Frequently Asked Questions
what type of medication would i be prescribed if i'm having back pains?
i'm having very sharp pains in my upper back, especially when i move my arms. i'm planning on going to the doctor, but what would they prescribe for that ?
ps. i live in mississauga ON canada.
If your pains are in the upper back and in your arms, the problem is likely in your cervical spine (neck). Most people don't realize that the nerves in the shoulders, upper back and into the arms are controlled in the neck.
It depends on the type of pain and the severity. If you're having numbness/tingling down to your hands, it indicates a disk problem at the C5/6/7 vertebrae. The standard prescriptions for most back or neck pain is an anti-inflammatory (Naproxen is the only one left that's still widely prescribed, 500mg), to reduce the inflammation, and Flexeril or another similar muscle relaxer to reduce the muscle spasms. Both drugs take about a day to really get working, but once they do they're great.
An important tip - never ask for painkillers as it makes your pain immediately suspect. Let your doctor ask you. You'll be taken more seriously if you don't ask.
If your doctor thinks you need it, they'll typically give you a Schedule III painkiller, like Vicodin. They typically only prescribe Percocet and other Schedule II drugs for post surgery pain or long term severe chronic pain like mine.
For those people who think it would be great to have Percocet or another type of opiate, be careful what you wish for - you just may get it in spades, like me. 30 years ago after getting my wisdom teeth out, I had my first experience with Percocet. Over the years, I thought to myself how great it would be to have access to it all the time.
Well, 11 years ago I got my wish - after my first spinal operation I started into a formal Pain Mgt. Program. The first 3 years was low end stuff like Vicodin and OxyContin. My second spinal operation, 3 years after my first, left me with pain that was so severe that for the last 8 years I've had pretty much the same prescriptions - 120 - 150 Percocet 10/325's (every month), along with 100mcg Duragesic Patches. And the real irony? Most opiate patients, once they become dependent and tolerant, become so tolerant of the side effects that we can't get high anymore.
Some wishes always sound great in theory, but in reality it's a much different story.
If you want to use some OTC meds for your pain, this is what I use if I don't feel like using Percocet, and if I've run out of prescription Naproxen and Flexeril:
OTC meds that are effective:
1. Bayer Back & Body Aspirin - I use this more often because Percocet has Tylenol in it, and I use a lot - 120-150 tablets per month, for the past 8 years. This stuff works fast.
2. Tylenol ES Rapid Release Gel-Tabs - I use this to boost the level of Tylenol in the Percocet. It also works fast - within 20 minutes.
3. Aleve - Aleve is Naproxen is non-prescription dose. Prescription is 500mg, so you need 2 1/2 tablets to get prescription strength. It takes a bit longer to work and you need it in your system longer, but when it works it will get the inflammation down.
4. Valerian Root - Valerian is a natural form of Valium, and is a great muscle relaxant. Any doctor will give you Naproxen and probably Flexeril for the relaxer, but you can use Valerian in a pinch as a substitute. Works good for dealing with withdrawals too.
Thermophore pad - It is an Instant Moist Heat pad which heats up and gives you moist heat within a minute. Ice helps some people, for others heat is more effective - it depends on the person. For me, heat is more effective.
You can get a Thermophore pad here:
The pad you want is the 14"x27" pad.
Another nifty item you can use is a Salonpas pad - they come in large and small pads, but they're great for spot nerve pain. It used to be you could only get them in Asian markets, but you can get them online and even at Wal-mart now.
Bio-Freeze is pretty good as well - most Chiropractic offices have it, and you can get it online as well. You need to be careful about using chemical pads or lotions though, as the pain is so bad you can wind up putting too much on trying to get rid of the pain and actually burn the skin. Been there, burned that.
How to get off of hydrocodone?
I have been abusing hydrocodone for the last six months and I am trying to get off of it. I am looking for tips and advice on how to get off of it. I have read that loperamide has help some people, but I am also open to other ideas. If anyone can offer some advice or encouragement on how to get off of it that would be great.
