Pain Management Community

Hi Sharon,

I was on 8 tramadol a day for 5 years and at first they worked fantastic!!! I had no pain and was happy as a clam. But I promise you that you will build up a tolerance to the drug. A year ago I went back to the doctor because I was getting 30 mins of pain relief versus the initial 4 hours of pain relief when I first started the drug. I was switched to 2 vicodin (5/500) 2x per day and remained on two 50 mg tramadol tabs 2x per day. I got horrific withdrawal symptoms (shakes, cold sweats, chills, and the feeling of wanting to jump out of my skin). After 2 months of the new regimen I finally started to feel like myself again. The bad news is, the vicodin never got me back to "feeling fantastic!". Right now, I get 15 mins of pain relief from two 50 mg tabs, then I have to wait 3 hrs and 45 mins to take the vicodin while my pain crescendos up to "barely tolerable". Then I take two 5/500 vicodin tabs and I get 1 hour of pain relief. I have recently discovered that if I take the vicodin on a empty stomach, I get 2 hours of pain relief. Trust me...I would rather starve then be in pain! Then I have to wait 2 to 3 hours to take the tramadol. It is a vicious cycle. I get 4 hours of pain relief out of the 16-18 hours I am awake each day! I am also getting epidural injections in which the first one worked extremely well the 2nd one didn't work hardly at all and tomorrow I am going in for the 3rd and it better work or I quit! Tramadol is an synthetic opioid and it does cause physical dependancy (not addiction unless you abuse them). And, you will build up a tolerance. I currently take the 5/500 vicodin, tramadol, Neurontin, Flexeril, and Valium and I am still in debillating pain at least 1/2 of every day. I am not trying to ruin your moment of bliss. Trust me I know how wonderful it feels to not be in pain! Just beware that the effectiveness of tramadol will wear off and if you have been taking it for awhile and you miss a dose or replace it with a stronger pain med your body may revolt. The withdrawal symptoms do go away with time. I am glad it works for your pain and it will for 2 to 3 years before its effectiveness starts to die. Pain management of chronic pain is a constant lifelong battle. Best of Luck. ~Kelly

hi Kelly_30,
I was in the same boat as you for awhile.
My surgeon changed my dose of Tramadol completely. He put me on a 200mg tablet 1 time per day. This is an extended release pill instead and it works great for me. I have Norco for any break through pain that I don't have to take too often.
This switch was a life saver. I was always chasing the pain before.
You can talk to your dr about this option and see what he/she says. Maybe it could work for you too.

Good Luck,
AcheyBreakyBody,
Sheryl

Please don't ever just stop the tramadol without discussing it with your doctor. It should be tapered off slowly to avoid any withdrawal symptoms.

I also used it for many years as a BT med along with long acting opiates. When I stopped using it, I did not have withdrawal symptoms at all, and I never built up a tolerance to this drug. I just changed long acting opiates and did not need it any more.

Tolerance is very individual to patients, soe develop it to certain drugs and some do not. Another point made in some research is that it is difficult to know for certain with pain, whether it is tolerance to the medicine developing, or whether it is just the original pain process progressing or getting worse.

There are always possible side effects to any drugs, be glad that you are not getting any of them.

Either way, it sounds like it is working for you right now, enjoy it.

Take care, Annette

Hi Sheryl,

I just got back from the doctor's office and I did speak about the desire to have a longer acting opioid (extended release) so I wouldn't have so many gaps in the day when I have pain. I was told that Kaiser doesn't carry them because they are too expensive. She put me on 5/325 mg of percocet 4x a day. I just took my first dose and they are much more powerful than the vicodin and many times more stronger than the tramadol. I am completely done with tramadol now. I am going to go through another round of withdrawals but I am okay with that and I know what to expect. I am supposed to try the percocets for a month and let her know how I am doing. If it fails to relieve my pain, they said they could refer me to pain management. At the pain management center, they are more options for extended release pain medicine. I would like to not be chained to pills all day. I know it must be really nice to have an extended release form of tramadol that works for your pain. I would love to stop chasing pain too! PS: have to wait a week for my epidural. My blood pressure was too high today So they switched meds for that too. I'm on vacation next week and I hope the perocets keep me active and not bedridden in pain. I gotta take my little boy to the zoo!

Update: It has been over 24 hours that I haven't taken tramadol and guess what?1? No withdrawal symptoms!!! Woohoo! I am so pleased with this new pain regimen!

