Why won't doctors prescribe pain meds?? I have had daily migraine headaches since last July.. I have seen 3 ENT's and 3 Nuerologists. Two of the neurologists put me on topamax. This did absolutely no good and just made me stupid. This last one has put me on a beta-blocker. It's too early to tell I guess if it's going to work but I'm still having headaches everyday. But why is it that they all say to me..."we just want the medication to work"??? Well so do I , but I can't function with these daily headaches and they are unwilling to give me a pain med. I'm really having a hard time understanding how a dr. can look at you (hurting to the point of tears) and say, "I'm so sorry you are hurting. Good-bye now." OTC has zero effect...up to 6 Advil and nothing! Why is this okay with them and not one pain med pill?? I'm ready to order something off the internet just for some relief!
I've been in that position, and it's horrid to say the least.
Is there a specific pain medication you have in mind? If you're thinking of medications containing opioids / narcotics, I just wrote an article to answer that question. Please take a look at Opioids for Migraines - Why Not?
Hang in there,
Thanks for your response Teri. Nothing in your article surprises me but I'm not accepting it! I am almost 50 years old and have been on this planet sometimes longer than any of the drs. I have seen! For them to refuse pain managment meds to me just because they're scared is NOT my problem. Like this dr. says...they need to do a better job of screening their patients. Why should I suffer because they can't figure out what is causing or how to fix my headaches? It has gotten to the point that I sit everyday in tears because of the pain and frustration of it all. I'm going on 8 months of this now and I can't tell you how fast the depression is coming on. They are going to force me into drastic measures of ordering some kind of overpriced crap off the internet just to get relief. Please explain to me how their position is justified because I sure as heck don't see it!
You're quite welcome.
Honestly, I'm not sure what to say to you at this point. Doctors being scared isn't the main point. The main point is that opioids often do more harm than good.
I've been very close to where you are. Ten years ago, I was in bed in pain at least five days a week. The turning point was getting to a true Migraine specialist. I had to drive eight hours each direction to do it -- well, my husband had to drive -- but within a few months, I was seeing improvement. Now, I often go two or even three months between Migraines.
You said, "Please explain to me how their position is justified becaus I sure as heck don't see it." OK. I'll do my best, and maybe you'll read the article again too...
• Studies have shown that ANY use of opioids or barbiturates increases the risk of transformed Migraine. That's daily headache with severe Migraines on top of it some days.
• Opioids do cause medication overuse headache. Again, daily headache, actually caused by taking opioids.
• Opioids can change the brain's response to pain, resulting in increased pain and decreased responnse to medications.
• Given the evidence that Migraine is a progressive brain disease, it's important to abort Migraines as quickly as possible. Opioids can't do that. All they can do is mask the pain for a few hours.
Those are the reasons most doctors won't prescribe opioids or prescribe them only in very limited quantities.
I don't know anything about your doctor, but if your doctor isn't able to help, it may well be time to consult a Migraine and headache specialist. It's important to note that neurologists aren't necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.
Karen, I really feel for you. It's not fair forr you to be in pain all the time, and it really stinks that the medications that could give you a bit of relief can also make things worse.
The best thing I know to recommend to you is that if you're not making progress with your current doctor, it's time for a new one.
I'm here if I can do anything for you, Karen, or if you need to talk.
I do get it that they *could* cause more harm than good.....for a normal person. I am one of those that is hard to medicate and even in the past for a normal headache had to take 3 or 4 Advil to get rid of it because 1 or 2 just wouldn't do any good. I just have a very high tolerance to pain meds and trying to get anyone to believe this has always been a hassle until I've been a patient for a while and they see if for themselves.
Thank goodness these headaches haven't put me to bed yet...although I guess if I would let myself, they probably should! I don't have the luxury of going to bed for them...I have a business to run.
I *have* been to a migraine specialist...Dr. Brandes here in Nashville is supposed to be the best in the state. All she wanted to do was put me on a bunch of psych meds that made me stupid and had absolutely no effect on the headaches. She also was unwilling to help with the pain. I felt like I was dealing with the psych ward at One Flew Over the Cookoo's Nest! I never went back. This latest neurologist *is* the new dr. I've only been to him this one time. He has me on Atenolol and wants to wait 3 months to see how it works, but again is unwilling to help with the headaches as far as relief is concerned.
I would like for these medications to work as well, but I can't be their guinea pigs for trying to figure out what is wrong and they not help me lead a somewhat normal life. If I'm not having a headache, I don't take a pill. So if their meds are working, there's no need for the pain meds. It's all pretty simple in my mind!
Thanks for listening...............I'll just have to do what helps ME and to heck with these people that call themselves doctors.
