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Moved, new pain mgmt

We recently moved across the US, in our previous location I saw an amazing pain management practice for just over 5 years; with them we found a great pain management regime. I was on the fentanyl patch @ 25mcg with Tramadol (two/day) for the pain and zanaflex 4mg for muscle spasms. I got regular trigger points, epidural steroids (until they stopped giving relief) then moved onto RFA's in my c-spine for C-2 through C-7 disk herniations. I was in a motorcycle accident where I was thrown and landed on my head (thank goodness for helmets).

This move brings us back to where we previously lived which allows me to see the same pain management practice I saw 5 1/2 years ago. I've been dealing with this pain and pain management for 15 years, during this time I've tried OxyContin, Oxycodone, Nucynta, and Norco. I am unable to tolerate NSAIDS due to severe GERD/Duodenitis and Ulcerative Colitis. I use a TENS unit, lidocaine patches, Bio Freeze, side sleep pillow, adjustable bed and a Theracane for muscle knots/spasms between trigger points. I've done countless series of PT with no change.

I finally got into pain management here this past week. Upon sitting down with the NP she let me know they do not rx the fentanyl patch. I told her I understood (I knew my meds would be changed as this isn't my first move dealing with pain mgmt), then she questioned the use of Tramadol for b/t since I've had serotonin syndrome twice & I'm on Effexor. I agreed with her on that, as my primary doc has wanted it changed for some time but my previous team didn't get why.

The pain mgmt doctor came in and reiterated they do not rx the patch. He seems like a great doctor but between the two of them they didn't seem to have any idea what to put me on. I ended up leaving with a script for 5mg oxycodone 4x day, a script for 1mg clonidine patches (for withdrawal symptoms) and a sample of Flector patches (yes, I know they are a topical NSAID) and an order for a new MRI.

I'm not having any withdrawal symptoms but I'm in an excruciating amount of pain! I looked up the morphine equivilant & what they put me on is not even a quarter... Has anyone else come of Fentanyl to go on an oral med without such an increase of pain? I intend to call for a rx of the Flector patches as they seem to be more effective than the oxycodone.

I have all of my records from the previous pain mgmt where I was given the genetic test for how I process meds so I'm going to look through them to find the results...maybe that could help!

Thank you!



  • Hi Annaestia

    Welcome to Spine-health

    I have added two links below to help new members with information on this very informative site.

    It sounds as if you have extensive support from outside equipment you use in relation to medication. You may be interested to read 'The Blend' which was written by Ron Dilauro.

    Welcome to Spine Health

    Spine-Health Moderator

    L5/S1 herniation Apr 2013
    nerve root injections Oct 2013
    L5/S1 discectomy Jan 2014
    L5/S1 nerve roo &, facet joint injections & edpidural Jan 2015
    L5/S1 revised discectomy, L4/L5 discectomy & Wallis Inswing Stabilisation L4/L5 May 1st 2015
    L4-S1 TLIF with decompression June 2017
  • That's one heck of a shift in medication! Welcome to the "Opioid Crisis"! Physicians are running scared and some are now under treating pain.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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