and told me they where releaseing me ,for not having my oxycodine 10 in my system ,which there is no possible ... More
Was this Helpful?
0 of 2 found this helpful

Report Problems With Your Medications to the FDA

FDAYou are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.