So I saw the back specialist again today.  He informed me my MRI looks "great" and "isn't that good news."  Well, it DID show degenerative disc disease so I'm not sure what's great about having that, and no, it's not really good news since it means we don't really know why my back hurts all the time.

He told me he doesn't know why I have pain since my MRI looks so good.  I tried to point out to him that I usually have a fairly high tolerance for pain.  I'm sure he hears that all the time, but seriously... I had a natural childbirth, 17 hours of labor and did not feel the need for any kind of pain meds to cope with the pain.  I do not take pain meds often.  Or ask for them often.  My back hurts.  A lot.

He said he could try a medial branch nerve block if I wanted him to but he couldn't say if it would hel*****t.  He said there is probably a 50% chance it would help and a 50% chance it wouldn't do anything.

He told me, twice, that NSAIDS would really help.  I reminded him that I cannot take NSAIDS and he informed me that "that's a problem."  Well, gee.   What am i supposed to do?  Try to find a bariatric surgeon to reverse my RNY so I can take NSAIDS for my back problem that the MRI says I don't have?  And ask  Medicare to pay for that?  

I asked if he could prescribe something stronger than Vicodin, since it isn't doing the job, but he said he does not prescribe stronger stuff, I'd need to go to a pain management specialist for that, but he doesn't recommend that since all they would do is give me drugs.

He said maybe I just have weak back muscles (and I guess for some strange reason the physical therapy I did in the past didn't strengthen them) and that a back brace might help.  So he had the medical assistant get a brace and put it on and she asked me if my back felt better.  Apparently if it was weak muscles, the support from the brace should have made it instantly feel better.  It did not, and the doc suggested I get the brace anyway and see if it helped after I wore it awhile, but since my insurance would only cover 80% of it and my portion would be over $80, I decided not to.  I mean, if it had helped right away like they said it should have, I would have gotten it, but since it didn't, I thought it would likely just be a waste of money.

So then I got in my car and cried for a while because I just feel so discouraged, and also still really scared about how much trouble I am having with just basic daily activities because of the pain.  I wanted to call my partner but couldn't because he is at work and can't get calls at work, so I called my mother and she did not help.  She told me multiple times that accupuncture "might help" even though she knows I can't really afford to try it anyway, and then told me she does not think I should see a pain specialist or get anything stronger than Vicodin because then I will get addicted to it.  So I guess she thinks I should just be in pain all day, every day, for the rest of my life.  Which is what I am afraid is going to end up happening anyway.

I have been at my sister's for two weeks and planned to drive home after my doctor's appointment, which would be about a 3.5 hour drive except it was rush hour traffic so it was going to be at least four hours.  I made it a little over two hours in the car and my back was hurting so much and I was so upset from everything that I could hardly stop crying.  I finally got off the highway and found a cheap motel room for the night.  Then I took Vicodin and Flexeril and my anxiety meds.  And ate French fries.  Well, I went to Wendy's to get a baked potato and they were out of potatoes.  And that was the only thing right next to the motel and I was not getting back in the car.

Now I am going to lie on the bed and be dopey from my meds.

Have you had any injections for pain in the back?  I had back pain and finally went to a pain mgmnt specialist and now get injections.  There's nothing to the ones I get but it sure relieves the pain.

I've had epidrual steroid injections twice.  Both times it helped for about a month, but apparently they usually last longer than that and they will not do them very often so that does not provide enough relief.

I am so sorry you are having to go through this.  I have the spine of a woman 30-40 years my senior with quite a bit of degeneration and it is very painful.  I am fortunate that my weight loss and an amazing chiorpractor have kept my pain in check.  I hope you are able to find something that will help soon. 

I am so sorry you are going through all  this crap, and your cost of a back brace...hell no , if you have weak muscles a back brace would only make them more weak, if you need a brace your PCP might be able to perscribe one and a lesser cost.
While I agree accupuncture may help , if your insurance doesn't cover it , maybe your mom would want to pay for it
Maybe you need a second opinion close to home?
I have been using the liquid Lortab because it is fast acting and in between take  Norco which is stronger than vicodin, and I can function fine during the day and I am NOT addicted. I see a physiatrist , which I think is a sports medicine guy ( he is 12 ) and he is wonderful uses ultra sound to guide the needles and does it in his office instead of a surgery center.
I wish we lived close so I could help you find the right doc, the one you have may not be it

I"m gonna get a second opinion.  I think the Cleveland  Clinic has a back pain center or something like that.

I am so sorry that your appt with the back specialist was not more productive.  Did he have ANYTHING to offer other than the brace, NSAIDs or a pain specialist?? Is there any possibility that it is nerve related (which would not show up on an MRI)?

Although I understand your mother's concern about addiction, I also know -- from last year's abdominal pain and my ongoing knee pain -- how miserable life can be when you have constant pain that makes it difficult to just get through the day.  If it takes something stronger than Vicodin to help you, then that is what it takes... at least until they can find out what is going on.  