Hi, I have the same problem with my so called doctors and specialists who think they know how to deal with "my pain". they forget we have to work and pay rent, buy food, etc. the pain pills let us function. they are not for recreational use. I am so sick of these godly doctors trying to tell me whats best for me. I will get my relief elsewhere I guess and yes pay a mint for it so i can be pain free since they don't want to take their oath and help me. thanks for nothing. glad your able to function and be painfree doc!
I'm 50 also so I think I am where you are. Have you ever taken note if your headaches are weather related? When the barametric pressure changes I get headaches. It changes often in the south. I live in Florida so I know. I went years without doctors asking me that question, it was an eye opener when I took note. Just something for you to check out then maybe a doctor would be able to do more for you.
Hope this helps,
Hi flchristie! Oh absolutely barometric pressure is a "trigger"! I have spelled that out to every single doctor I have seen. I'm in a little different place these days than I was when I first started this message. I finally broke down and went to a pain clinic (the one I had tried earlier had finally gotten a neurologist on staff and was now treating headaches/migraines). He put me on Amitryptiline and Verapamil as well as gave me Fiorcet for pain. All this was only helping a little, but at least he was willing to help! Well, after a couple of months he left to open his own practice and I tracked him down! He has kept me on the same regimen upping the dosages to not much avail. At his suggestion I also went to see a chiropractor in his office (what was I going to say....no?) that didn't do any good either. I go to see him Tues. for my 30-day follow-up so we'll see what's next. Last visit he changed my pain meds to Percocet and even taking TWO of them doesn't take away the pain! That's just how high my tolerance is.
So, the update is that I AM seeing a pain management/neurologist who has made me sign a pain contract (outside of the pain clinic...never had to do that before!) which gives him the right to drug test me...whatever! He is trying to help with the headaches and does give me the pain meds. But, 2 1/2 years after they started, I am STILL having a headache every single day all day long on some level. Some days are worse than others but NEVER pain-free. They now want me to do a nerve-block which I am refusing. If they don't know which nerve, or if any, are causing the pain, how are they going to block the right one?? Right now with pain meds, I can do my yard work and go to the gym and lead a somewhat normal life. I can't be guaranteed that the block will work and what else is it going to block? Not to mention painful and expensive!
Karen, I feel so close to you because I have been fighting the same battle for decades. My migraines went ballistic after I underwent surgical menopause because of cancer at age 27. I guess the hormone changes pushed my headaches over the edge.
This was over 30 years ago. In the 80's and early 90's, my PCP prescribed about 60 Fiorinol w/codeine/month, and I was able to live a relatively normal life, raise my adopted child, volunteer, etc. I never abused the meds or built up a tolerance.
In the early 90's I decided to see a neurologist, hoping he would know how to provide even more relief. Big mistake. He immediately took me off of the codeine (no problem, since I wasn't addicted), and prescribed plain Fioricet. He put me on a beta-blocker which did help somewhat, but made me tired all the time. I managed okay for a year or so, but then realized I was taking more and more Fioricet, because it wasn't strong enough for my major migraines.
I never abused it, but evolved into chronic daily headache, because I had nothing strong enough to relieve the pain of a serious migraine, which would often drag on for 5 days.
I cannot take triptans because of cardiac risk, especially at my age now (64), and a diagnosis of coronary heart disease. I dislike what I've heard of Topomax. At my age I do not need to be dumbed down.
I would do well with 15 - 20 hydrocodone pills/month and the Fioricet for milder headaches. But, like others here, I can find no one to prescribe any. My son is getting married soon, and my PCP gave me ten 5mg Lortab to keep on hand for the wedding. That's it..no refills..don't ask again.
When I go into the doctor's offices, I feel as though I should apologize for being a pain victim. This is outrageous. I know what works for my body. I have lost so much of my life to this pain. Thankfully, I haven't had to work, as I would have had to go on disability.
I am angry that because some people abuse pain meds, we must all suffer for it. I am constantly seeing articles about migraine and addiction. The people in the articles took ridiculous amounts of pills.
Alcohol is extremely addicting; yet one can buy as much as they please in any supermarket.
Sorry for the rant. But, like you Karen, I am so tired of being in pain. I am currently trying Botox, but haven't had much response.
Karen, I hope you see this. I would love to hear from you. We seem to be on the same journey. Good luck to you and the others.
PS I have traveled a good deal, and in many countries such as France, England, Holland, Canada and others, aspirin or tylenol with codeine is sold over the counter in small amounts. Don't get why we are permitted nothing here.
Hi Theresa! I did get this message! It does help to know there are other people out there in the same boat doesn't it?