My Dr. PM office is getting more into morphine pumps and electrods/generators in taslled under the skin . I was a lineman and climbed cell towers for 25 years untile I couldnt do any longer I had tears when I signed up for disability and went from 125K a year to 20k and the three years it took to get it I had to use up my kids collage money.All my cervical disc are degenitive my shoulder has been operated on three times collar bone cut off 1in and several others that cause chronic pain also my l1 to l4 have no space between them and l5 has 1/32 . Its hard to say what hurts worst at time but they all stand out at diffrent times , Any way Ive been taking 3-10/325 lortabs , 3-4mg zanaflex , 2-60mg kadian and two .1 zanexs . It all most drove me crazy to have to give up my little company . Mt pm Dr. tried to force me to have the generator and electrods installed in my back and I wouldnt because all though Ive never taken anything that got ride of the pain i was treating it and able to be some what productive but when I declined the took the zanex and I all most lost it and my Family Dr. started writing the perscription move to last month the Medical group decided that they was"nt going to perscribe anymore break through meds so the wrote a script for ten and more or less said good luck . When I went back yesterday I told the Dr. that the Kadian helped from detoxing and the zanaflex still helped a whole lot for spasms but I just was'nt able to be productive in any way. He said we would try the tramadol and it in two days I"ve been taking it seem to help in my legs mostly and seems to be one of the better meds . I just stay in the house and do what my pain allows which is not anything . At least I could be some what productive I was just slow and careful . I have made a apointment with another pain management group 25 miles closer to home but am really tired of being treated like trash , My self I cryed when I signed up for disability I really though I could get my back fixed and keep on going but that was'nt to be I've paid around three hundred thousand dollars into SSI and still hate drawing . Any way when I go to this new Doctor how should I act or what should I say ? While being down just to be of help I had a friend stage 3 cancer in his lempnoids and a grapefruit size tumer but Im glad to say he is doing great but while he was in bad shape a couple times he was smoking pot and I smoked it to , I take regular pee test so it was very little but it helped are they looking for THC when they pee test ? should I even ask the new Doctor anything about it , I dont want kicked out and have been testing for 4 years all most now . I just want advise from a profesional or someone who knows . The tramadol is a good med as far as I can tell.

Forgive my spelling and grammar .

It sounds like your pcp is prescribing your pain meds for now, and that Kaiser does not let pcps prescribe long acting opiates, that they would prefer the pain management doctors do that? Is that accurate? Methadone is dirt cheap, far cheaper than a month's worth of Percocets. So that "too expensive" excuse sounds fishy to me. I would just prefer a doctor tell me the truth, not make up reasons why they won't prescribe something.

There are also generics of MS Contin, a long acting form of morphine. I took that for 12-14 years prior to going on methadone. Both worked fine for me.

I would ask for an appt. with pain management now, rather than later, just to have a consultation. Why not have the "experts" thoughts on the subject? They also suggest other treatment modalities for pain management.

Best of luck.

Take care, Annette

Just be honest with the new doctor. I have found that is the best thing overall. Be yourself. I would not smoke any more pot until you know where this doctor stands on it. Most doctors do screen the urine for pot along with other drugs. If you test positive, they may decide not to care for you. They do not want to deal with folks on illegal drugs if they will give you opiates.

After I had established myself with my doctors when I first moved, I asked them about smoking pot for pain, they both said "anything that works, in moderation" was okay with them. We have a statute for medical marijuana in our state. I tried it and it did not help me at all, so I stopped all together. That was nearly 15 years ago.

I have been told that xanax or any benzo should not be prescribed while one is also on opiates. The mix of the two can be very dangerous, so doctors are getting away from that nowadays.

It sounds though like your doctors are pushing surgical interventions over meds. I personally believe that is due to the financial reimbursements from insurance companies to the doctors, but I have been known to be a bit cynical, lol.

I am glad your friend is doing okay.

Take care, Annette

Do the best you can and don't worry about it.

