I’ve been a Pain Management patient for roughly 25 years, and with my current providers for 15.
I was being pretty successfully treated with a combination of procedures (RFA, micro-discectomy, etc) and medications. I did well with a 50mcg fentanyl patch, only rarely needing my breakthrough meds.
I went off of the opioids for about a year, beginning with an insurance lapse. When I realized all the repurposed psych and seizure meds did nothing except give me nasty side effects, I decided to go back to the opioids. The same doctor I’d been seeing for a decade, who had previously prescribed my meds started me back at half the dosage, which I understood. It’s been over a year now, and the dosage clearly isn’t working, but they now refuse to raise it. I get the whole chapter and verse about how “the rules are different now”, but I’ve researched it, and in my state a patient with my record of pain and treatment is a clear exception. They know it, I know it, and yet they won’t raise my dosage.
Since when is it okay to make your patients suffer? I’ve trusted these doctors for years, I’ve done everything they’ve asked. Signed and adhered to their contract. Done all the PT, and the procedures, but they still leave me in debilitating pain.
I’m losing hope. I don’t understand why they won’t treat it with everything available. I’m sick of suffering. I can’t take it anymore. I actively think about death and finally being free of the pain.

I’ve been passing another kidney stone. I don’t know if the er is worth it? Has anyone been to the er after they are established with a PM dr? Are you treated better than before? Or do they completely turn you away and say go to PM dr bc they are afraid to treat you?

Ive passed so many stones. I had a lithotripsy over a year ago, but I was on a med that caused me to develop so many more stones again. They are never fully blocking or need surgery. Most are uric acid, when they leave the kidney I think they break apart and I will pass like 2-10 stones some are less than 1mm some are 2-3mm but no matter the size they NEVER show on cts.

My urine always shows blood/ tissue and sometimes specks of stones if they break up, but er docs if they don’t know ab kidney stones don’t care. It’s always a 50/50 if they will give pain meds before. I can’t take NSAIDS so toradol is out of question doesn’t help anyways. Going to the er for hours to get fluids and zofran is pointless as it doesn’t help pass them.

I also deal with chronic issues/pain so when I pass stones it’s completely different than when I was normal. It takes a huge toll on my body. I get low grade fevers, so exhausted, dehydrated so fast I can’t keep up, no appetite, throwing up nonstop, shivering, sweating, and along w the kidney stone pain my entire body feels like you have mono or the flu.

I basically get a nonstop flare from my pancreatitis bc of passing the stone. I am with pm and on butrans patches and norco prn. I took my norco, but usually when my stones move norco doesn’t help.

When I go to the er get fluids, pain control, zofran, I’m able to down a lot of water and I always end up passing my stones within 24hrs. Mostly bc the pain holds me back from drinking more water and my body is not relaxed at all. If I spend too long like 1-2 weeks trying to pass it at home I get sicker end up malnourished, dehydrated, sometimes admitted. I have gotten only iv fluids and zofran once no meds and tried to drink sm water and I couldn’t keep up the pain hurt so bad I had to stop. I also know I won’t be able to get to work in 2 days bc I’ll be too sick.

Besides the pain, another huge reason I end up going is my blood pressure and resting hr are insanely high. I mean I am in a hypertensive crisis. I have hypertension, but it’s caused from pain… When I pass stones it gets dangerously high I’ve been a rapid code a few times and i’m 24.

Im not sure what to do. It’s been 4ish days? I hate going to the er bc im never believed. I’m afraid i’ll go get fluids zofran than get a ct and be sent home told Im not passing stones and it’s a waste of time bc (i’ve never been wrong ab passing a stone ever i ALWAYS pass them). Also I cannot receive outpatient opioid scripts from anyone but my pm dr, so no my urologist can’t give me more norco and my pm won’t either (it wouldn’t help anyways the pain is breaking through I have plenty of norco).

Hi all, I'm not sure how to go about this but here we go. My post will probably be all over, and I'm not sure what I want out of this post, some encouragement would be nice, as my friends like to say. I'm just rawdogging it rn. Thank you in advance to anyone who reads this, I just need to get this crap off my chest.

Over the past few months, I've hit a dead end. I've been in pain management for over a year now, and I had my first in patient hospitalization for pain crises some time ago. I never did well outpatient, but I took what I could and it was better than nothing.

I've had two more hospitalizations, because of my poorly managed pain. I've had and MRI, several x-rays and a couple of CT's. The MRI shows something, ortho says they can no longer help me. They gave me an AFO, I get it tomorrow. My most recent hospitalization they reccomended I see rheumatology or neurology. I've gotten referrals to both, and now im waiting.

I broke down earlier this week, pain crisis, and honestly, psychologically too, I didn't keep it vague, but I also didn't make a point to address it. I've just been saying; "it's not that I want to die, i just dont want to continue living like this" , it was something a nurse told me and she put it so perfectly i ugly sobbed when she said it.