Lopermide can help but it is also a weak opiate which could draw your physical withdrawal symptom out longer. And of course it will help with the diarreah. Without looking in your medicine cabinet I usually suggest you treat withdrawal the way you would treat any other stomach flu, which while its definitely worse, its very similar. Load up on the Nyquil. You only need 3 or 4 days to get past the worst and the more you can spend sleeping the faster and easier it will go for you. Benedryl will help. If you're lucky enough to have valium or a similar product hiding on a shelf dole it out carefully, its like gold. And plan on using the flu story or food poisoning for work, its close enough to the truth. If you have any Cymbalta or Lycria, they are n't god for much else but withdrawal, they work wonders on. Same for Elavil (amitryptiline) and flexeril or any muscle relaxant will help you from running in bed, that jumping out of your skin feeling.
Since you are noiw actively using if you have the will power (and there's no shame in telling yourself you don't) however much you're using, if you can taper it down over a few weeks, like break them in half, then skip every other day it will go much smoother. There is an old blood pressure medication called clonodine that if you can find a sympathetic doctor, will virtually eliminate the worst of the feelings, meaning you will only feel bad, not miserable.
Phenergan will help your stomach upset and will not extend the jones the way Loperamide may. If you doc doesn't know and you can keep your insides inside,maybe you can tell him you think you have a stomach bug or ate something at 7-11 that was sitting out all day. But really think of it as the flu or food poisoning and treat it the same way, just watch your intake of tylenol and advil for body aches, they canmake your stomach distress worse.
I wish I could help you more its not nice and even company that knows won't help you don't want anyone around when youre blowing up the can while you toss your cookies in to the tub at the same time. Day 2 will be the worst, but it's down hill from there. There is the mental component sometimes, not always, that they rightly call addiction. You may or may not have that issue, the person looking back at you in the mirror is the only one who knows for sure. But if you look around your place and see the many other good things you cando with your drug money and the expensive adult toys you can buy and think that's the stuff that lasts, it won't be gone in the morning when the buzz would be, it's a much easier choice tto pick something other than drugs. I could have purchased several really fine cars, all in cash, no payments, had I not know friends whoo were getting high and found myself joining in. A few nice trips 1st class the whole way. You treat yourself to something good with that money you'll have saved in a few weeks. A 70" LCD HDTV so everytime you fire that bad boy up you know why you quit. first thing I bought was a 00 stereo. Still got it to remind me that you can spend money on things that fizzle away like the morning fog, but you can also buy things you can enjoy for years. I know you have the common sense to see my point since you are sensible enough to want to quit. You have everything it takes to get it done, there's nothing left but to do it. And dont go out and have one last big hurrah to celebrate the last time or it wont be. Good luck. I know you can do this. Maybe you just needed to hear it from someone else who's worn those shoes before. I'm telling you that you have it handled. 3 days. Another 2 or 3 to rest and eat and get fluids back in you. Then buy yourself something for all that hard work, something that will be there for months or years to come. Hang in there and best of luck for an easy journey...
3 months of severe neck pain with neurological problems too: Can someone help me?
I had a CT scan done of my Cervical spine (neck) 8 months ago. The report concluded that there was no "significant" abnormality.
In the last 6 months, I have been experiencing severe, chronic neck pain associated with terrible headaches and even trouble breathing at times. Most of the time, the pain is dull, heavy, aching and throbbing. But other times, it can be sharp, shooting, and stinging. The pain occasionally radiates into both of my shoulders, collarbones, biceps, and forearms- and even down into the upper thoracic spine area. My arms feel fatigued and totally exhausted with even minimal exertion and the tips of a couple of my fingers sting, and then they go numb. I can only write for about 5 minutes, then my right hand starts to seize up, I lose muscle control, and it goes spastic. Then it feels like the hand is locking up...then it goes weak...and I have allmost no power to clench my fist.
Also, I get muscle spasms in the neck, but also in the soft tissues surrounding the collarbones, shoulders, biceps, and forearms.
