i have chronic back pain with arthritis. how do i get out of the ibuprofen crap and get some pain pills that work? i have a therapy ap. on the 29th for my back. i asked last time for tramadol b/c a friend gave me a couple and it helped a lot. the doc told me i was to young for pain pills and prescribed celebrex which the VA wouldnt fill.

what do i need to do or say to get relief!


thanks

Calll your Primary and ask for a Pain Clinic Appt and play by their rules.

You should get some relief.

J

Bob,

Jbasser's suggestion on the pain mgt doctor is right on the money.  I was placed on Oxycontin for several months from the base doctor (active duty and still am)....this was prior to my Total Knee Replacement.  I was referred to a civilian pain management specialist (THANK GOD FOR HIM) who helped me wean off of that crap so I could undergo the TKR.  He is currently treating my pain (leg, back, groin, shoulders) and also uses some "alternative" methods such as fish oil, supplements, etc.  It has done wonders for me even though I am still in severe pain...but managing as well as possible (not a fan of narcotics whatsoever).  If you get to go to a pain doctor that is worth a dang, then they will help you tremendously.  Mine insists on all my med records associated with the probs, all radiological films, and once I began I needed to promise/sign a document that indicated that ALL of my pain meds will be prescribed through him.  That is 100% a good thing.  The base doctor (who is outstanding btw) knew that he could not treat my pain issues adequately.  If you are going through severe pain I would again recommend seeing a pain management doctor if you can.

BTW....I was told I was too young for a TKR by three surgeons.  I finally found the BEST one and so far so good (with some minor issues I am only 3 months out).  If your back has arthritis, you have pain, and it is complicating your life....by all means have them look at your films as well!  I dont know when your last films were but you may have gotten worse since then.

I literally feel your pain and wish you the best on getting some help.  BTW...how old are you.  They started me on the narcotic crap when I was 40.  I am 41 now.....still on some but trying to get the underlying issues fixed to be off them for good!

thanks for the advice, i am going to schedual a pain clinc appt after i go to theapy on the 29th.

MDB1968NM i am 25 years

You know pain doctors outside the VA usually want to do procedures. They don't want to just prescribe pills. There is no money in that. The basics of pain management are drugs that deal with pain. What the doctors need to do is to invent a drug that really blocks pain without turning the patient into a drug addict. If you take pain meds exactly as prescribed you will become dependent. You will become habituated, and you will need more to get the same pain killing effect. The only way to deal with it that I know of is to wean youself down to a level of drugs that will do the job, and when your tolerance starts to go up again start to gradually cut down again.
Opiates have been around for about 4000 years because they work. They are not evil except in the mind of our government and DEA. My state of Florida is trying their best to turn every chronic pain victim into a criminal thus victimizing them again.
My private pain mangagement doctor just fired me because I did not want any more nerve blocks. When the pain guy finds out you don't want procedures done on you he does not want you around because he is losing money by just seeing you.

VA Docs are encouraged to treat with Meds. Cheap Meds at that although if you try the cheap ones and they don't work they will up them.

I remember asking for Vioxx and the VA gave me morphine instead. Morphine is cheaper. One used to be used as anti-inflammatory and the other is major narcotic. What were they thinking?

John999...that statement you made about the vioxx vs morphine makes me think that THEY were on drugs at the time...

As far as my pain mgt doctor, he is very good IMO.  He LISTENS.  He is VERY strict and has my best interests at heart.  We have treated my issues VERY conservatively IMO and the nerve shots are the last step in achieving the reduction I am looking for.  I would hope, that all pain mgt doctors are similar but obviously they are not.  As far as costs go...being on active duty, I didnt pay too much attention to the tricare statements.  I just happened to see what my last appt cost (statement came in the mail today) and it was a whopping $84.00.  For ME that is not too expensive even if some reason I had to see him on my own.  For others that may be very expensive....to me either way it is worth it.

Bob....25 is very young...I am 16 years older.  They very well may be concerned for your health with regards to long term narcotic type drugs.  If you have not had this done already, you may want to consider having your PCM delve into your situation more...(current radiological studies, neurologist referral, and even pain mgt).  I wish you the very best and truly hope you can find some relief to your pain!

John999...that statement you made about the vioxx vs morphine makes me think that THEY were on drugs at the time...

As far as my pain mgt doctor, he is very good IMO.  He LISTENS.  He is VERY strict and has my best interests at heart.  We have treated my issues VERY conservatively IMO and the nerve shots are the last step in achieving the reduction I am looking for.  I would hope, that all pain mgt doctors are similar but obviously they are not.  As far as costs go...being on active duty, I didnt pay too much attention to the tricare statements.  I just happened to see what my last appt cost (statement came in the mail today) and it was a whopping $84.00.  For ME that is not too expensive even if some reason I had to see him on my own.  For others that may be very expensive....to me either way it is worth it.