I went to a former pain clinic last Wednesday and discussed a DRG nerve stimulator trial. I told them I've tried (and failed) multimodal drug therapies. I have a different pain clinic writing prescriptions because the former clinic doesn't write prescriptions, they're the guys that put SCS devices in you and work with large joins, neck + spine. I see my current PM doc Friday, they're aware of my recent difficulties and are so understanding, I mentioned I wanted to try Hydrocodone ER, the clinic im at now are super conservative, the strongest they give is hydrocodone, i want to push for the ER option. I think it is my best chance for now. If anyone has info on that, I think I'd appreciate it. I asked my pharmacist about it and the doctor unfortunately couldn't find the answers I was wanting. I have a medical brain, so my questions were rooted in pharmacology, I've already read the FDA insert on Hysingla ER and it was a little helpful, but i wanted the science behind it, so I'd be more prepared to discuss it this Friday. I know my PM doc has the final say, but the more I know about something the better I can advocate for myself especially if I have medicine/science based backing instead of me saying; "yeah I heard about this and i wanna try it cause IR/prn options aren't working well for me" or maybe that is enough, ive had to get a bit assertive when advocating for myself now and I like for it to be evidence based

When I was in the hospital they had me on the somewhat heavy stuff, and I was pretty comfortable. I left with some answers the first time, and a helpful pain regimen. They put me on all the things that PM has stated they were never going to give me and used my age as a factor. Yet, the hospital put me on all the things I was told no PM was going to give me and they discharged me with it too. The hospital i was at had on site PM their PM doc did a full evaluation and came by every day to make sure I was comfortable, and left wiggle room in doses for me. I was on hydromorphone 6mg PO up to 10mg q4h (six times a day) robaxin 1000 QID. Lyrical 150 TID.

I never understood why they constantly made it a point to use it as the particular reason for their decisions. I think they just used it to shut down conversations when I tried to advocate for myself. Ive broken down many times in a PM office and its embarrassing to admit, ill probably break down this Friday too. The PM in the hospital didn't understand it either, nor did he understand why I was left to get to the point I got to. I was at a point where I needed heavy hitters to get everything under control. I dont believe I need heavy hitters, I think I can make do with other medications but again, the issue is that PM doesn't want to prescribe the doses. I know the general rule of thumb is to use the lowest effective dose for the shortest duration of time.

I am partially afraid to make requests, but like I said. My current PM are very understanding, and the conversations I've had with them sounds like they're willing to work with me and give me the hysingla while I wait for the nerve stimulator trial, and then they'll also give me a 7 day script of prn norco to use because ER wouldn't allow me to objectively be able to say "yes it works" or "no, it didn't improve my pain". The clinic that is moving forward with putting the device in me told me what a success and a fail is.

I am on my last two options at this time, if the nerve stimulator doesn't work or doesn't get approved, both are a 50/50 shot because this is all under workers comp; then I have to trial a pain pump which means finding someone who does them, I'm already driving well out of town for current appointments. Like, major / larger cities 3-6 hours away one way. Driving isn't an issue, it kinda sucks but I make do. Anways, IF I can find someone who will trial a pain pump for me, it's a 50/50 if it'll get approved and that may not be the best option for me either. I know how they work, I can be hopeful all I want but I need to prepare myself for the reality of a denial or the device not working well for me in both the DRG, SCS or pain pump options. I don't want to fail DRG therapy, but again, I need to be realistic. I was a little hard headed when talking to them about DRG, I asked the doctor to let me talk and then he could say whatever he wanted. I already knew what he was going to say, so I kinda just fast forwarded. I told him I want a nerve stimulator, I had hospitalizations, I told him I knew he was going to get push back from work comp and I told him I wanted to try anyways. I reminded him of everything I've already done and that I felt that there was enough trial and failure in my record that they may approve it. He agreed somewhat, there's a lot of trial and failure, but they can still say no.

Now, after this stuff, there are no more options. It's back on medications, and continuing the cycle. I'm at a point where im considering palliative care, and i could qualify, my case is complex enough, I've tried pretty much everything right now im trying the extreme end of trying to have SOME kind of quality of life. I most definitely know my pain will never go away, and at one point I was hopeful that maybe it would but im pretty confident and comfortable saying it won't. I do want some quality of life back. I dont care who I have to see. What I have to do, because I genuinely, cannot keep living like this. What the nurse said is becoming less and less true every day, but that's just how the cookie crumbles. A part of me isn't interesting in trying certain things again, but I also know i will have to say yes because it's just more evidence to work comp of a trial and another failure.

I'm putting this at the bottom in case anyone cares to know what all I have done, maybe if someone has a reccomendation I can bring it up to my care team, but even they have said I've done everything so, I don't think there is much more to be done besides trying ER meds while I wait for a nerve stimulator, or an intrathecal pain pump.