I have trouble swallowing sometimes. I have over-active or over-responsive reflexes, like my head suddenly jerking to the side for a second while watching TV, or I'll be using the computer mouse, and my arm will just bang into the wall. It does not matter what I do, I just cannot get in a comfortable position with my pillow. My neck never feels relaxed. Valium/Ativan? They do not work. The only thing that takes the pain away is OxyContin- but I hate that drug, and I am searching for a medication that is effective and not addictive. My hands are completely bombarded with tremors, my eyelids will not stop twitching, and now and again I feel strange sensations that come and go- all over the face, around the head, the jaw, and the arms- like someone is lightly caressing my skin with cotton candy.
Is it possible for degenerative changes to occur in the neck in as little as 8 months? Do these symptoms indicate that there has been a rapid onset of deterioration? Is it possible that there could be old AND new findings that were not detected on the CT that an MRI scan would detect? I think I need an MRI for further investigation. Your thoughts?
Some information you might want to know:
PREVIOUS MRI REPORTS: Thoracic, Lumbar, and Brain.
Upper back: Moderate kyphosis, disc degeneration at T3&T4 with T4 2mm disc protrusion, multiple level bilateral facet joint arthritis, osteophytosis and sclerosis.
Lower: Congenital central lumbar canal stenosis at L1/2 to L4/5, L5/S1 disc degeneration and narrowing present/desiccation expected to follow.
Brain: Normal Examination.
First off, if you're wondering if cervical problems can crop up suddenly, you bet. I woke up one morning in 1996 with what I thought was a pinched nerve in my left shoulder. After 2 weeks I couldn't hardly use my left arm. MRI's showed 2 flattened disks at C5/6/7, which have long since been fused. I still have permanent nerve damage that weakens my left arm due to the initial misdiagnosis. I had no prior indication or warning before it happened, and there was no prior injury.
Secondly, please don't confuse opiate dependence with addiction. Those of us who are in true pain and rely on opiate therapy are dependent; opiate addicts have no real physical need for opiates, and are only looking for an escape from their current reality problems. The fact that the media and even the ignorance of many in the medical profession blur the difference (or just don't know) keep people who are suffering from seeking relief.
I will grant you that OxyContin just doesn't cut it. Over time, the effectiveness drops, and the dropoff from relief to withdrawal symptoms is a lot steeper than most opiates. I used it for a year before switching to Duragesic patches.
My point with opiates is that while none of us want to be opiate dependent, the alternative is living with extreme levels of pain and discomfort. Don't screw yourself just because you're stubborn. I did that for too many years; while I've never liked being dependent on anything, the amount of pain I've been through in my life would make you cringe.
Duragesic / Fentanyl patches last 48-72 hours, and once you're on a maintenance dose, the only thing you feel is being normal again. My doctor pushed me for a year to make the switch from OxyContin to Duragesic, but like you, I was too stubborn as I didn't want anything stronger at that point.
It's not to be considered lightly, but again, don't let social misrepresentations about opiates get in the way of getting yourself proper pain relief.
You might try Fiorinal w/ Codeine; though I use it specifically for migraines, I'll use it to help relax everything when I get severe neck pain as it works better than Percocet sometimes. Flexeril isn't bad either; it's much better for muscle spasms than Valium (I've got both).
You should also revisit your symptoms; while you're assuming that the neck pain is causing headaches and breathing problems, it's more likely that breathing problems are causing neck pain and headaches. My asthma sometimes forces me to unconsciously tilt my head way back at night to open my airway to breathe better,. Having my head tilted back so far for hours has made me wake up with killer headaches, arm/shoulder pain and weakness, and with half of my neck fused, I'm a mess for most of the day.
Your symptoms might also be from other sources, or a combination. Given that your previous MRI's show problems in the Thoracic spine (though at T4) degeneration higher up in the thoracic spine due to stress caused by kyphosis (hunched back) can also cause arm pain and breathing problems.
You should also consider any ergonomic stress on you neck. For example, think about your computer monitor and how you sit looking at it; if it's higher than your eye level and you need to bend your neck up to look at it, it puts a lot of stress on the neck and can cause enough pain and headaches to bring about nausea.