I also know how frustrating and almost lonely it can be to be in pain and not know why, to have doctors that don't seem very concerned about the pain, and to not have much helpful support from family.  You DO have us, though, for whatever that is worth.

I hope you feel better in the morning.

Lora

Well, he offered to schedule the medial nerve branch block, which is an injection in the back that would interupt the pain signals from certain nerves if indeed those nerves are where the pain is coming from.  But he said he thought there was only about a 50/50 chance that woule help, and it's difficult for me to arrange because I can't drive myself home from that appointment.  Although I would find a way to work it out if I thought it would help.

I'm gonna get a second opinion.

I was thinking of you as I left his office and the pain you had in your stomach and how hard it was to get someone to actually do anything about it.  That just drives me crazy.  And it is hard to get through the day.  And the night, for that matter, since the pain wakes me at least six times a night.  It's been nearly six months since I have had a single night I was not woken many times by pain.

Somewhat ironically, I had my 5-year RNY follow up today (a couple of months early, because of the surgery I had last year AFTER my yearly appt) and the surgeon commented on how good I looked and asked if I had any more belly pain, and when I said that I had not had so much as a twinge since the muscle healed from the open surgery, she said "I'm so glad we decided to take care of that"! Huh?!?  After everything I went through trying to get someone... ANYONE... to go in and FIND the problem that didn't show up on any CT scan... and after she only relented and offered to do it after my PCP put me on disability until I could keep the Cleveland Clinic appt (or get her mentor to agree to do surgery locally)!  She made it sound like she jumped on the opportunity to help me out! All I could manage to say was "me, too".

Although now that I think about it, maybe that was her round about way of apologizing for not taking my pain seriously for so long...?  She would NEVER just come out and admit that she was wrong. Not her style.  Hmmm...  something to ponder.

Hopefully you will find someone to help, too.

Lora

 Kelly, I am an RN with 32 yrs of experience. IT IS TIME TO MOVVE ON!! There is no better place near you than Cleveland Clinic. Start researching GF and move on from your mother's BACK DOCTOR! You should not be in this amount of pain. and If you are without a known cause, it is time for a pain specialist. YOU WILL NOT GET ADDICTED!

I'm gonna get a second opinion and was thinking of the Cleveland Clinic.  I'm not that concerned about addiction, really.  I mean, I certainly don't want to get addicted to anything,  but I'm more concerned about being on heavy duty pain meds that would make me unable to drive or things like that.  It's my understanding that using pain  meds as prescribed when you have a lot of pain does not usually lead to addiction, although I'm sure it could in some cases.

My PCP, while not a pain specialist by any means, is acting as my pain management doctor -- This is an important service he provides for me -- Particularly as long drives to get prescriptions from the nearest actual pain specialist would entail a drive of 100 miles round-trip.

One thing that my PCP said regarding the narcotics was that there are two issues involved with them. Dependence and Tolerance. He said that addiction -- as in abuse of the meds -- isn't likely because I am taking them for a known reason. He said if I stop taking them, I'll hurt, because I'm taking them for pain, and without them I'll feel the pain. More insidious is the "Tolerance" issue.... in that as the body becomes more and more used to the narcotics, they have less and less effect. I can tell you now that the meds I take today -- four years ago and I'd be a mind-muddled mess and unable to function .... but I've had issues with tolerance, so the pain meds the way they are now don't really affect me cogntively like they would have when I first started. I need to have a conversaton wth my doc about the background meds, upping them, or increasing the frequency so that they are more useful.

In any cases, I just wanted to point out that my PCP was far less worried about addiction than he was about tolerance and the side effect of pain if I come down off the narcotics.

One of the things that used to bug me.... mum was dying of cancer, and the docs kept saying, "we don't want to give her too much pain medicine, that will get her addicted." I was like Really? really? she's going to die in the next couple of days, and you're worried about addiction? Made me want to smack a few docs upside the head. Idiots!

I wonder if the gel injections would help with your back ???SUPARTZ, . Pain patch? Pain pump?
Not all "pain specialists" are the same , I took my daughter to one ( because she couldn't drive) , we went in and she was USING A WALKER , pale , unable to stand straight , looked like death warmed over and the "doc" jumpt on the ground and told her she needed to do yoga and he showed her all these things she should be doing...I said what the F???? she can barely breath without passing out and YOU want her on the floor??? fat chance, she went to him a few times and then we fond someone else.
Just because you have a DR. in front of your name does not mean your aren't  an idiot.
My PCP passed me off to the phisiatrist - sports/pain management , he thought I would be mad at him and I told him I would go to ANYONE who would help me, and I love my 12 year old doc, I am not out of pain , but I am so much better than I was !!!