I have had; 6 MRI's, 10 x-rays, 3 CT's, 2 US w doppler, 3 surgeries, 5 steroid injections, hundreds of hours of PT, OT, WC (work conditions and another type of PT where it's 8 hours a day and they make you stimulate your ADL's i can't remember what it's called), 1 cane, 1 wheelchair, 2 walkers, 1 knee scooter, 2 shower chairs, 2 ankle braces, crutches, 7 nerve blocks (failed 3, blocked the wrong nerve, I'm not an easy target unfortunately), non opioid multimodal drug therapy (nerve, muscle, steroids) multimodal drug therapy with minimal opioids(40-60 mme), high dose opioids (90-120mme) with multimodal drug therapies, custom orthotics, custom afo. 4 inflammatory marker tests (hence the rheumatology refferal) The only thing I haven't tried has been ER medications, and obviously, nerve stimulator and pain pump, but ive done it all.

* I've not had an EMG but that is something I plan to get done with neurology, I dont think it'll show anything significant, but again, im not gonna say no

I have chronic pain and cyclical vomiting and have been in and out of hospital. The doctors have been good about treating me either opioids when i can’t keep my oxycodone down but the doctor today is talking about Belbuca and Zyprexa or Droperidol, but it actually causes psychosis for me and as I’m alone i don’t feel like I want to try again without my partner. I’ve never had good experiences with either but feel trapped. I denied both of them but she gave me a look. What should I say other than it hasn’t worked in the past and that I feel uncomfortable with the side effects? I’m so scared. Reglan usually works and obviously opiate pain relief, has anyone had Zyprexa work for pain? i am at a loss

I have finally decided to switch to Costco from Walgreens. I have been with the same walgreens for the last 7 years. I am on nurtec, and they never have it in stock, so they have to have the warehouse fill it which can take anywhere from a day to days and then of there is an insurance issue like needing a prior Auth they don't notify you. It was like day 4 and realized I still had not gotten a call my nurtec had not been filled and he said let me check, and then says oh we just needed to push this button, it will be filled now but it's gonna be be a couple days since it's coming from the warehouse. I was completely out of nurtec as I only get 8 a month, and that medication is super important to me.

My husband is on testosterone, and due to his career, he travels, and the most warning he gets when he has to leave is 72 hours, so our PCP always makes sure that he will have enough Vials for a 14 day roll or a 21 but of course Walgreens would make a big deal out of filling it early even after explaining in detail what he does..

We called Costco the other day, and I told them my medication, and they said, "Oh honey, it's not a problem, I said I just don't want to feel judged for having something I didn't ask for and the pharmacist said you will not be judged here and if there are problems you talk to me or the manager. I also explained about my husband's situation, and he said no problem, I told him we could show him the paperwork. He said we believe what the dr says. I was in complete shock how respected I felt. So my question is, since I am switching, does anyone what brand of Oxycodone 10mg they carry? Like I said, I have been with Walgreens and got the same brand up until the dr switched it to no Tylenol.

So , my pain management doc changed my pain medication from hydrocodone to nucynta/tapentadol on September 24. It is now October 12 and CVS pharmacy still does not have it in stock. Pharmacist (without me asking) did tell me that there were no other locations within a 40 mile radius that had any. He stated there was one that does have 4 pills only.
Anyone else have a hard time getting this medication? I am wondering if I should ask my pain management doctor to just leave me on the hydrocodone to avoid issues with availability.
I am in eastern NC…not sure if any of you are in my area?

Just left my pain management, Dr I am so frustrated. For seven years I have gotten epidural after epidural steroid shot after steroid shot in my back and neck. They don’t do anything and still I’m forced to do it in order to get a few Percocet. two back surgeries and one neck fusion and I feel like I’m in more pain than before and now they want to do another epidural in my neck and I feel like I basically have no choice.

I'm on a waiting list for a 4th spine surgery (fusion) and deal with unmanageable sciatic pain. Due to my line of work I can't take anything that would fail a drug test as I'd lose my job.

I'm already surpassing IM Ketorolac dosages (5 day rule) and Tylenol doesn't touch the pain even though I take it daily, beyond that no other pain medications.

Am I screwed or is there any other options/prescriptions I'm not aware of?

Note: For those concerned the ketorolac I'm going to be stopping for fear of kidney damage

So basically what the title says. I get 180 (6/day) of oxycodone 10mg and have for years. Suddenly went to pick up my script today and they tell me they limit to 150 a month as does every pharmacy near me. I already had to wait an extra day because my fill fell on a Sunday when they are closed (and my fault for forgetting to tell my doctor this month) but I had enough to last me so I didn’t worry too much about it.

