Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Pain Management

Just wondering if anybody's ever been sent to see a pain management specialist-are they simply a route to stronger drugs, and gruesome shots, or do they actually introduce a different HELPFUL treatment that the rheumy can't?

My rheumy wants me to see one, but as I'm uninsured, I can't afford to see both docs. I left a message trying to explain this to the rheumy, but the message she left on my voicemail simply says that I must keep my followup with her (I was thinking maybe I would see the pain doc first, give whatever new thing they start a month, then followup with rheumy, but she says no).

I guess I don't understand. I see the rheumy every month or two at least. Each time, she pokes my trigger points (18/18), checks my joints, and sends me home with scripts for Norco, some new NSAID she's hoping will work, yet another muscle relaxer (going in circles with those, and have now tried them all I think). So far I'm still not seeing any major change in my pain, in fact I'm actually getting worse according to the BASFI.

So is there a point in seeing the rheumy this often? There's no cure, the meds aren't helping, and each visit is literally food off of our table. I think I've lost sight of what the goal is supposed to be>

Hiya!

I saw a pain doc about a year ago, and found it to be quite helpful. My GP and Rheum were both under medicating me, so I wasn't getting the proper pain relief.
At the time, I thought I was taking alot of narcotics also, but nope~ not enough.
So, he suggested to my GP that I start a long-acting pain med and one for break-through pain, and it has helped immensely.

These days, so many docs are afraid to give pain meds to chronic pain patients because of the reputation that "drug seekers" have created. So, the pain docs give their input on what meds would be appropriate for the docs to Rx. The pain docs do not rx any medications~ they simply tell your GP what meds to treat you with.
So, your Rheum probably wants you to keep your appointment with her so she can give you the meds that the pain doc recommended.

Hope this makes sense!?

Take care~

I have to say that right now, Id give anything to get back the treatment I got at the pain clinic. my pain was handled so well that I was able to go work a cna job at the hospital which includes lifting patients and passing stretching tests and endurance before the job even started. When I was forced to leave my pain clinic due to the fact that they changed thier policy on meidcal marijauna and was forcing patients to take a urine test, I said see ya later, I dont want my doctor testing my pee to keep me as a patient, i want him testing it to make sure im not sick from a disease. That was the only wierd thing. They dont try to find the reason you are in pain. And its probably why it took an extra year or two for me to get diagnosed because they handled the pain so well. I even was able to go back to school and went through almost a year. I got my cna license, went to music festivals, met my current husband and was doing absolutely fantastic. When I left, it was a slow crumble and break apart of everything I had spent those two years building. It all went away. I lost my job due to the pain, did find an excellant rheumy, even though it took 3 more doctors during that time. All through this, I had no pain caretaker at all. The pain clinic had me on oxycontin's ( i never told anyone and even had to get a NOTE from my doctor for my CNA class, they had no idea that when you take pain medication for pain, it doesnt make you high, it make you normal and able to move around!?!?!) and i also had a steroid shot in my SI joints, and / or busae sacks depending on how I was feeling. I had those every 3 months. Even though the shots would cause 3 days of being really sore, it was the next 2 months being completely pain free that made it worth it. I miss it sometimes because the pain control was extremely high, but at the same time, the high potency narcotics (the oxys and vicodin i was taking ) I started to worry about my body and so I never asked for them from my current doc. Needless to say, the pain clinic was both my savior and my satan at the same time. They sure took away what they gave to me.

Make sure, if you do choose that route, to be honest and open with your doctor about everything. I was seeing a nurse practitioner there and ironically, my wonderful fantastic rheumy's office is RIGHT UPSTAIRS from thei pain clinic so i usually stick my tongue out at the doorway when i pass and say gee, thanks a lot, if you had tried to figure out what was wrong with me, maybe I never woulda goten as bad as it has been. Oh well. Ive never actually shared this story with anyone but my husband but you asked ;-)

*hugs*

Ok, am feeling a little better about the need to go, but now need to figure out how to work the money. Anybody want to buy some yogurt covered raisins? (it's all I have at my desk )

Pain management is not only about drugs, it is a holistic approach to your pain, Identifying the correct pain control agent for particular pain, whether it is asprin or morphine, it is about about triggers, it is about identifying early signs so you may take smaller doses for an earlier intervention, it is about relaxation techniques.
It is worth the time and the cost.
phil

Yum! I'll take some of those yogi-raisins! I'd pay much more for yogi-pretzels, though! lol

I think I misunderstood something about the pain management topic~ There are pain management clinics, like the one tele was writing about, and then there are pain management docs who GP's send their patients to, to get a recommendation on what type of pain meds or treatment would best suit the patients needs.
I've gone to both. I didn't get very far with the pain management clinic~ it was just prior to getting dx'd with AS. Can't recall what it was that I didn't care for about it, but it just wasn't for me.

Take care!

Hiya,

I'm in a similar situation can't work not much money and kids so.....

painkillers vs anti inflammatories vs DMARDS (methytrexate etc).......

I think you need to workout what is what, taking pain killers for the inflammation I've found is the wrong thing to do, you need drugs which control the inflammtion...and pain killers for rest respite or basic functions.

Taking painkilers to do more on inflammation (in active flare) you make it worse.

On nerve pain pain kilers are a must, keep the pain down and it stops it affected all my nervous system. By managing the conditions you actually need less medication and avoid the higher doses over prolonged time.

If I'm on the right doses of steroids and MTX I'm much much better and need little for pain.

Both of these drugs are cheap and limit the damage esp to the peripheral joints. Personally I'd prefer to keep the steroids for fires short term low dose usage but that has n't been the case, so I'm locked into them but as they treat several related conditions then I have to wait til something else becomes available.

Methrexate I've beenon it for 9 months it helps esp the peripheral inflammation and on the higher doses the gut and now the spine, you take it once a week and so it works out really cheap.

As for NSIADs well personally long term I'm against them. Short term occasional use ok, except if you are at risk or have IBD.

David

Methadone!!!!!

Lady Fierce
If you PM me,will give you some info on a doctor
in Wichita Falls that I use..

David R

hi!

i use shots of steroids during flares. i used to gain 15 # every time i took even a dose pack orally... not to mention it's a whole lot easier on tummys!

gentle hugs,
teddi