What kind of workup have you had for your injury?? MRI?? Nerve conduction studies?? Sounds like you have been tried on the proper medications for neuropathic pain/sciatica. Lots of times meds are done on a trial and error basis to see what works best for you.

Addiction is a psychological condition and must be differentiated from tolerance to narcotic medications. Most everyone will develop a tolerance to narcotics, meaning you need higher and higher doses to achieve the same effect.

Studies done so far-

The injury occurred on 9/12/08, and we did an MRI on my right calf in Oct 08 -at the time, the calf was the painful area, not my back. The calf MRI was normal, but an orthopedic specialist said it could have been a partial tear of the gastroc muscle that had already healed by the time they got around to doing an MRI.

About a month later (Nov. 08) my back began to hurt, and the original thought was that it was simply from my altered gait (limping and dragging my leg) from the calf injury.

Then in March 09, a lumbar MRI was done, showing "slight disc bulge at l5-s1" and degeneration in the facet joints at l4-l5-s1(?). The radiologist indicated that while this could cause some discomfort associated with aging (at the time I was 36) but should not cause my intense symptoms.

In April 09, I was examined by a spine specialist, who did only x-rays and said my discs at l4-l5 and l5-s1 looked "like flat tires". but that I was not a candidate for surgery. He asked if I was open to steroid shots, which I agreed I would be, but then they were never done, mainly because with WC, there's not a "regular" provider to provide ongoing treatment, and when we went back to court, the judge sent me somewhere else entirely.

So Nov. 2009 I have an EMG with a Doc hired by the ins co., she says it's 'normal' and shows nothing, but the official report received by my lawyer says that there is some nerve damage or issues on the left leg. (The right leg is the problem )

Nothing else getting done....until, Spring 2010, we go back to court, and I protest to my lawyer that there has to be SOMETHING that can be done, so my lawyer sends me to a physiatrist/pain management dr for evaluation. (In WC eval. means he can't treat me, just tell the court what I need, and then we hope the court makes the ins. co pay to get me that treatment somewhere else.) This physiatrist says I have a "severely bad disc", recommends ongoing chronic pain management and consideration of a SCS implant, a discograph, and possible spinal fusion surgery dependent on results of discograph.

So then the ins co sends me to another dr hired by them to say the opposite of what my lawyer's dr says...this guy, formerly with NASA, says I may have "post polio syndrome" ( I have NEVER had polio) or something else that would not be related to work injury. Thats what it all comes down to for them, not whether I'm hurt, but whether they can say it wasn't their problem. (which, I was FINE before 9/12/08, worked as a custodian 10 hrs/day 6 days a week, lifting tables over my head! and on my feet all day every day!)

So then, back to court we go! A few months ago we went back to court, and the judge ordered that my local PA, who wasn't the 'authorized treating provider' for WC, but who had been refilling my scripts for 2 yrs, is now 'authorized to continue pain management'. So now they'll actually pay him for what he's done for 2 years, but, as far as I know, no discograph or further investigative tests or whatever. I think we're at a stand still.

Which is again, why I'm here. If the PA is finally authorized to provide pain management, I'm pretty sure he'll do whatever I ask him to try, so I just wanted some ideas to throw at him for things that may help and eventually get me back to normal, or at least off meds?

Dearheart, you will NOT become addicted if you take your medications ONLY as prescribed!! You will become physically dependent, which is a WHOLE LOT different than addiction!!! With addiction, you crave the meds, you will do anything to get them, you think of nothing else. With physical dependence, your body is just used to having the meds and you go thru withdrawal when you stop taking them. That's all. That's why you have to WEAN off them when you stop taking them. There is NO craving, etc.

So you should have no problem taking Oxycodone, or any of the other long acting medications. Most of chronic pain patients take them and we can't ALL be addicts! LOL

I wish you the very best of luck. I hope you can get a handle on your pain. God bless. Hugs, Lee

Thanks Lee for explaining it that way- that puts my mind at ease a bit. Ya know, I know there are people out there who do abuse the system to get narcotics, but because of them, its so hard to even get painkillers when you need them sometimes, and the fact that I have to ration my own each month and suffer some days because I know I can't get a refill before a certain date just really makes me feel like an addict already. I know I need them for the pain, but they sure do make people feel guilty for taking the needed meds, let alone asking for something different or stronger. There have been times that I've hurt so bad I've gone ahead and taken more than I'm "supposed to" in order to last the whole month, and I think, 'Screw it, i'll deal with it then" but its always a trade off of hurt now or hurt later.

I appreciate the compassion I've found here- it means a lot if only to have folks to talk to about the whole bit.