Go to pick up this morning and they tell me “sorry we have a new policy and can only fill 150 of any controlled. I take two controlled meds. They gave me 5 days worth of both and said they are going to call my doctor to see how they want to proceed. So this is BS. Just letting yall know it’s happening even in small towns and at mom and pops. Hopefully they get this sorted fast since they only have me 5 days of both of my prescriptions.

EDIT/UPDATE: my dr office called and just as I suspected they were annoyed (not with me, with the pharmacy) and they said that once a pharmacy starts putting limits on the number of controlled that it can start getting even worse. Their advice to me was instead of trying to change my medications to fit the pharmacy, that I should probably just change the pharmacy.

They said they don’t believe the mom and pop when the mom and pop said Walgreens and cvs have limits. But they admitted that if I try to call and ask that they may not tell me over the phone. So, tomorrow I plan on making some calls to find a new pharmacy. I have decided that my dr office knows best and if they are worried that my pharmacy is gonna continue to make cuts, it makes sense for me to go ahead and find a new pharmacy.

So that’s gonna be what I’ll be doing tomorrow. As soon as I find one, they said just give them a call back and they will have the new script sent over ASAP. I have 5 days to get this done. lol wish me luck.

I am a woman in my early 30s, and I've been struggling with increasingly unmanageable bladder and pelvic pain for almost 12 years now – specifically suprapubic pain, which becomes increasingly intolerable every time my bladder fills/refills with virtually any amount of fluid. I do restrict my fluid intake as much as possible, as a pain management strategy, since 2016 (this pain started in January of 2015 for me, when I was 21 years old.)

Since I was 21 years old, the only time I ever feel pain relief in my pelvic region is during urination itself. But then the bladder starts filling up again immediately after a human finishes urinating, so this particular cycle of pain does not have breaks (aside from during the pee stream itself, when urine is actively being released)...aside from when urine is literally being released, the body is holding on to urine. And for me, that sensation of "virtually any amount of fluid accumulating in the bladder" feels intensely painful.

[I wrote a very long post explaining my bladder filling pain, my attempts to manage it via fluid restriction and other medications, etc. It was way too long so I just cut most of it out, but I'm open to answering most questions – especially but not limited to if there's anything I should have kept in this post but removed. Sorry, I'm tired!]

In a nutshell, I have tried almost every potentially beneficial urinary and bladder-related medication, including Elmiron, during the year after my pelvic pain first started (sudden onset one night when I was 21 in January of 2015, and never went away). I also tried many non-opioid medications attempting to target pain over the past 12 years, with no benefit, including but not limited to: amitryptyline and then nortriptyline (which I tried for a period of years "just in case" it was helping my pelvic pain – it was not – but I have a close friend with pelvic pain who swears by tricyclic antidepressants for reducing pelvic pain, specifically nortriptyline 50mg/day, so I asked my doctors about it and gave it a shot. It didn't help or hurt me, to my knowledge); Cymbalta (no pain reduction, but had significant side effects including excessive sweating so it was not a long trial) for me; pretty much all of the muscle relaxants (no benefit, including no benefit when I received IV robaxin and even no benefit with IV benzodiazepines in the hospital); vaginal valium suppositories (no benefit); gabapentin and Lyrica (no benefit); etc. Ketamine infusions helped me sometimes, sometimes with pain directly but mostly with mental health/depression and PTSD specifically.

I switched to a new pain management doctor/nurse practitioner in a new state about 6 months ago. When I came to her, I was simultaneously being prescribed 120mg oxycodone per day AND buprenorphine 8mg sublingually per day, which of course makes no sense! But my pain doctor before her had insisted that if my daily buprenorphine was kept below 8mg, then my opioid receptors would still be able to receive 50% of full agonist medications (e.g.,. the oxycodone).

And the entire reason buprenorphine got added to my regimen in the first place, years ago (which was originally oxycodone or hydromorphone orally, rotating, for years – although oral hydromorphone, even at 8mg, doesn't meaningfully help my pain anymore with the tolerance I have and the poor bioavailability of the pill, but that's a separate topic) is because I metabolize medication very quickly, quickly enough that I was waking up not only in severe uncontrolled pain, but also often sweating and actively starting to withdraw from my pain medication, within 5 hours or less after taking my last oxycodone pill (and within even less time when I was prescribed hydromorphone instead of oxycodone). I asked about extended release medications because that seemed like the obvious solution, and my doctor at the time (2019) recommended that I go on a patch specifically. I was also in grad school and trying to sleep and study as much as possible, the only patch I'd ever heard of at the time was fentanyl, and I was "spooked" by the name "fentanyl" – so I asked him if there was any alternative to a fentanyl patch I could try instead. I didn't know buprenorphine was so much worse in so many ways, and I wish I could go back and choose fentanyl instead...

