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Pain medication tolerance ( it is not what you think, read on)
I learned something today from my PM doctor.
He said that as far as tolerance your body becomes tolerant to the meds after a couple months. Therefore the need for a raise in meds due to tolerance is simply bunk. Your body gets adjusted to the meds and the tolerance after two months and when the meds stop working as well as they used to it is because your body ( pain) has simply become worse.
Now I am like you and have always heard that after taking a medication for too long it becomes ineffective. But he says he has the research to back this up and is currently getting me copies to post here as I explained that no one would believe this because we have been told that tolerance is a huge issue when taking narcotics.
I had been explaining that I needed an adjustment because the dose I am on and have been on for years and years just isn't cutting it anymore. Well I had my annual MRI and he showed me on the scan results where indeed I am definitely worse off than when I had my last MRI last year. Anyone with degenerative disease knows it gets worse over time just as injuries to our back does.
So tolerance has to do with our bodies and injuries getting worse and the meds are effectively working just as they did we just got worse.
I will post the results and research when I get it. It does make sense to me and although it also makes sense that the meds lose its effectiveness after time. But My PM doctor is one of the best in the country, he actually got into pain management because he broke his neck and never got sufficient relief. He invented the blood transfusion machine years ago and is very up on anything to do with pain management. So I trust he knows what he is talking about. Something to think about in any case. We are not getting tolerant to our meds we are just getting worse. Not to scare anyone though:)
He said that as far as tolerance your body becomes tolerant to the meds after a couple months. Therefore the need for a raise in meds due to tolerance is simply bunk. Your body gets adjusted to the meds and the tolerance after two months and when the meds stop working as well as they used to it is because your body ( pain) has simply become worse.
Now I am like you and have always heard that after taking a medication for too long it becomes ineffective. But he says he has the research to back this up and is currently getting me copies to post here as I explained that no one would believe this because we have been told that tolerance is a huge issue when taking narcotics.
I had been explaining that I needed an adjustment because the dose I am on and have been on for years and years just isn't cutting it anymore. Well I had my annual MRI and he showed me on the scan results where indeed I am definitely worse off than when I had my last MRI last year. Anyone with degenerative disease knows it gets worse over time just as injuries to our back does.
So tolerance has to do with our bodies and injuries getting worse and the meds are effectively working just as they did we just got worse.
I will post the results and research when I get it. It does make sense to me and although it also makes sense that the meds lose its effectiveness after time. But My PM doctor is one of the best in the country, he actually got into pain management because he broke his neck and never got sufficient relief. He invented the blood transfusion machine years ago and is very up on anything to do with pain management. So I trust he knows what he is talking about. Something to think about in any case. We are not getting tolerant to our meds we are just getting worse. Not to scare anyone though:)
Hi. My 1st posting. I have Chronic Pain(CP) from multiple sites for multiple reasons.
As a former ER RN, I witnessed a lot of patients dealing w/CP. I was disgusted by some of my colleagues who assumed that 99% of ER patients w/CP, were drug seekers. We did have our share of "frequent fliers", who were actually addicted and were seekers and they were handled appropriately. But, their actions brought suspicion, to legitimate Cp'ers.
Advice- go to your PCP for a referral to a Pain Management group or individual. I'll get off of my soapbox now.
Question. Has anyone experienced increased "Rebound Pain" after increasing their pain med. due to tolerance?
In other words, does the pain increase due to more medication, in a snowball type reaction? I have heard of this and am reluctant to increase my pain med.dosage, only to create a higher degree of pain.
As a former ER RN, I witnessed a lot of patients dealing w/CP. I was disgusted by some of my colleagues who assumed that 99% of ER patients w/CP, were drug seekers. We did have our share of "frequent fliers", who were actually addicted and were seekers and they were handled appropriately. But, their actions brought suspicion, to legitimate Cp'ers.
Advice- go to your PCP for a referral to a Pain Management group or individual. I'll get off of my soapbox now.
Question. Has anyone experienced increased "Rebound Pain" after increasing their pain med. due to tolerance?
In other words, does the pain increase due to more medication, in a snowball type reaction? I have heard of this and am reluctant to increase my pain med.dosage, only to create a higher degree of pain.
Hi Kmart....This is a really old thread....why don't you start a new one with your information. You will get better results. Thanks,
Molly
Molly
I have been reading through a lot of older posts as I have found a lot of the discussions very informative & interesting. So I know this post is old but it piqued my interest & I was curious as to whether or not the research being discussed here was ever posted & if so could someone help me find it?
To add my two cents into the conversation...
I have been on a low dose of norco (5/325) & neurontin (100mg) for right at a year for SI nerve damage/low back pain/localized lipoma pain, a condition/conditions that has only been partially diagnosed (FRUSTRATING!) up to this point. I suffer on a daily basis with this mess always on a moderate to severe pain level.
Recently (and extremely warily I might add!) I asked my doctor to increase my doseage (1-2 tabs 4 times daily as needed of norco & 1 neurontin at bedtime nightly) to 2 more norco daily & 1 more neurontin daily.
He refused this stating that since I didn't have a definitive diagnosis for my back pain (MRI showed no abnormalities aside from lipoma in right side sacrum at L5 level) as well as my age being a factor (I'm 33) he felt that I was experiencing increased pain levels due to having developed a certain amount of tolerance to the meds.