Bob....25 is very young...I am 16 years older.  They very well may be concerned for your health with regards to long term narcotic type drugs.  If you have not had this done already, you may want to consider having your PCM delve into your situation more...(current radiological studies, neurologist referral, and even pain mgt).  I wish you the very best and truly hope you can find some relief to your pain!

Some of the posts below are spot on. I filled a claim for DDD and a few other things regaridng to my back a few years ago. VA Dr, only wants to treat with pain meds and TENS Pack. When i went to a local Ortho clinic on my former companies insurance policy, the prescribed rehab, after that faliled they did a steroid injection and are ready to continue treating it more aggressivley. So the point about VA doing it cheaply is correct. i wouldn
't wait around for the VA to act on your best behalf. The Dr. gets paid regardless if he does nothing or goes the distance for you.

Matt

[quote name='bob barker' date='Sep 23 2009, 12:42 PM' post='167602']
i have chronic back pain with arthritis. how do i get out of the ibuprofen crap and get some pain pills that work? i have a therapy ap. on the 29th for my back. i asked last time for tramadol b/c a friend gave me a couple and it helped a lot. the doc told me i was to young for pain pills and prescribed celebrex which the VA wouldnt fill.

what do i need to do or say to get relief!


thanks

I have chronic pain in my neck ( From C6-C7 ) from prior neck fusion and DDD (10% ) and the VA gives me naproxen or ibuprofen. I have taken Celebrex from my own DR. and I have to say that Celebrex works great for me. Better than the other pills for sure. The VA told me Vioxx and Celebrex are on there list as meds they do not handle due to reports of problems..

Honestly, I taken everything for my back and legs. Nothing really works. That's been my experience. Other than that, your VA doctor might give you some BS statement like "the DEA is about raid this VA facility for over prescribing narcotics". That was no joke, my former primary care doctor back in Houston told me that.

Ask for a referral to the VA pain clinic. Be sure to rate your pain on a scale of one to ten as at least a seven. You have to complain like hell. Tell them your pain wakes you up at night and you have pain 24/7 that is making your life miserable. The next step is to get a psychiatric referral for chronic pain disorder.

Bob it has been several months now since your last update, how are you doing now?

I have had cronic lower back issues for 36 years now and I have been rated at 60% for several years. I have been up and down the medical gammet several times and have been prescribed anywhere from bio-fed back to demral injections, I have never had surgery because I always felt that science was not up to speed enough to be successful. I have used VA and private insurance companies and VA does do it on the cheap side and is behind the private sector on the technolegy side. It does not matter which one you go to (VA or Private), some doctor are in it for the money and don't really care about you and some do a fantastic job, I have found the best thing to do is be honest about your pain and about what you expect them to do. I have finally got tired of the pain and always making it worse so I have put in for my 100% unemployable.

John999's right. You have to complain a lot. I got a referral to the pain clinic, but the pain clinic closed out my request without any reason or even seeing me. I have an appointment later in the week, so I plan to do some more complaining. The service I got was a complete lack of service.

I went to my VA pain clinic and on 2 different occasions I crashed during the injections in the Neck.
They scheduled me a return trip but I cancelled and asked for some pain meds. I got the old you need to see your primary care doc for that one.

Cant win for losing. cant getmeds and if I have the shots, I may crash again and not return.

jbasser,
That happened to me when I was getting an injection into my shoulder. I passed out cold because it hurt so bad. The next day, my shoulder froze up and I was in serious pain.

BTW Ibuprofin is generic for Motrin. I only got tyl#3 in the 80's from the VA. The last 7+ nothing more than ibuprofin 800mg, so all these yrs been seeing own private dr's as have since early 70's and 80's too. Get hydrocodone and fentanyl from them. Have to pay over $110 for dr visits to keep geting the scrips. The VA Pain Dr did try an epidural steroid injection with no results 2+ yrs ago. He left, still waiting for another. Told him I had received the steroid injection yrs prior via neurologist, but he thought he was a better dr, and it would work. NOTTA!!
Good luck in your quest to find a Dr who can/will order you more appropriate medication, ones that may assist in the allieviation of pain, or which may give you some relief.

I had three steroid injections in my lower back, which were administered by a private anesthesiologist. The first one offered minimal relief. The second was two years later and was much better. The one I had last month really helped and my pain is minimal. I still have ROM problems with my flexibility and leg raises, but at least it doesn't feel like I have a knife in my back. The private physician knocked me out and used a flouroscope to administer the injections - I would have it no other way.

The VA gives me ibuprofin 800 3x/day and tyl #3 and tyl #4 for days when it gets really bad.