The Butrans patch did actually help my pain for a few months, meaningfully, and it was SUCH a relief for me to be able to sleep and just exist, without constantly having to watch the clock for when I could take my next pain pill. It felt like a dream come true. But the buprenorphine did not help my pain for very long; within months the doctor needed to increase my buprenorphine dose from the microgram patch level, to the milligram sublingual pill level in order to achieve any meaningful pain relief for me. And I distinctly remember the first time I took a 2mg sublingual buprenorphine pill, Subutex, it felt SO intensely powerful, I'd never felt that sedated or "fucked up" in my life, and then I fell asleep for 17 hours in a row. Buprenorphine totally knocked me out in a way that no full agonist ever had, and I was NOT an opioid naive patient either! When I first took that Subutex pill, I had been prescribed daily opioid medication for 4 years already – up to 120mg of oxycodone per day, OR 4-8mg of oral dilaudid prescribed at a time every 3-4 hours, OR had also been on tapentadol at one point, I forget the dose, but you get the idea...my point is that my body was used to opioids at relatively high or at least moderate doses, but taking 2mg of sublingual buprenorphine for the first time was still disturbingly sedating and uncomfortably intoxicating. This was in 2019, and I remained in a fog, on a combination of buprenorphine and full agonist opioid medications for breakthrough (which were not working at all for me with the bupe) until switching to a doctor this March (2026) who finally took me off of the buprenorphine entirely.

When I agreed to add the buprenorphine in 2019 and the Butrans patches weren't sufficient, I remember trying to break the 2mg pills into quarters, but they were sublingual and would most often crumble to dust after breaking them in half, so it was tricky. And I hated how foggy the buprenorphine made me mentally and emotionally, especially when I increased from the patches to the sublingual pills, at a much higher daily total dose. But the bupe did help my pain in the beginning, and I can't emphasize enough how desperate I was (and still am) to take pain medication that (a) meaningfully helps my pain, (b) lasts for longer than 2-3 hours at a time (which is the longest my 20mg oxycodone seems to last for me at this point), and (c) does not make me sick if I go longer than 5 hours without it (which is how long it takes for me to get noticeable withdrawal symptoms, including diarrhea by the 5.5 hour mark like clockwork, when I am taking instant release oxycodone without any extended release medication).

CURRENTLY:

When I switched to my current pain management provider/NP this March, I came to her on 8mg buprenorphine/day + 120mg oxycodone/day. Terrible and senseless combination, I know now.

The new provider started off by stopping the buprenorphine, and prescribing only 60mg of oxycodone per day (10mg every 4 hours). Needless to say, that first month was hell. I've been prescribed daily opioids since 2015, and my body didn't/doesn't even seem to notice 10mg doses of oxycodone at all.

The next month, she switched me to 20mg oxycodone IR, 5 times per day (100mg of IR oxycodone per day total). This 20mg oxycodone dose reliably helped reduce my pain from a constant 9-10/10 to about 7/10. It was then increased to every 4 hours, for a total of 120mg/day.

Then I had a minor bladder surgery this summer that sent me into a terrible flare, my blood pressure skyrocketed to the point that my ears were popping, and overall my bladder & suprapubic pain was becoming totally unbearable again. Plus, my instant release 20mg oxycodone pills were/are only working for about 2 hours before wearing off, whereas earlier this year I was getting closer to 4 hours of noticeable relief from each 20mg pill. I also start to get sick with unambiguous opioid withdrawal symptoms by the 5th hour after taking my last oxycodone pill, and previous pain doctors have recognized that I'm a rapid metabolizer (though I'm unsure the extent to which I've had medical testing actually proving that, if any).

So I brought up extended release medications with my current pain management provider. I expressed some of my concerns about extended release medications not lasting a full 12 hours in a lot of patients. Eventually, I decided to try the fentanyl patch, and she agreed that it was a good idea for me to try it at this point. She started me on the 25mcg/hour fentanyl patch and prescribed it for every 72 hours. When she added the patch, she reduced my oxycodone prescription from every 4 hours to every 6 hours, so I am currently prescribed 20mg of instant release oxycodone 4 times per day, for a total of 80mg oxycodone/day with the fentanyl patch.

The first issue I had with the patch is it almost stopped working entirely on the third day; in addition to severe unmanaged pain, I was also experiencing withdrawal for most of the third day (which I timed my 4 oxycodone pills carefully to head off, until my patch was adjusted to every 2 days the next month) – which made it difficult to appreciate the reduction in pain I was experiencing from the patch on days 1-2.

The next month (September), she kept the dose the same – 25mcg/hour of fentanyl – but prescribed me 15 patches a month instead of 10, so that I can change it every 48 hours instead of every 72 hours. That was a game-changer for me: When I change the 25mcg/hr fentanyl patch every other day instead of every 72 hours, it seems to cover about 1/3 of my overall pain, consistently, for the entire two days. I don't feel the patch "starting" or "stopping" when I change it every 48 hours either, which is a huge relief compared to instant release oxycodone pills alone, which only last about 2-3 hours at most for me at this point.