What I also found interesting was that he said he didn't want me to be entirely pain free for fear of me overdoing it & engaging in activities that could further aggravate my condition. I don't know if it's just me but he sure seemed to contradict himself with these explanations. He was basically saying that I was too young to have anything seriously wrong (he doesn't really believe me is how I took that!) with me & that he wasn't yet able to find a diagnosis for the pain in my back (I took this as him saying it's all just in my head!) yet at the same time said that if I were to get complete pain relief (from a 'condition' that's 'all in my head' because I'm 'too young' to be experiencing pain!) I would be risking injuring myself further (yet he insinuates there is no injury to begin with?) & aggravating my condition (the 'condition' he hasn't yet diagnosed?).
I apologize everyone if it seems that I'm whining or overreacting to this; maybe I'm just reading into this too much? I just thought this an interesting experience of my treatment to add to this discussion.
I guess I could understand his reasoning if he had already increased my meds in the past & I was on a high daily intake of pain meds but I am on the same amount I was started on a year ago & yes it does help me to a certain extent but my daily life is still significantly impacted by my struggle with this pain. I feel like I should at the very least be able to hold my baby while standing up for longer than a few seconds & not have to have help putting him in his carseat, etc, etc. I'm not sure if my doc thinks that just because I don't have to go to a job everyday that I'm able to just lay on the heating pad on the couch all day & tend to myself but if he does he is so off base it isn't even funny.
I also have noticed (of course it may just be me being overly sensitive as I just had my 1st urinalysis) that lately my doc has been treating me differently. I feel as if he's distancing himself from me, a bit standoffish & as if he's not taking me seriously. I swear it seems he's asking me the same questions over & over & I'm recounting my different types/levels of pain over & over & he's acting as if he's never heard them before. I'm beginning to think that along with several other factors (including my age & the partial diagnosis)the fact that I asked for this increase has made him suspicious of me in some way. I just really hate thinking that my doc doesn't believe me & thinks I just see him for meds. I've done everything he's asked, from PT to injections and will continue to do so.
Anyhow I ended up getting way off in left field here, sorry about that everyone! I just wanted to mention the doc's concerns of 'masking' the pain too much & causing further injury. Anyone have any thoughts on this? And I'd love to read that article/research if anyone knows where it can be found.
Thanks to everyone so much for listening/letting me vent! It was much needed!
To add my two cents into the conversation...
I have been on a low dose of norco (5/325) & neurontin (100mg) for right at a year for SI nerve damage/low back pain/localized lipoma pain, a condition/conditions that has only been partially diagnosed (FRUSTRATING!) up to this point. I suffer on a daily basis with this mess always on a moderate to severe pain level.
Recently (and extremely warily I might add!) I asked my doctor to increase my doseage (1-2 tabs 4 times daily as needed of norco & 1 neurontin at bedtime nightly) to 2 more norco daily & 1 more neurontin daily.
He refused this stating that since I didn't have a definitive diagnosis for my back pain (MRI showed no abnormalities aside from lipoma in right side sacrum at L5 level) as well as my age being a factor (I'm 33) he felt that I was experiencing increased pain levels due to having developed a certain amount of tolerance to the meds.
What I also found interesting was that he said he didn't want me to be entirely pain free for fear of me overdoing it & engaging in activities that could further aggravate my condition. I don't know if it's just me but he sure seemed to contradict himself with these explanations. He was basically saying that I was too young to have anything seriously wrong (he doesn't really believe me is how I took that!) with me & that he wasn't yet able to find a diagnosis for the pain in my back (I took this as him saying it's all just in my head!) yet at the same time said that if I were to get complete pain relief (from a 'condition' that's 'all in my head' because I'm 'too young' to be experiencing pain!) I would be risking injuring myself further (yet he insinuates there is no injury to begin with?) & aggravating my condition (the 'condition' he hasn't yet diagnosed?).
I apologize everyone if it seems that I'm whining or overreacting to this; maybe I'm just reading into this too much? I just thought this an interesting experience of my treatment to add to this discussion.
I guess I could understand his reasoning if he had already increased my meds in the past & I was on a high daily intake of pain meds but I am on the same amount I was started on a year ago & yes it does help me to a certain extent but my daily life is still significantly impacted by my struggle with this pain. I feel like I should at the very least be able to hold my baby while standing up for longer than a few seconds & not have to have help putting him in his carseat, etc, etc. I'm not sure if my doc thinks that just because I don't have to go to a job everyday that I'm able to just lay on the heating pad on the couch all day & tend to myself but if he does he is so off base it isn't even funny.
I also have noticed (of course it may just be me being overly sensitive as I just had my 1st urinalysis) that lately my doc has been treating me differently. I feel as if he's distancing himself from me, a bit standoffish & as if he's not taking me seriously. I swear it seems he's asking me the same questions over & over & I'm recounting my different types/levels of pain over & over & he's acting as if he's never heard them before. I'm beginning to think that along with several other factors (including my age & the partial diagnosis)the fact that I asked for this increase has made him suspicious of me in some way. I just really hate thinking that my doc doesn't believe me & thinks I just see him for meds. I've done everything he's asked, from PT to injections and will continue to do so.
Anyhow I ended up getting way off in left field here, sorry about that everyone! I just wanted to mention the doc's concerns of 'masking' the pain too much & causing further injury. Anyone have any thoughts on this? And I'd love to read that article/research if anyone knows where it can be found.
Thanks to everyone so much for listening/letting me vent! It was much needed!
Hi Tigerlily yes it is very interesting and I just found this the a couple days ago as well.
I PM'd Sandee and she is still working on getting this research out there for us...so keep posted there will be something, although she did say she would be off site of awhile..
I PM'd Sandee and she is still working on getting this research out there for us...so keep posted there will be something, although she did say she would be off site of awhile..
Sorry I just noticed that this wasn't a new thing, where can I find the info?
Lily
Lily
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