Take care, Annette

Hi Annette,

I agree with everything you just said. It is very fishy. I was thinking to myself that generics of the longer acting opiates should be available by now. My long time pcp said there was no pain mangement group within Kaiser. But I went in and saw a different pcp and she said we may have to refer me to the pain management group. I am going back in on Monday. Thanks for posting this, it helps me think of a better way to go about the appointment. The pcp I saw Friday (not my long time pcp), gave me 5/325 percocets for a month (I don't think my long time pcp would have done this). I was told to take one every 6 hours. The first 1 or 2 doses worked better than the tramadol/5-500 vicodin regimen I have been on for a year but yesterday things started to go downhill. There was a tiny window of pain relief (1 hour) and the pain came back faster than ever. I felt like I was in the eye of the storm. I felt so bad before bed last night, that I went to Walgreens and picked up some thermacare heat wraps for the low back pain and a heating pad to sit under during the day. I got very little sleep even with the thermacare wrap on. I tossed and turned like crazy. And I woke up this morning and felt awful. I still have a months supply of vicodin so I started researching on the web about drug iteractions between vicodin and percocets and their weren't any. I ended up calling the Walgreen pharmacist this morning and told her that my pain is worse since being pulled off 2 5/500mg vicodin 2x a day alternated with 2 50 mg tramadol 2x a day and switched to just 1 5/325 mg percocet 4x a day. She confirmed that the percocet is a stronger med than vicodin. I told her I was miserable and asked if it would be okay if I cut one of my 5/500 vicodin tabs in half to take 2 hours after taking the percocet. She said that it was fine if I did that. So this morning I took 1 percocet at 7:15 am. After getting off the phone with her at 10:15am I took a 1/2 of 5/500 vicodin and my pain was gone! I was able to get dressed and go shopping today and I didn't take another percocet until 1:30pm. It is 3:30pm now and I am still sitting comforably on the couch so I plan on relaying this to my long time pcp at my appointment on Monday. I am a little freaked out about telling him. He may think I am "addicted" cause I took 1/2 5/500 vicodin for breakthrough pain. Any ideas on how I should approach him with this? I have been on pain meds for 6 years now and this is the first time I have took matters into my own hands because the docs keep giving crap that doesn't work or makes my pain worse! So frustrated.

Hi Mtman1ontop,

I am so sorry to hear the terrible news about you being unable to continue your business because of the pain that you are in. I am just 30 years old and some weeks at work just kill me, I wonder how I will ever make it to retirement some days. I would not ask for stronger meds when you go to the doctor. I would simply say, that x doesn't work well for my pain. Be very specific, "I took x at x time yesterday and my pain returned within an hour and on a scale of 1 to 10 it was an 8". Drs are trained to be suspicious if someone request a particular narcotic even if it is requested with no ill will. Many people research drugs on the internet and simply heard good reviews and want to see if it will work but when you are specific about a drug, most physicians go by the book and categorize you as a drug seeker. When I went in for my appointment on Friday, I said "I wish I could get away from having to take so many pills per day, It would be nice if I could take 1 pill in the morning and have something else should breakthrough pain occur." That prompted my pcp to search for longer acting opiods and she even investigated the fentayl patch. Unless they have a really low dose of that patch, I don't think I am opioid tolerant enough for that patch. All the longer acting opioids were too expensive for kaiser to cover which I agree with Annette that it is probably a lie. If a generic exist like Annette said then there is an affordable generic out there. I am certain Monday's appointment will not go well and I will have to be refered to pain management and hope for the best there. I am being switched to Anthem the first of next year. Are any of you Anthem members?, would you know if Anthem healthcare is better for pain management?

Hang in there Mtman1ontop, let us know how your doctor's appointment goes. Best of Luck!

Sorry, if your prescribing doctor told you to take percocets now, I don't think it is okay to take those along with half a vicodin a bit later in the day. It is not a matter of what is okay with the pharmacist, they only tell you that it won't kill you. It is the prescribing doctor that should be in the know about your drugs.

I would not take any more vicodin, and if the percocets do not work, call the prescribing doctor and tell him. Let him know that you have some vicodin left over and ask him if it is okay to combine them in some way with the percocets.

Most chronic pain waxes and wanes, comes and goes, stronger and weaker at times. I don't know if you will necessarily need both meds all the time, I would take just the percocet and see what happens, and let the doctor know, in person, how you are doing.

I don't think that taking a half of the vicodin was enough to make any difference in your pain, that is not even a theraputic dose for an adult. Both percocet and vicodin only last 4-6 hours, and the fact that you remain comfortable over six hours after your last dose of anything means that at this point in time, you are having less pain than usual, and neither drug is working for you anymore!!!

I suspect the pain may have gone way anyhow, or the shopping trip was enough of a distraction to help you. Be glad!!

Take care, Annette

Regarding Kaiser:

Kaiser may contract with an outside group for pain management if they don't have the MDs or enough patients right now where you are to provide that service themselves.

My mom had Kaiser, and my best friend and her family have always had Kaiser and I think they generally do a really good job. My mom died of lung cancer and they did everything, I could have thought of on her behalf. They contracted out for theraputic radiation services for her with a group outside of Kaiser. Mom was very happy with them also. The thing that I really like about Kaiser in general is that they use evidence based medicine to show that what they use actually works.

It may be that their pcp that said they didn't carry the long acting pain meds just did not say it correctly or misunderstood the policy. if you are referred to a pain management doctor, check first and make certain he does not do only interventional type pain management, but rather handles all kinds of techniques.

I have never had Kaiser or Anthem.

Take care, Annette