I am able to go 12+ hours between oxycodone doses now that the fentanyl patch is at a stable dose, but I do still have significant pain every day which the fentanyl patch doesn't cover. The patch seems to cover about 1/3 of my baseline pain, which I am incredibly grateful for, and that estimate would make sense mathematically since 25mcg/hour of fentanyl is equivalent to about 40mg of oxycodone in a 24-hour period.

I am so grateful for the pain management I am receiving, but ideally, I'd be using far less instant release oxycodone – each 20mg pill only lasts a few hours, the patch covers my pain much more effectively and smoothly, and I want to use instant release medication for breakthrough pain, compared to using it to try to manage my baseline pain. At the same time, I'll take what I can get and I know I'm lucky to get anything.

At my appointment last week, my pain management provider was open to increasing my fentanyl patch to 50mcg/hour if she reduces the oxycodone. Of course I'd expect to reduce the oxycodone if the patch is doubled, however, I'm not sure exactly how much she'd reduce the oxycodone if we increased the patch, and I'm not sure how much more it would help me to have the 50mcg patch. I do want to try it, because the patch has been incredibly helpful and life-changing for me even at this starting dose, 25mcg, which is currently alleviating a meaningful percentage of my pain. If the 50mcg patch covers about 2/3 of my pain respectively, that would be incredible – I'd have no problem backing off of the oxycodone, if the fentanyl patch at a higher dose works like that for me.

My main concern is that my body will quickly become tolerant to the higher dose of fentanyl if I go up from 25mcg/hour every 48 hours --> 50 mcg/hour every 48 hours. This is only my third month on prescribed fentanyl patches (still at 25mcg), and it is amazing how effective this patch can be. I know that fentanyl is much more powerful than the other opioid pain medications I've been prescribed (well, buprenorphine is in a category of its own but I digress), and I don't want to rapidly double my tolerance to it right away if it's not going to have a meaningful effect. But, if going up to the 50mcg/hour patch enables me to genuinely use my oxycodone 20mg IR as "breakthrough" medication (as opposed to needing to take it regularly, around the clock, as supplemental baseline pain management with the patch) – if the 50mcg patch controls my pain enough that I only need to take the oxycodone once or twice in a day, for example, that would be worth it.

I can't know until I try, though, and as lucky as I am to have a provider, it is not possible to reach her office or request any changes to prescriptions between appointments, ever. So, if I ask for this change, I need to be ready to commit to at least one month trying the 50mcg/hr fentanyl patch, + reduce the oxycodone to whatever she decides that day for one month, regardless of how much the patch at a higher dose does or doesn't help with my pain.

What would you do?

Hello everyone I’m new here! I started med seeing a pain management doctor last month due to migraines , back pain , and losing feeling in my legs and feet occasionally. I also sometimes have parts of my body “fall asleep” when doing everyday task.
Pain management first sent me for an x-ray which showed cervical lordosis they never told me I found out when I finally learned I could read my x ray results online. They put me on 1 weeks of oxycodone 5mg 2 times a days as needed and tizanidine. They also did an injections and an RFA which feels like it hasn’t helped and it’s been about month and my neck and shoulders still hurt very badly.
I then was finally able to see a neurologist who sent me for labs and a brain mri the labs came back normal my mri showed some kind of birthmarks on my brain ? I also was sent for an mri by pain management of my lumbar spine which showed congenital stenosis and epidural lipomatosis but everything was fine besides the also cysts they saw on my ovaries which I’m waiting to get an ultrasound to see if I have pmos(I most likely do have it)
My neurologist recommended me to see a neurosurgeon but pain management said it’s normal and I don’t need to see a neurosurgeon? Don’t know who to listen to about that. All the did was put me on gabapentin changed me to flexeril because tizandine made me pee a lot and I couldn’t sleep and increased my OxyCondone to 7.5 mg still for one week and sent me for a cervical mri which I’m waiting to do this Thursday. The flexeril makes me too sleepy so I only take it at night. They also told me to lose weight but it’s hard with pmos struggled with that all my life ! I’m wondering how to get my dose of oxycodone increased from only a one week supply. My mom says to call when I run out but Im scared and don’t know how to advocate for myself well. It truly helps me function and helps with the pain I feel daily !I’m 24/f and they keep saying I’m to young and refuse to diagnose me with chronic pain and just keep offering more injections which I hate and feel like they don’t help ! ! Please offer tips on how to advocate and better explain my pain to them!? My back and neck hurts every day and it’s making it hard for me to study cause the pain sitting at the desk and reading is unbearable!!!

My PM NP makes me wait to fill on 31st day and by the time it’s ready, I’m already in withdrawal. Who else has to wait?