I would suggest to you that you find a pain clinic in your area. I decided to take this route when my PCP made the comment to me that he wasn't a pain clinic. I had to bite my tongue to keep from telling him the he was MY pain clinic! He would never give me more than the 5mg either. That's like baby aspirin to me! Going to a pain clinic is not a fun experience but they do treat pain. There are a lot of "dregs of society" as I called them in there, but as long as they were going to help me with my pain, I would suffer through it once a month. I believe they have to have a neurologist on staff to treat migraines. So before you go make sure if you find one and call them that you specifically ask about migraines. They certainly won't tell you otherwise until AFTER you have paid an office visit!
I was lucky in that my neurologist ended up leaving the pain clinic and started his own practice. He is specifically trained for pain management. He has upped my dosage of Lortab now to 4 of the 10mg/day. I still have a headache but it's not as bad. He wants me to do the Botox but I did some research and it showed that it was 31 shots! Oh heck no! I'm not about to do that and not know for certain that it would work. Are you taking that many shots?? Yikes! He also wants me to do a nerve block but I have nixed that too. That would also be a shot in the dark and I'm not willing to let him block what may not need blocking and me not be able to still go to the gym, work in the yard, etc. I did break down and go to a chiropractor that is in his office. Of course, he was going to cure me like no one had! He swore that in 2 weeks I would be "cured". Probably don't need to tell you the outcome! At the end of 3 weeks there was no change and he said I really didn't need to continue...to which I agreed. Then he started on me about the nerve block. I looked at him and asked how could he sit there and tell me it was going to work when 3 weeks prior he told me he was going to cure me but hadn't even had an effect. He didn't have much to say after that!
And yes, the folks that are abusing the system are what's making this so hard for us. My neurologist was telling me about a patient he recently had to cut off. She had been a referral to him and she came to him with having been given 500 - yes, that's FIVE HUNDRED pills a month! I about croaked and said..."DANG..maybe I should go see HIM!!"
I have resigned myself to believe that I will end up having these, like you, for decades. I never feel great nor am I in a good mood...EVER. I just cope and maintain and try to get through the day. I guess for now this is the way it is and the way it's going to be... I just pray that maybe some day I will wake up and they are gone. Gone for no reason just like they came. That would be so wonderful! I have a massage every week. It hasn't really helped but it sure does feel gooe and it's the only time all week that I am absolutely still and relaxed (outside of sleeping). I'm doing all that I'm supposed to...eating right, exercising, getting enough sleep and still the only thing that works are pain meds. That's just the way it is!
I hope you have a pain-free day at your son's wedding! How very special that will be for you!
Karen, thank you so much for writing! Yes, it is wonderful to find someone out there who is on the same page..so to speak, as I am. During the last decade or more, all of the books I have bought on migraine, as well as the headache forums I've visited, support the same point of view...pain meds are a last resort. In fact, they aren't even alluded to in some of my migraine books. Amazing!
I do not subscribe to the idea of taking an assortment of pills on a daily basis in the hopes of preventing the headaches. Many of these drugs have serious side effects, and others simply make you feel bad. I have tried a few...Elavil for example made me into a zombie for the entire day.
As I mentioned, I am on a beta blocker, and have endured the fatigue it induces, because it did help the headaches to some extent. But, from researching it recently, I learned that beta blockers can weaken your heart and even lead to CHF. I assume that is a remote possibility, but my point is that these preventatives are powerful drugs and usually given in a daily "cocktail" of sorts, which I find hard to believe does not have adverse effects on one's body over time.
My hair stylist takes 5 preventative drugs daily...including a beta blocker, a muscle relaxer, a tranquilizer and a couple of other ones. Yet, she has absolutely nothing for pain. Her only rescue med is a triptan.
As I mentioned above, I maintained a good quality of life for the most part, when I was permitted 60 Fiorinol W/codeine/monthly. On the days I didn't have a headache, I took NOTHING.
I'm sure the current protocol works well for some people, but I don't want to go there. I don't want to pump myself full of assorted daily meds.
Pain meds, if used responsibly are safe for most people. They have been around forever, and so their side effects are well-known. I always feel like I'm banging my already pounding head against a wall trying to explain this to a doctor! : ) Hey, it's my body!
I love your approach to nixing the stuff you don't want them doing to you...like the nerve block. I feel as you do. If I'm not comfortable with it, I don't want it!
The Botox injections aren't too bad, because the needle is very tiny and doesn't penetrate deeply. Any migraine sufferer would be able to take the pain. I have had mixed results with the shots. My previous neurologist, now retired, seemed to hit the right spots, and I often could count on about a 30 percent reduction in pain intensity for a couple of months. My current neuro has given me the injections three times. Once with an excellent response, and twice without much improvement at all.
