Wednesday, February 15, 2012

Wednesday, October 15, 2008 Always_in_pain asks

Q: about pain medication when is enough enough ?

I need some help please, I'm on oxycodone hcl 30mg i have a shit load of pain and it seems like its non-stop. when my pain med feels like its about over the pain rushes back like a broken dam. i have multilevel degenerative disease combines with a congenital stenosis to cause multilevel canal and neuroforamen narrowing as above.

Degenerative disease causes sever spinal stenosis at L4-L5. right lateral disc osteophyte complex causes sever narrowing of the right foraminal zone and extra foraminal zone.

Small focal right paracentral zone disc extrusion at L3-L4 extends inferiorly to the L4 pedicle level. It causes significant impingement upon the traversing nerve roots ,especially on the right side.

Small focal left paracentral zone disc protrusion at T12-L1 impinges the left sided nerve roots that are emananating from the conus.. well i hope some one knows a little about what that means and why the hell i have so much pain.

i know the doctors said i have some ruptured discs that are pushing on the spin and it hurts to got to the bathroom when i sit down, ( trying to keep the conversation clean ) lol .. please give me some feed back if you have any idea what it say's.. thank tou  Rob,

        ps .. and why all the sever pain.

 

forgot to add this is all the pain meds i m on right now , and in the process of seeing pain management i hope a good one.. the direction says take one tab every 4hrs for sever pain . my question is when do i not have sever pain .

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Answers (1)
10/15/08 11:05pm

I saw a 74 year old today with a very similar problem: severe spinal stenosis. Normally, the pain of spinal stenosis is from the nerves being pinched, causing pain to shoot down the leg. Other times, the pain is from the swollen joints that cause a deep ache that can refer to wide spread areas. The key to treating pain is identifying the cause. Nerve pain responds to different treatments than joint pain. Today's patient had pain coming from her joint. So, I gave her an anti-inflammatory and recommended an injection (actually nerve block called RFA). If she had nerve pain, my recommendation would have been for Zonegran (a type of seizure medication used to treat nerve pain). My point is that your MRI may look really ugly, but the pain needs to be categorized into managable, bite-sized chunks.

 

Severe pain usually needs to be attacked from different directions. One trick you need to know about is that most cases of spinal stenosis respond to using a walker (it feels better when you lean on the grocery cart, sound familiar?). And use a stool softner to allow for easier (less straining) bowel movements, too much straining increases spine pressure. Stool softner and a walker should help take that pain down a few notches. Medications (hammers) are just one type of tool. I prefer to build a house with more than just a hammer.

Dr. Christina Lasich, MD

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