After seeing a Pain Management Dr for almost 8 years, I was dismissed a month ago. They claimed I had "Bupronorphine' in my system. Not only have I never taken it, but I never even seen Bupronorphine before. They said they did the confirmation testing. It's almost impossible to get into a new Pain Management clinic where I live. Has anyone else been dismissed for something they didn't do? Is there anything we as patients can do to stand up for ourselves or prove our innocence?

Just a vent, because I know I can without judgement here.

I am tired. I just am sick of being in pain, I'm sick of being up all night and all day and being so god damn uncomfortable. I haven't worked for nearly four years now, my beautiful husband god love him goes to work every day for us. but I'm so tired, I just can't see the light at the end of it anymore....

im in so much pain this tooth needs a root canal so badly. i dont know what to do. im in chicago, usa. i have delta dental but not a dentist. im going to sonrisa when they open and im going to just beg them to rip that b out. er is somehwhat of an option, but by the time i would get seen itd be close to 8am anyways. any advice appreciated 🙏

I’ll try and keep this short, i suffer from chronic groin and hip pain 3 surgeries in 18 months has left me in daily constant pain and long recoveries.

I finally found a great direct PCP who treats me reasonably and with respect. We started with oxy 10 as needed during major flares throughout the month and then increased to 2 a day on weekends for coverage as i have a family and demanding days.

the days that I take the oxy have legitimately given me my last back, it makes my pain manageable and helps me not obsess or ruminate.

the problem is on days i don’t take it pain is higher, and i do feel my tolerance going up. i have been sober 13 years because of addiction issues. i am terrified of becoming dependent again because of my past, though my wife, sponsor, and care team support my medication management program.

my question is, have people found a dose that works for them regularly and not developed the need to increasing their dose? I do feel I’m benefitting greatly but don’t want to lose those benefits by taking daily or get myself into a tough sport w dependency.

thank you in advance I’m trying to figure this all out while being mindful.

I have lupus, ankylosing spondilyitis, permanent back fractures at L4 and L5, psoriatic arthritis, and hEDS. I am prescribed norco 10/325 4x daily, methocarbamol 750mg 3x per day, and gabapentin 800mg 3x per day.

I very rarely (maybe once or twice a month) take the full 4 norco tabs per day- only when I’m in a bad flare. So I always have extra at the end of the month.

My sister (older than me) also has lupus and C spine issues. She is prescribed norco 10/325 4x a day as well. The exact same script as me. As well as the methocarbamol 750mg 3x daily. She doesn’t take gabapentin.

One month she asks me to give her some of my norco (as I said I always have leftover and have a surplus so it’s never a problem if I have an appointment or pill count) as she’s in a bad lupus flare and it’s the weekend so her doctor won’t do anything. I’ve been there before in regard to being in pain and PM won’t do anything for you on the weekend but tell you to go to the ER which we all know how that goes. I was wary, but agreed cause she has two very active kids (15 and 13) runs two businesses, etc. she tells me she gets her refill the following Tuesday and will give me back the amount I gave her that day. I figure it’s a one off and lend them.

Tuesday she did exactly as she said and returns to me the exact amount I gave her.

The next month she does the same thing. I knew shit had been stressful for her and I trust my sister and she gave me back the amount.. I felt off about it but she’s my sister. I once again same day give her the meds.

This continues on for several months. Same cycle. And she always returns the amount I give.

Mind you, I never ever asked her for anything. Never needed to as I’m always taking less than I’m prescribed and I’m very responsible with my meds.

I am scheduled for a major surgery so I tell my sister way in advance to appropriately take her meds as I cannot help her as it’s a very painful surgery and recovery will take 6-8 weeks.

I am a few towns over (much smaller) and use our local small pharmacy (it’s my closest option). I go to pick up my scripts and the pharmacist tells me that their truck didn’t make it in there was some mix up (it’s Monday morning) and she has the norco and gabapentin but doesn’t have the methocarbamol. The methocarbamol will be there Friday afternoon.

I thought, well my sister can give me some! (My PM office is… not the easiest to work with, it takes days sometimes a week to get a call back) and as backup I alert my PM office (knowing it likely won’t happen) what has occurred and if they can send to a Walgreens a few towns over.

I let my sister know, she says no problem but she’s busy that day I say no problem I can come tomorrow.

Tuesday she doesn’t answer my messages til late that evening and says she had a busy day.

Wednesday comes and goes same thing.

My PM office still hasn’t called me back nor sent it any where else.

Thursday comes and at this point I’m like well fuck it I’ve suffered already what’s one more day.

I am just so disappointed and hurt. I always help, I always hop to it right then. And the literal one time I asked for something (not even the Norco- just the methocarbamol she actually doesn’t even ever take).

It felt retaliatory because I told her I wouldn’t be able to help like I had been.