Don't discount the possibility of vitamin or thyroid deficiencies either. One of the problems I have is my left hand or fingers locking up (with prejudice) and I can only untwist them with my other hand. It's usually due to one of a few vitamin problem I have, due to a lot of the meds I take and the fact that I sometimes forget to take supplements.
My point is don't just focus on your neck; it could be a combination of several different problems.
Two things I'd recommend to help you that I've used for many years myself:
Though they're not cheap, they're worth it. The trick in the winter is to put a couple of hand or body warmers (e.g., Heatmax) under it (or under the pillow inside the pillowcase) while you're sleeping. The packs warm the pillow and your neck so it stays pretty loose when you're asleep. I've used one for 17 years.
Thermophore Heat Pad
I've used them for 25 years, and they're lifesavers. They do make one specifically for the neck, but I use and always recommend the classic 14x27" pad with the switch you need to hold down. Instant moist heat within a minute.
Here's some other links to help you out:
my wife has been on 15mg oxycodone 5x a day for the past 3 years. she's trying to ween herself, possible?
She also denies being addicted. she alos take a myriad of other meds, vicodin, alpralozam, flexeril and tizanidine. Does she need rehab to stop or can she do it herself?
There's a difference between being a drug addict (buying illegally and crushing/snorting etc) and your body building a tolerance to the drug.
If she's getting these legitimately from a doctor, and using them for pain, and has been for 3 years, her body has built a tolerance for it, that's all. And yes, that means she will go through bad withdrawals if she stops altogether. She can wean herself off, but only if SHE wants to. Rehab may not be necessary as long as she has a strong desire to do this herself.
She should start by going from 5 pills a day to 4 1/2 pills a day. (This is how I did it). I used a kitchen timer and would not let myself have another pill until that timer went off. Then go from 4 1/2 a day to 4 pills a day, and keep decreasing until her body adjusts. She will show signs of withdrawals but weaning this slowly is very possible and not at all dangerous.
Vicodin and Oxycodone are the same thing, opiates. So she can't replace one with the other, because that won't be of any benefit, UNLESS the Vicodin is a weaker strength.
She should keep the xanax (alpralozam) the flexeril and tizanidine the same for now. Right now, just have her get the narcotics/opiates out of her system. Then she can work on the Xanax.
Can you get addicted to Muscle Relaxers?
My friend let me try one today because he said it feels good. Of course I had to be an idiot and take it. I sweat all over the place and was freezing and I felt really nauseated. First, does the symptoms I just described go away the more you take the pill? And second, I seem to be craving another one. Is that considered an addiction? And last, are Muscle Relaxers deadly?
This question cannot be answered in the most helpful way without knowing what type of muscle relaxer you took. Many such as Flexeril will not provide much pleasure yet Soma will definitely give you that warm fuzzy feeling similar to opiates. Therefore, I am assuming you took a Soma.
In that case, let me tell you a little about them. According to a doctor I spoke to, these are actually in their own class of drugs, yet are marketed as a muscle relaxer, because they are extremely helpful for relaxing your muscles. Unlike most other muscle relaxers, they are more similar to a tranquilizer and often cause extreme sleepiness and an "out-of-it" feeling. This extreme relaxation might help with muscle soreness, etc. yet these pills are extremely addictive and dangerous.
I was actually taking 8-9 350mg pills at once and up to 40-50 a day at my worst point in my addiction, and believe me they are extremely addictive. Also they are a very old drug, and in from what I have seen not to many doctors or even addiction specialists know much about an addiction to them!
It might be surprising, but after going through withdrawals from alcoholism and heroin and OxyContin addiction several times, none was more brutal than the withdrawals from the muscle relaxer Soma. Also in high doses as I was taking, they completely knock you out and cause the shakes, and while I never once ended up in the hospital from and overdose of any other drug, Soma's sent me three times, all of which I almost dies from!
Therefore, I recommend you find out what type of muscle relaxer you took, and if it was something different that Soma, let me know and I can give you more info about that specific drug! Yet, no matter what type of muscle relaxer it was, it is better to stay away from them all unless you really need them and they are prescribed to you from a licensed doctor!
For more information on drug and alcohol addiction, check out the listed source I used to find this info!