I think we ALL have taken an extra pill at one time or another when we were in excruciating pain. We ARE, afterall, only human! And the medical community UNDER medicates us so terribly that they MAKE us feel guilty for trying to find some shred of comfort. Like I said, I've had this nasty pain for 26 years, and I do not remember what it feels like to NOT have pain. I think I would feel like I'd died and gone to heaven if I did NOT have any pain. LOL

Try to be open and honest with your doctor. You'll get further with him if you are. As for the burning type pain, the zapping/etc., I have better luck with Topamax. The Neurontin made me feel like a space cadet. With Topamax, I don't have ANY side effects - and I even lost weight on it. LOL You might ask your doc about it - it took ALL the burning, zapping, stinging away completely. I love that drug. No highs, no nausea, etc.

Good luck ~ keep us posted on how you're doing. Hugs, Lee

An older couple is lying in bed one morning, having just awakened from a good night's sleep.

The husband takes his dear wife's hand and she responds, "Don't touch me!"

"Why not?" he asks.

She answers back, "Because I'm dead."

The husband says, "What are you talking about? We're both lying here in bed together talking to one another."

She says, "No, I'm definitely dead."

He insists, "You're not dead. What in the world makes you think you're dead?"

"NOTHING HURTS!"


Doc "I Don't Write 'Em" Smith

Workers comp throws a whole new problem into the mix - that's for sure.

Nothing like delayed or denying care to make everything get worse

With my RSI wc claim - I finally sought some care on a cash pay basis (outside the wc system) with a very nice knowledgeable chiropractor that also used the PT therapeutic modalities that I needed.
I also found an advanced PT and paid cash for a comprehensive evaluation from him. He also gave me some very good advice & tips on things to help me long term.

But paying cash and not using private ins was the thing - so not to mess up or complicate the work comp claim with other bills or paperwork showing on your medical records.....but sometimes ya gotta just help yourself to feel better...
Just my thoughts on that.

Well, so now I've got new complaints about w/c to throw in the mix-
My PA who has been providing my care and advise and pain med refills for 2 + yrs has now been told by the docs at the clinic (which he relays to me) that he is supposed to be for 'back up care' in case the docs are unavailable and should not be providing primary care- therefore he can no longer treat me or refill my meds. Of course, this comes just after w/c judge finally orders HIM to provide pain management. (I posted all of this on the w/c forum thread...)
So, Idk if they'll pay for another dr at the same clinic to treat, and Idk if another dr will continue my medications. Just one big hassle after another, or just when I think one thing has been resolved, here comes another problem...ugh.

So anyway, now a couple of other questions...given that I may not be able to continue receiving the pain meds, I'm more desperate than ever to find alternatives...

Does anyone have experience with ultrasound therapy? For example, they sell these ultrasound therapy wands and machines, etc, with the transducer gel, online, and I wonder if they work for deep pain?

Does anyone know anything about making a homemade topical cream/ointment with crushed medication? I read on some other boards some recipes for cream with emu oil, capsaicin, etc, but those kinds of creams haven't worked for me before. And then I have seen others discuss maybe crushing the vicodin in a cream base of some sort to apply topically. Anyone know anything about this?

Finally, and if this is a 'taboo' subject, I apologize, but medical marijuana. Anyone know if it works for pain? I honestly haven't smoked pot since high school 20 yrs ago, but if I knew it would help...I've also heard that this can be made into a topical product, but I have no idea how or with what, etc. If anyone has any info or thoughts about this at all, PLEASE let me know- and if you'd rather not post in the forum for all to see, don't hesitate to PM me instead. Let me make clear, I am NOT a narc, or cop, or whatever, and I don't care who uses or doesn't, not interested in getting anyone in any trouble. I am just asking *hypothetically* for information.

And just in general, if anyone has any ideas of something I can try, suggest or mention to a new dr, or thoughts of how to approach the pain management strategies with a completely new doc, PLEASE LET ME KNOW!

I have a family and friends, all of whom I feel like I am burdening with my pain and limitations, so this is my outlet and resource. I am so thankful to have found this board, if only for the emotional support, so THANKS TO ALL

In Dr. Tennant's article, Hormone Treatments in Chronic and Intractable Pain
http://www.practicalpainmanagement.c...tractable-pain
I found mention that:

It says animals - not humans (because the human studies haven't been done yet) I'm not saying to jump in and take it; hormones are serious stuff not to be messed with w/o a knowledgable doctor's guidance. I'm just mentioning it as something to look into and, if it makes sense to you, discuss it with your docs.

Doc

I had a bout with sciatica a couple of years ago while I was in hospital. They started me on PT, which they said would continue 3x/wk for 3 months.

When I was released from hospital, the pain was worse that ever. It took over my life, ironically hurting the most when I lay down. I couldnt imagine putting up with this any longer, & really couldn't fit the time-consuming PT into my schedule if it was going to continue to prove useless.

I haven't seen acupuncture mentioned in the thread. I opted for acupuncture, which I used first for pain management when I had shingles.

This time I had three treatments a week for two weeks, then once a week for two weeks, then monthly for two months. The last 2 were my idea, combined with a general energizing treatment. By the fifth treatment, all pain was gone.

15 months later I felt some twinges in the affected butt-to-ankle area & I had a week of 3 sessions. It didn't come back.

Any question...ask away.