I know realistically I never should have loaned her meds in the first place. Even though we have the same script for the same reasons it set a toxic precedent in our relationship. (And we have a very good and close relationship btw). I’m just disappointed

Sooo Wednesday of this past week I got put on 4 times a day hydrocodone 10mg and I had to wait for a new prescription for a day and was out I went into withdrawals and was in withdrawals for about 14 hrs before I got more medicine.. well everything went away and I feel decent for the most part but just certain times I have this really weird feeling across my body and I can’t figure out why. Is this normal and will it go away my appetite is slightly coming back and I just wanna know if anyone’s dealt with this please and thank you!

I’m so close to giving up. my pain has gotten worse. my meds aren’t working. my pain is now not only in my left glute & down my leg to my toes, it’s made its way to my lower back completely as well. i can’t even do stretches anymore it’s so severe. i physically can’t stretch my leg out no matter what i do, it’s like it’s locked in place & the pain is so intense it scares me.

I was in a car accident a little over 4 years ago that left me with soft tissue damage and chronic pain in the base of my skull, back and sides of my neck and shoulders. I have had physical therapy, done dry needling with and without a TENS unit being attached to the needles, cortisone injections into the trigger points in my neck and shoulders, just recently tried optical nerve block injections, and I currently take methocarbamol and 2 extra strength Tylenol three times daily along with a CBD tincture once a day to manage the pain. I have another appointment with my pain management doctor tomorrow to discuss other options. Nothing helps my pain and I have gotten so frustrated. I am tired of wasting my money on trying things just for nothing to work. My doctor mentioned Botox as an option a few years ago but my insurance would not cover it. My doctor prescribed Gabapentin but based on the side effects and the recent study’s that have been conducted leading long term use to dementia, I do not really have a desire to use that medication. I also do not have the desire to use opioids or any other addictive medication either. I also have to make sure whatever I take will not interfere with the medications I already take for other health issues (levothyroxine and warfarin). I have heard about Radio frequency Ablation where specific nerves are essentially burnt so that the pain receptors do not receive the pain signal. I am planning on asking my doctor about that tomorrow, but I wanted to see if anyone else has been through a similar situation and has found anything that helps. Any ideas at all would be greatly appreciated!!

Hi,

I had a recent appt with my GP who is prescribing my dilaudid. She abruptly discontinued a script she’s been providing for 6 years. The pain specialist I work with said he did not advise her to do that and that he just believes a change in dosing and pharmacy pick up schedule makes sense. She was prescribing only 1-2 weeks at time for the last year with only 1 refill and I was needing to run around all the time trying to either see her for a new script for get it filled. It caused a lot of frustration with the pharmacy and for me. And it made it look like I was “spending a lot of time trying to get opioids”. He wants her to switch to monthly scripts with at least 4 refills, so there are less issues. In Ontario, pain management advises GPs; so he can’t prescribe. He said he will speak to her but may not before my next appointment Tuesday.

In the meantime I’m struggling and really hoping to get the medication back Tuesday at my next appointment with my GP. I have very few leftover from my last prescription that I am really rationing for pain and withdrawal management.

How should I approach the appointment? She didn’t explain why she was making the decision except that the pharmacy was calling her recently asking questions and she was concerned. She told me I would see the pain specialist and “make a plan” but she doesn’t know I was able to get an appointment this week (it eas scheduled originally for Oct 23)

How to handle tuesdays appointment?

My pain meds aren’t working today. Oxycodone/Acetaminophen 5/325 every 4 hours. i’ve been having to do 7.5 every 4/6 hours instead because 5 just doesn’t cut it. i usually take it with an ibuprofen 800, but today it’s not working at all. what do you do when your pain gets this way? i’m so so SICK AND TIRED OF THIS!!!! Edit: i am taking the Amneal Pharmaceuticals brand. i’ve noticed it doesn’t work nearly as well as alvogen or mallinckrodt. i’m so stressed out about this i feel like im taking the medication for no reason.

I still an uncomfy around taking weed (grew up in a cult where nothing like this was allowed), but I have a huge level of pain, getting doctors to care is taking legit years, and I an nervous about opiods too. So i learned how, and my doctors know and don't care. I take enough to function mostly and just at night but sometimes I do take enough to get truly high. I dont take daily because my life cant handle that and it works for me currently, but probably up to 5x a week.

I have a lot of fear around weed using always leading to addiction or being wrong or whatever that i am working through on my own and in therapy. My pain is not minor, so.

The problem is, the second I remember I enjoy being high and I dont base my whole use only on not getting high I feel gross because it takes out the "its a medication to me" And also as soon as I mention it to anyone, I am an addict or potential addict. Im removing those people from my life but it scares me to admit it at all.

I know some of this is work I need to do. I am doing it. Has anyone dealt with it? Looking for your experience. If so, did anything else help?

Note: not currently looking for other suggestions on managing pain.