Pain Management?

So it is now over three months of the headache and neck pain from Hell.  It came out of no where and doesn't seem to be going anywhere.  I have some better days and some worse days.  So far I have: had x rays, CT scans, MRI's, seen my PCP, a neurologist, pain management doctor, physical therapist, acupuncture and massage.  I have taken just about every non NSAID med there is and some that were NSAID when desperate, with Prilosec (it didn't help so I didn't do it again).  I have been given various reasons and no reasons for the pain.  The physical therapist I just saw said it is because my neck is unstable due to age and the ligaments are shot, which also explains my low blood pressure.  She had a great explanation that made a lot of sense and gave me an exercise to do every day which she said I would have to do for the rest of my life.  She said that is why it gets worse when I exercise.  My pain doctor gave me Topamax, which I am taking, increasing the dose every week.  And the pain is worse then ever.  There are days I can't do much of anything because the pain is so distracting and other days I can function almost normally.
My routine is basically I get up, take some Tylenol with caffeine, which does nothing, later I take regular Tylenol, which also doesn't do much and by the late afternoon I usually give in and take an Oxycodone which sometimes helps for about half an hour or sometimes does nothing.  I usually don't take more then one a day, if that.
My pain doctor's plan of action, that she has been talking about for the past few months, is for me to get Botox or a nerve block but nothing has been scheduled.  She wanted me set up with PT first and a sleep study, which is scheduled next week.  
I am just tired of the pain.  My kid is tired of hearing me talk about the pain.  In fact I think everyone around me is tired of hearing about it.  I'm tired of hearing about it.  I am trying to not let it control my life as much as I can but it's hard when even when I try to do things all I am thinking about is how much it hurts.  What I'd like to know is if anyone has any advice for some kind of medication or treatment that will at least make the pain bearable for more then half an hour.  I mean, if the big guns, Oxycodone, only helps for a little while, is there any hope?  Is it maybe because of the way I absorb it now?  What about some kind of pain patch?  I keep forgetting to ask about a TENS unit, would that help any?  What are some ways to treat pain on a long term basis?

Ask about steroid injections and about a medial branch nerve block.  Whether or not those things would help depends at least in part on where the pain is originating and what exactly is causing the pain.

Have you tried a neck brace?  Like a soft collar?  If the neck is unstable, that might help.

Are you on antidepressants or have you tried them?  Sometimes antidepressants help with chronic pain.  It's not a matter of the pain being caused by depression, although chronic pain can cause depression.  But it's believed that some of the same neural pathways in the brain are involved with both depression and chronic pain.

Have you seen a chiropractor?

I know what it's like to have constant pain for a long time, because I've been dealing with daily pain from my lower back for well over a year now.  Unfortunately, when you have pain like this, it often seems to take a long time to figure out what to do about it and to find something that works.

Those were all options she talked about.  I might try one of those soft collars.  That may help.
I have been on anti depressants for years and I currently take Cymbalta, which is supposed to help pain.  I would love to see a chiropractor but I just don't have the money.  I know someone who is a chiropractor but I hate to ask for any special treatment.  I think it would help but things are so tight right now I just can't see it.
What bugs me is no one seems interested in finding out what is causing the pain, only in treating the symptom, which is good but I have a feeling that if they don't know what is causing the pain they won't be able to fix it.

The MRI didn't show any problem?

It took a ridiculous amount of time to get my back issue diagnosed.  The first specialist I saw diagnosed me with degenerative disc disease, which my current specialist says I do not have.  But I do have a herniated disc, which somehow the first specialist managed to miss on my MRI.

I would suggest cortisone shots in the affected joints, PT, acupuncture (provided you've had the required MRIs/Xrays to role out other causes). Works great for my rotator cuffs and SI joint.

I am a MSN so I have experience here.

Good luck.

It showed mild degenerative disk disease and a mild herniated disk but neither should be causing me significant pain according to my doctor.  She said that most, if not all people my age would show the same things on a MRI as a natural part of aging.  So, at least at this point, other then some theories that aren't concrete or proven by any tests, there is no known cause for the pain.

I once had extreme neck and headache pains, and couldn't turn my head and I was going berzerk! Then I begged (and pleaded) for a soft neck collar, and that turned it around. After months of pain, the support of the neck collar turned teh corner of the pain and allowed me to get over that.

Now I still have chronic daily headaches (today was a good day, just a mild headache all day)... and of course my butt-pain, plus some neck pain. I'm getting another occipital nerve block and while my spine specialist was not sure it would help with my neck, it really did help with the muscular part of my neck pain in February and March... because the headache pain was causing me to tense my neck muscles, leading to a feedback loop of pain. The stiff neck and pain went away after the occipital block and it really helped. I'm getting another one on Monday (he focused on the one side, and the side he didn't focus on still has more pain).

Sometimes (I've heard, don't know) a single chiropractor visit can make a difference. In the anecdote about my neck pain, I saw an ... I can't remember the name of the specialist... sort of a chiropractor but it had ortho in the name .... he was the only one employed by Kaiser at the time and he was moving the next week, so his one "adjustment" to my neck helped.

Even though I know that I don't get as much from it as someone with a normal digestive system, I do find that the oxycontin helps better and longer than straight up oxycodone. As part of pain management.

Likely you're having issues of pain caused by the pain, and it's a bad vicious cycle. If they haven't offered any nerve blocks, or cortisone injections in general it seems like they're not trying too hard.

I knwo some antidepressants can be taken in concert with others... perhaps you might benefit from taking Elevil (amitryptaline) which I'm takign and it really helps my pain levels at least the neuralgia ones, not the headaches. I found that changing to nortryptaline helped my headaches but not everything else, so if it was ONLY for the headaches, I'd have switched. but the things the Elevil does for me are so varied, that it wasnt' a goodd enough switch.

Pain is so individual, and so difficult to treat and to eliminate the source of pain.

Isn't it amazing someone can look at a scan, and tell you how much pain you shouldn't be having. When I ruptured a disc in my neck years ago, I had a severe flare up that caused my entire neck to shoulder joint go into a nonstop spasm. The only things that helped me other than a heating pad was traction to my neck, and muscle release massage done by my physical therapist. I have to admit, that PT was worth her weight in gold, as she knew by my symptoms the best course of treatment. Perhaps a fresh eye by either a new PT, or a chiropractor can be helpful. So sorry you are in such pain, I hope you get relief soon.

I agree!  It's not like pain shows up on a scan.  There's not a test that shows how much pain someone is having and I don't care how much pain my doctor thinks I should have, apparently my body didn't get the message.

I'm so sorry you are having chronic pain like this. I have SI joint dysfunction (very low back) and when it has flared up, it's excruciating. Getting cortisone shots helped immensely to alleviate the horrible inflammation and the relief has lasted years now. I also saw a 2nd PT who gave me new exercises and I think that helped as well. If I were you, I would ask your friend who is a chiropractor to see you, as well. I have heard they are not that expensive, even w/0 insurance. Maybe they would cut you a deal. Don't feel bad about it; they may be more than happy to help you out. It's worth a try. But, yes, the steroid injections were what I believe has given me long term relief. Good luck!