I tried acupuncture a few years ago, and it did help. It was very time consuming for me as I had to commute to another city a few times/week, and it wasn't covered by my insurance either. I would say that it was at least as helpful as the Botox.
I am so happy for you that you have some pain meds! That is wonderful! What a relief for you! Over the years, I've had a few root canals (piece of cake compared to migraine,) and was prescribed a few Lortab or Vicodin. I held onto them and saved them for my bad headaches, and it was such a blessing to know I had something to ease the misery.
It is so cruel to have to live this way. I have missed out on so much of life. I actually spent two days of a vacation in Rome in the hotel room trying to treat a severe migraine with plain Fioricet. I have never smoked, done drugs, etc., and I don't even drink alcohol...because of the migraines. I just want some relief from what has become daily pain.
Low pressure is my biggest trigger, and I live in the hot, humid south. This winter was so mild and the weather changed constantly. It was a migraine nightmare.
Karen, thank you for just being there...for understanding. Thank you for not thinking pain meds are a "no-no" for migraines. Thank you for caring enough to write.
I will consider your suggestion about a pain clinic. I notice that most of them in my area advertise migraine treatment which sounds alot like what the neuros do. Assorted drugs and nerve blocks, etc.
Someone told me about an integrative medicine doctor who does prescribe for pain. She is in family practice and has a holistic approach. I may check her out and just be up front with her that I need a life.
I hope to hear from you again when you have time. I would have answered sooner, BUT.....had a major migraine last week with all of the thunderstorms and rain.
I hope your pain regimen works wonders for you, and at least permits you to have some quality of life. That's what matters.
Best of luck to you, Karen!
I've had migraines AND chronic headaches for 30 yrs. I recall the very first one. I thought dying would feel better.
I'm almost 50 now and tried everything the dr's give me. The only thing that helps is Fioricet w/o codeine (never tried the codeine). I never smoked or drink alcohol. I'm not on any other meds. I don't understand the big deal.
I can't work or function at all when I get these terrible migraines. I vomit uncontrollably from the pain, the pain is unbearable. I have to take personal vacation off from work to recover some 3 or 4 days at a time. I have these several times a month.
I know my triggers; weather, perfume, chemicals, smoke, alcohol, excessive noise and or stress. I'm ready to commit suicide. I can't take this anymore. Life is not worth living in a dark room for days unable to be with my family. They live their lives and I live in bed with a cold/hot compress on my head and a trashcan for vomiting.
I've always been a strong person in my younger days, I've had 2 chldren, never took any meds during my pregnancies. I've had several surgeries that the DOCTORS screwed up on me causing me to have to have a colon resection.
Fioricet is cheap and I pay a hefty price for insurance. My health is suffering. I have to plan my life around my headaches and fly for work. I always end up with a migraine when I get to my destination.
Please if anyone can help let me know where I can go to find help. I just bowed out of a once in a lifetime vacation b/c I know I'd end up sick in bed the whole time from migraine.
Tired of living in pain.
I have so much enjoyed reading your post's!
I may have MS and was wondering what would be the best pain medication for me. My pain is very bad and dont know where to go from here.
I'm already on Gabapentin but nothing else.
Evie. English Lady Living in Denver
Helo and welcome!
Sorry you're going through so much. I hope your doctor is working with you to get you diagnosed soon.
MS is something I don't know much about. You might want to visit out HealthCental MS site at http://www.healthcentral.com/multiple-sclerosis/.
Before I tell you what I think you need to know I need to give you some backup information...sorry but you will see how this is relevent. My first eperience having a migraine headache was at the time the worst pain I had ever had and that includes giving birth naturally twice! At the time I had no idea I was experiencing a migraine. Just a few months prior to the headache I was involved in a horrible car accident. I seriously injured by lower back and needed surgery a total of three times for two different problems, and had suffered renal failure more than once. Before all of this I had taken narcotic pain meds only once in my life, ten years before. Because of all of the different types of pain and and all of the different types of medications I learned a whole lot really fast! I never once had a problem aquiring pain medication but I became sort of fascinated with the whole subject.
Back to the migraine.... like I said ... it was horrible. I was used to taking heavy duty "narcotic" pain meds for the other problems after the accident. When I woke up that day I couldn't move from my bed, and had to call for my poor 6 year old to bring me a barf-bowl because I was literally too ill to move. My head hurt a lot but I had a whole host of other symptoms. I thought I had the flu!
