Breakthrough Pain, Please Help

[medic1]

Usually I have pain and I deal with it. I currently take Ultram ER, and have Lidoderm Pain patches for my pain. I cant take the Ultram Er everyday because it causes problems with my bowel program. I use the patches but have to have them off for 12 hrs, and they dont seem to get deep enough to take the pain away. The last two weeks I have been having increased pain to the point that I just want to stay in bed and cry. I have thought about going to the ER but I dont want to because I know how some of the nurses and doctors can be when people come in for pain control. I dont want to be labeled a drug seeker or such for going to the Er for pain meds. I have brought up to my doctor that I would like something for breakthrough pain. Something stronger than my Ultram for times when I need it. So for he seems to just ignore it and doesnt really say anything. It isnt often that I would need to take something but when the time comes it would be nice to have it on hand. God knows I hate having to take pills as it is, and Nyquil puts me out. I have exams in less than 2 weeks and I need to be able to get to my classes and be able to study. If any one has suggestions for a pain med that will work for my breakthrough pain please let me know.

[metronycguy]

it sounds like you need a pain management doctor.
ultram ER is to be taken everyday, not here and there, it needs to build up a level and that takes 3 days or more. ultram er doses comes in 200 or 300mg. you may need the higher dose, but not until you try the 200 ER for a couple weeks straight.
lidoderm doesn't work at all for me for neuropathic pain, i use them for localized weight bearing pain in my foot. they do nothing for the neuropathic pain in my foot's you cant find a pain management doctor, call your doctor up and tell him it's not working.
where is your pain?

[SoFla]

Is your pain, what I call, real pain, or neuropathic pain? Each needs to be treated differently. Have you seen a pain management doctor?

[medic1]

If I take te Ultram Er for more than a couple days in a row I end up getting constipated and have a difficult time with my bowel program. I had a burst fracture of L1 and am fused from T12 to L2. I am having pain just above where my fusion is at, also in the low back on both sides and both sides of my hips. Right now I have three of the lido patches, one in mid back and one on each sides of low back hip area, which seem to take the edge off.

[medic1]

Is your pain, what I call, real pain, or neuropathic pain? Each needs to be treated differently. Have you seen a pain management doctor?

This is real pain. Most of it comes from being able to walk. I dont have feeling and the muscles dont work in the back on my legs. I have some feeling in my feet and feeling in my big toes. My hips are really weak and my right side is weaker than my left. This really messes with my back and hips. I have not seen a pain management doc. Up til this point everything has been ok. Once in awhile a flare up but other than that it was manageable. The last 2 weeks thought have been difficult. If the pain continues in the morning than I will call my doc.

[metronycguy]

you would be better off taking regular ultram if your not going to take it every day. once you get in the world of pain , you find out that constipation is part of the package.
colace helps a lot, so does many other things.
every med stronger than ultram is going cause a lot worse constipation.
colace a day for a start, plus some fiber should help a lot

[SoFla]

This is real pain. Most of it comes from being able to walk. I dont have feeling and the muscles dont work in the back on my legs. I have some feeling in my feet and feeling in my big toes. My hips are really weak and my right side is weaker than my left. This really messes with my back and hips. I have not seen a pain management doc. Up til this point everything has been ok. Once in awhile a flare up but other than that it was manageable. The last 2 weeks thought have been difficult. If the pain continues in the morning than I will call my doc.

A pain doc can help you deal with the real pain. It's not easy to get control over this gawdawful pain. Best of luck to you.

[metronycguy]

A pain doc can help you deal with the real pain. It's not easy to get control over this gawdawful pain. Best of luck to you.

so fla neuropathic pain is real very real, many times it is much worse than the other real pain.
medic i is you doctor a physitrist? a lot of your pain problems sound pretty complicated, due to the different ,unnatural , unbalanced ,stress you are putting on your body by walking with no functioning muscles.
you need to find someone that is going to look at

[SoFla]

so fla neuropathic pain is real very real, many times it is much worse than the other real pain.

I understand what you are saying. Indeed, neuropathic pain is real pain. It's the very worst pain. I just use the words to differentiate what might be really hurting in my body, and what the damaged nerves are making things hurt. What I call real pain is gone with a vicodin. Not much helps with neuropathic pain, for me.

[metronycguy]

Nociceptive Pain (Somatic/Visceral)
we try and get people to try and not propagate the not real pain wording, is non pain patients and too many doctors believe its all in the head.
anyone that has had sever neuropathic pain knows otherwise.
the problem with neuropathic pain is its hard to treat.
i went from my normal good day dose of 15 mgs of oxycodone a night to 50 to 80 mgs with a recent pain spike, i also added lyrica,and now adding amitriptyline to bring it to a manageable level. i believe this neuropathic pain flare up was caused by wearing a shoe, a mechanical or nociceptive originator.