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Percocet tapering

Hi  I have this constant back pain that the pain dr can't figure out. I have tried everything nerve blocks, cortisone shots, creams, tens machine, physical therapy you name it I've tried it. The only thing that seems to work is Percocet. A few months ago the dr said she seems to think the pain is  in so many words "in my head" she seems to think the Percocet is causing me to think I am in pain. She started tapering me down from 3 325mg/5mg a day to 1 a day. I tried the best I could to not take it when I was in pain to try to taper town but I work full time Have a 4yo and a home I have to take care of I can't lie in bed or under my desk at work (which I have been known to do) praying for the pain to go away I have a life. The last prescription was for 30 and I went through that in two weeks. I made an emergency appointment to see her to see if she would write me for more and she said no. Maybe we took too long to taper down and we are just going to do it cold turkey. I explained to her that I can't do anything when I'm in pain and she said since she can't figure out or can't find a definative cause for the pain she thinks it's the meds causing my pain. She said I'm too young to be taking this everyday (39) and she doesn't want me to get addicted. She wrote me a prescription for gabapentin 100 mg 3x a day and a muscle relaxer. Reading through these threads I am terrified of the pain I will be in but more terrified of withdrawls that might happen please advise on what to do to help if I go through withdrawls and what to expect. Thanks.
4 Responses
7721494 tn?1431627964
Hello Boston, and welcome to the pain forum.

Your experience is typical for the many millions in America who live with daily debilitating pain, and you have become another victim of the latest phase of "the war on drugs."

I too live with chronic pain and today is a difficult day, so I won't bother with the political diatribe -- let's find you some help.

There are many kinds of physicians that call themselves pain doctors. You've found one of the wrong types that does not agree with treating long-term pain with opioid-based pain medications like Percocet. It is time to either change the dynamic of the relationship, or find a new pain doctor.

You only experience withdrawal symptoms if your nervous system has changed to become dependent on the Percocet. This change, called dependence, takes time to develop.

I used medications like Percocet for years without developing dependence. During this time in my life, there were many months when I would use up my pills in three weeks or less, and then have to get through the rest of the month using OTC meds or alcohol to quiet my pain. I didn't experience withdrawal symptoms -- just more pain. I imagine you'll have a similar experience.

Of course, increased pain is no party, either.

If you plan to return to this doctor, it is time to discover if your doctor has a plan to treat your back pain, or is playing the clinical game called: ignore the problem and maybe it will go away.

Her theory that the meds are causing your pain is based in a concept called opioid-induced hyperalgesia. This is a real phenomenon. The use of opioid-based pain medication does reduce your pain threshold.

However, the studies that support this finding are weak when it comes to examining what's going on with real human beings with long-term pain.

More likely, you have moderate to severe pain, and it responds to Percocet because opioids provide the best analgesia.

Gabapentin can treat certain neuropathic pain types, and may do something for you, however, you're on a very low dose -- I don't know how she expects this to work.

Central muscle relaxants also can reduce certain kinds of pain, like myofascial pain or the pain felt in muscles and soft tissues.

If you want to keep your doc, try this regimen for a month. Keep a pain diary. Do you know what this is? You evaluate your pain level -- a number between 1 and 10 -- at certain times of the day, like when you wake up, before medicating, 2 hours after medicating, after lunch, before dinner, at bed time, etc. Also keep notes on the quality of your pain -- aching, burning, crushing, deep, stabbing, throbbing, easily localized or diffuse -- and any activities that affect your pain. For instance, does your pain increase or decrease from sitting for long periods of time, exercising, laying down, doing certain tasks, whatever.

Then bring a copy of this pain diary to your next appointment. I use an Excel spreadsheet when I need a pain diary and print it out for my doc. I ask that it be placed in my medical record. Lined sheets of paper work well, also.

If you're lucky, they new medication regimen might help you. Either way, the pain diary documents their efficacy.

Now, when you return with the pain diary, and you're still having trouble managing pain, ask her for more guidance. What else can you try?

Back pain responds best to multiple modes of treatment, however, many pain docs believe that an opioid analgesic is a useful part of that treatment.

Let us know if you need more advice.

Best wishes.
14982247 tn?1437701806
Have you tried Inferential Current Therapy? PM me if you would like to talk about it in more detail.
7721494 tn?1431627964
ky1032, are you suggesting this therapy for the back pain, or for opioid withdrawal symptoms?

Or perhaps you're suggesting this therapy for her doctor?

Pain patients often have this fantasy -- two beefy orderlies to restrain the patient, the use of a discarded 60 amp automobile battery (direct current therapy), and the application of probes to more sensitive areas of the body.

Avatar universal
Phil gave you excellent advice, he always does.
I'm going through the same you are and have been for more than 1 1/2 years. Test after test and no definite answers as to why I'm having this back and side pain.
I really don't understand why some Drs think that just because you don't have a diagnosis you're not having pain. It just makes no sense. You know you're in pain because you can feel it. Medication helps with the pain. It's very clear that medication works for you.
I do agree with Phil. Keep a pain journal and take it to your Dr. If she still refuses to treat your pain then it's time to find a Dr who will.
We're always here to listen and help anyway we can.
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