After being unable to help myself by the next day I called my dr. and she had me come in right away.
This is what you need to know... She asked me a whole bunch of questions and did an exam. She then told me she thought I had a migraine and I was seriously confused. I had taken morphine myself that morning and it didnt touch the pain. I know now that there are way better things for treating migranes. I thought she was wrong but took the meds and within 15 min the puking stopped and the headache had lifted!! There all all different types of migraines too and there are different meds for that.
My big tip though... what I have found out over the last two years of at least 6 fifferent narcotics and patches etc, and a few tips from my friend who is a physician is that the doctors ask you all different trick questions to see if your story ads up! I have heard of some CRAZY things doctors will do. They know if you want narcotic pain relief or just pain relief and there are so many tricks. They don't just ask you trick questions but they do trick exams to check how you "react" I have been told that in one visit, it is not at all uncommon for a dr to use 3 totally different techniques and asking you try something other than narcotic is either because that something actually fits the symptoms or because they don't believe you and are stalling to see what you will say next time.
I was so shocked when I found all that out. I have heard some really interesting storries from the doctors side of the couch. I hope that helps.
My latest specialist questioned my sleep and tooth grinding at night. My dentist had suggested I might have TMJ. I have actually chipped my front tooth a couple of times, supposedly due to grinding. So I have been put on Zanaflex, which is a muscle relaxant. I take a larger dose at night and instead of tossing and turning I am pretty much like a stone. I can take 1/4 tablets during the day if I feel the HA tension. Maybe that is something to ask your dr. about? You can look up Zanaflex and chronic daily headache to see studies that have been done. It is slightly addicting according to my pharmacist. My side effects have been extreme dry mouth and some leg/foot cramps.
Pain medications are highly addictive. Doctors don't want you to deal with addiction on top of the migraine issues you already face on a daily basis.
Why hasn't anyone prescribed you migraine abortives like Imitrex, Relpax, Maxalt...?
Concern about addiction has nothing to do with it. Please read the article I recommended to Karen.
UGH I have the same freaking issue! No one will help me. I take tons of OTC drugs & most of the time they don't work! Good luck.
So true, Concern for addiction has Nothing to do with it. Most of the doctors here in my town are afraid of the DEA, and because of that the people with Choric pain have suffered. The doctors in my town just stop giving out pain meds and the only people that are affected the most is the ones who really need it. I'm am 57 years old and have RA, Disk Disease Fibromyalgia, stenos ices of the 5c an 6c in neck, numbness’ in right hand that is nerves dyeing and is so painful I feel like little rats are biting at my hands and fingers All The Time it is horrible...at any rate, I have been in pain for several, years and I cannot get a doc to help relieve my suffering. OTC drugs are all I take and I take MANEY, because of the many Tylenol I have taken I now have high liver enzymes…It is never ends. I have never been addicted to anything, and yet I cannot get pain meds. It’s sickening... I wonder if the doctor would let his mother suffer the way I do. He should be ashamed of himself...He took an oath to help.. I am going to end up killing myself just because I can’t' stand it anymore!
I am currently addicted to several drugs. . . Insulin, Metformin, and several others. I literally cannot live with out. If I start to run low of ANY of my meds I get nervous and jittery because I will die without them. If a person has chronic pain they NEED chronic relief! How hard is that to inderstand? Let me tell you that addiction is a state of existance for EVERYONE with chronic medical problems yet pain is the only condition we balk about treating, why is that? I am so tired of hearing the "addiction" excuse for not treating people in pain. No wonder there is such a HUGE market for illegal drugs in this country. People will get relief one way or another, wouldn't it be better if it was from their doctor? Stop fear mongering about addiction, let me tell you this. . . it's better than pain.
I think they have concern about medication rebound, which can happen with so many pain meds if taken more than a couple of times a week. The preventatives do seem to take a couple of months to even begin to tell if they will work. Nevertheless, I have no problem keeping on seeking out new docs until I find one that can address ALL of my needs. I would try a headache specialist if you can. They know more about HA than even neurologists oftentimes. Many of the clinics will take you in and do an IV to get it to stop. I don't know how insurance reimburses for this though. Best of luck!
I am so sorry for you. I have a similar problem. I have had constant headache pain for 43 years. Sometimes I can cope but most of the time I need relief to be able to get out of bed. I have no quality of life, I miss so much. . . I am sure you know what I mean. I have been driven to the point of depression by apathetic doctors and I have considered suicide many times because there seems to be no hope for me. I don't know what to do. Is there long term help for people with chronic pain? I haven't been able to find it yet. We need to get the government out of our doctors offices where they do not belong. And doctors need to start caring about their patients again. . .