Pain Management Community

hey there Jason in vancouver, you may want to post this in a "Discussion" rather than a "Tip" like you have. The links are pretty close together, but the Discussions link is just to the left of the Tips link. Then maybe someone will get back to you on your question.

Personally, I know that the healthcare system there is rough. I have heard that it takes too long to get in to see anyone and if you finally do and they don't help you, then your up the creek. If I were you, I would ask the specialists (who ask for an increase in your pain meds) to refer you to another doctor. Is it a general practitioner that prescribes the meds? If so, then it shouldn't take long for you to get into see another one. Don't live in chronic pain day in and out to wait for someone to say, "wait, jason really is suffering, maybe I will actually give him something to help him"...because that's never going to happen. Take charge my friend, and if one doc doesn't help, just move on. Make sure you leave on good terms though, because they have their way of sending your records to the new docs and could jeopardize your future relationships with those potential new docs. Also, be aware that before a doc is going to get your pain under control with the correct mixture of medications, you are going to have to earn his trust. There has been much research done on chances of legitimate chronic pain patients (who take opioids) becoming "addicted" to such medication. It's like less than 3% (for those who don't have a history of drug abuse/alcohol abuse), so sorry, your current doc is malinformed and should be shot for not taking care of a person who is in so much pain. I'm sorry you have to deal with this, and if it's any consolation, we do too in the states. Feel better soon, Jason, B

Hi Jason and welcome!

You've posted this as a tip and it may be missed because of that and/or you'll get less responses because of that.

So I encourage you to repost it as a discussion so others can better spot it.

P.S. You live in my neck o' the woods.

Oops, I see Bren has already helped you out. Thanks Bren!

Could the specialist prescribe the pain meds or refer you to a pain specialist with a referral for the pain meds, maybe this would help, it cuts your primary out of the prescribing phase and allows you to get the meds you need and other options as well to manage your pain better. If you go to another primary they will unlikely prescribe and label you as a drug seeker because on your first appointment you need pain meds, down here they told me they do not prescribe narcotic pain meds until after 6-12 months of established care, I got my meds from my neurologist and when I needed stronger meds he referred me to pain management and they prescribed the bigger doses. Hope this helps you

Hi jasoninvancouver,

BrenBren and Corlaw spoke true words of wisdom because they have been through it just like you are doing now. The only thing I might add is that the reason you are probably not getting good relief is that you are on a cocktail of 2 short-acting pain meds and a muscle relaxer. The problem with those is that you get the highs and lows of short-acting meds which requires you to take them multiple times per day.

For some people with back pain, they obtain very effective pain relief from using a long-acting narcotic such as MS Contin or Fentanyl Transdermal. The Fentanyl patch is only changed every 48-36H depending upon how your physician writes it and it provides very effective pain relief that eliminates those spikes and dips in pain relief. Then you can use the short-acting meds for the times when your pain is not being controlled by the long-acting narcotic since almost everyone experiences bad days where they need a little extra coverage.

It sounds like your present physician doesn't understand how to Rx narcotics effectively and unfortunately is misinformed about addiction, etc. You didn't say what the cause of your back pain is, but going to a specialist who can determine the cause of your pain is important for further treatment and then go from there. There are also many complimentary therapies that can be used and don't know if you have tried any of them such as PT, Iontophoresis, traction, accupuncture, massage, yoga, etc. Before beginning any exercise or therapy, you should always clear it with your physician first to avoid further injury.

First see if you can find another physician who is more understanding of how to treat pain in general and then go from there. Subspecialists such as rheumatologists and neurologists also good choices for pain management. Good luck in your journey and let us know how you are doing. Teresa