My mother also suggested I try some yoga.  I've taken yoga classes in the past.  I cannot possibly imagine doing it now.  I mean, I can't bend over.  If I got on the floor, someone would have to help me get up.

I actually damaged myself more going to a yaga class.!!!! I do think strengthening your core muscles is very important ,  even if it is a struggle

I see  a pain management doctor for back and hip pain.  She helped me ween off all my nsaid's when I told her I was having bypass surgery.  
I asked her what should I do if the intense pain returns she told me there are other meds that I can take that aren't nsaids that could help control the pain.  
I right now am not in intense pain although I am in pain daily.  I use Lidoderm patches when it gets above tollerable and those help, but as far as intense pain, I know that fentanyl patches have worked for me before and I am sure I could go back on those again if an oral med just doesnt work.  
If your ins. covers seeing a pain management doctor, I would recomend it. (might have to get a referal from the doctor you just saw depending on what ins requires).
They dont all shove oral pain meds at you and if they understand your cir****tances, most are willing to work within those restrictions to find something that would help.
I plan on using the fentanyl patches again if pain gets out of control.
I hope this helps in some way. I really like my pain management doctor.
She helped me go from 85% bed ridden to now where its barable (I have a high tolorance also).

Leisa

 PAIN MANAGEMENT SPECIALIST PRESCRIBE IN A WAY FOR YOU TO CONTINUE TO LIVE your life daily. That is the ultimate goal. Go for it!

He doesn't sound like he's very empathetic. One of the things that really helped me was to see an orthopedic pain specialist. Believe it or not, even though he did prescribe me pain meds, To his perspective, he was there to try to alter whatever was causing the pain, to help the body to heal, and to move the patient towards independence from both medicines and from seeing him. He was very much an action man, and immediately he focused on the cortisone injections as a method of reducing the tailbone swelling and ultimately reversing the trauma that caused the overall pain.

In my case that didn't work out as you know, and I ended up having it removed. But I was truly impressed with the Pain specialist in that he didn't get me on a pain contract, and he didn't even begin to go to a pain-medicine mentality in the entire time I saw him. Like I said, he gave me pain meds, but it was never as part of pain control and meant to be a permanent thing. In fact, once he realized that nothing that he could do would eliminate my pain, rather than just saying "Okay, let's get you on a pain contract and dope you up for life," instead he said, "Let's get that sucker out," and he actually had to do the shopping around to find a surgeon who would remove my tailbone.

So my point is, an orthopedic pain specialist might be able to look more clearly at your issues and discuss methods of helping you to conquer the pain. Yes he or she might give you pain meds to help in the interim, but there is Radio frequency Ablation, the nerve block you mentioned, and they even have some fancy things they're developing using Botox of all things.

Addiction is the least of your problems if you are having severe pain.  I'm glad that you are getting a second opinion.  It sounds like this doctor had a very small bag of tricks.

I'm always amazed that doctors attempt to predict pain by looking at MRI's.  While you can see orthopedic damage with and MRI, you cannot actually see pain.  It's such an obvious concept that I'm always a little surprised when doctors try to tell me that I shouldn't be having so much pain from my knee damage.  It's always such a clinical opinion, too.  I'm like... so I can't climb stairs, but I should be able to?  How does that help me?  A few years ago, I had a bumper fracture of my left fibula (left knee, rear quadrant) when an SUV ran into me as I was crossing the street.  I went to an orthopedist who said that although they could see my fracture on the MRI, they thought that my pain was referred pain from some degenerative knee damage I had.  When I pointed out that the pain was in one knee only at the site of the fracture, I got a blank look.

Oh well... one of the reasons I had my RNY was to delay the need for knee replacements.  Even the weight I've already lost has helped immensely, BUT the knee fracture still hurts all the time (especially when it gets rainy).  

I'll be thinking of you and hoping you find some relief soon.  

Just wanted to chime in- I work in the addictions field, and ANYONE can become addicted.  Most of the women that I work with became addicted to opiates for legitimate pain. The two hallmark features of opiate addiction are tolerance and/or withdrawal.  (This would qualify someone for a DSM modifier  "with physiological dependence."  Once someone becomes dependent on a chemical, that's where the addiction behaviors start.  Dependence and addiction are not that far from each other.  Many of the chemically dependent women that I work with have a history of drug seeking, which may be what your doctor was concerned was happening.  And believe me, you would rather find out the root cause of the pain than become addicted to opiates.  It is a hellish addiction.  Think the movie "Riding in Cars With Boys" with Drew Barrymore and her husband becomes an opiate addict.  You won't die from opiate withdrawal, only wish you would (it's that bad). By the way, hydrocodone (originally marketed as non addictive) is simply synthetic opiates, many people say are more addictive than heroin. Lots of clints most recently addicted to Opanas (another synthetic opiate).  Not to scare you, but just be careful.  It CAN happen to anyone.