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24/7 NECK PAIN vs. Depression & Drugs

Started by PainInTheButt on 07/05/2010 3:34am

Suffered whiplash in 2007. 2009 I have a C5/C6 & C6/C7 cervical discs replaced. Pain however did not stop there. From an initial relief, pain has escalated to previous levels. Chronic 6 out of 10 pain level, 24/7. Underwent multi level rhizotomy on C1/C2 & C5 to C7. Weird reaction after the procedure. Painful but numb muscles. Limit movement of upper arm, 3 weeks post the procedure the pain is back! (WTF). Been diagnosed with clinical depression and dependency to analgesics. Got weaned off the meds and treated for depression in as to not do something stupid to get rid of the pain.

My Pain Specialist/Specialist Anaesthetist now advised the pain is from C4, but apparently due to the prosthesis at C5 he is ‘not allowed by law’ to do a rhizotomy on C4. Great! Still in pain, 3 procedures later and NO RELIEF experienced. Back on analgesics, TRAMAL SR 150 twice daily and Tramal 100 as an emergency dose. Hey great going. Back on the drugs, depression worse than ever, want to put my neck in a vice for a little relief.

GOING THROUGH HELL. Is the any help out there?

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I am sorry to hear how much pain you are in. I am a police officer, so I can't give you medical advice, but as far as the drugs go, I have a detailed knowledge. I am injured with L5-S1 disc, facet problems, and RSD/CRPS in my left leg so I understand about pain. The Tramadol family of drugs are good for relieving pain, and you won't develop a physical dependence, just a psychological one and that is a small price to pay. My sister-in-law had a similar problem, and she consulted a neurosurgeon, and had surgery and now she is fine. I was recommended for a rhizotomy, and to tell you the truth, my pain mgmt doc advised against it, but said it was my only hope. There is too much that can go wrong, touch the wrong ganglion of nerves and numbness and weakness sets in, and rhizotomy's are temporary in pain relief because the nerves grow back.

Stay on your meds, especially for the depression. Some SSRI's help with nerve pain when taken in conjunction with Tramadol. Consult a neurosurgeon, and I pray you get relief soon.

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PaininTheButt:

I'm not sure what Tramal is, but if it's only for pain and not an anti-depressant, ask your pain doctor about getting on one. I was seriously depressed for months due to degeneration of motor skills and increased pain. I was put on 100 mg. (or units) of Zoloft (generic) and 5 mg a day of Abilify. I can't tell you how much they have helped. I actually feel optimistic some days! I know how that depression is -- it's like a black hole. The anti-depressant meds help you find your way back out.

Hope this helps and hope you get some relief.

Pam

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I live in similar pain. A few suggestions. Fire any doctor who is opposed to treating you with pain killers. Opoids, like Vicodin or Percocet are *safer* and often more effective than Tramadol. Dependency is not addiction. Don't confuse the two.

My second opinion is to get help with anti-depressants. Chronic pain *does* lead to depression. There is no getting around it.

After 4 years of hell I get partial relief from meditation and stress reduction. Believe it or not, stress reduction and meditation will help you more than you can imagine.

No sense complaining about crappy surgery or medical procedures. It wont get you out of pain. I had failed cervical fusion-the freaking screws came out! I too am screwed for life. I take Norco 3x/day (it is like Vicodin) and muscle relaxors due to constant muscle spasms. The muscle relaxers help the most but the pain killer are a must.

I was also on morphine for 2 years and detoxed since it was not helping my pain, it left me even more depressed, and made my personality nasty as hell. So I detoxed but had to go back on Norco since it helps. It does help but it only lasts 2 hrs at a time.

Good luck.

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Thank you for the support, it makes life that little easier. Now been placed on Durogesic patches, 25 micro grams, supposable the safer option to morphine. The Durogesic however triggered the most horrible of migraine type pains, NOTHING seems to help. Been experiencing a repetition of bad muscle spasm, pain is just not being suppressed by narcotic analgesics. OTC meds are aggravating an old stomach ulcer, Depression & pain is becoming a way of life. Medical practitioners seem to be at a loss when I do not respond to meds.
Though I am on several anti-depressants, I have the feeling that I’m loosing touch with life. My employer is also not supportive, thought that a big financial institution would be more supportive? Not a chance. I seem to be in the process of loosing my job as a Credit Manager. Where to now, is medical boarding an option?
Just so many questions, and so little answers.

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I hope that "back on drugs" includes antideppresants. Under any circumstances, there is NO relevancy to warning you about dependence on drugs used to treat pain, including opioids. Although, as you know, you can develop a physiological dependency on this type of drug, most pain managers will try to instill in your mind the thought: "So What?". You are not using them to get 'high', you require them to control your pain so USE THEM without hesitation, at least until your orthopaedic/neuro-surgeons can find an answer to your apparent hardware problems.

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HELLO ALL, HAS ANYONE NOTICED THAT DOCTORS ARE TAKING "US" (CHRONIC PAIN SUFFERERS) OFF NARCOTIC PAIN MEDS? MY DOCTOR ACTUALLY TOLD ME HE WANTED ME OFF THEM BECAUSE HE IS AFRAID OF LOSING HIS LICENSE, DUE TO NEW RULES FROM THE DEA. WHAT??? SO HE HAS BEEN CUTTING ME BACK EACH MONTH. I LIKED THE IDEA, HAVING BEEN ON PAIN MEDS FOR 10 YEARS. I WANTED TO KNOW JUST HOW MUCH WAS ENOUGH TO MANAGE THE PAIN. I'M DOWN TO 1/4 OF THE MEDS I WAS TAKING, AND I THINK THATS ENOUGH FOR NOW.(PRE-SURGICAL PAIN IS RETURNING) TOUGH IT OUT, WAS HIS RESPONSE. HE HAS BEEN MY DOCTOR FOR 6 YRS, AND WE HAD (I THOUGHT) AN OPEN AND HONEST RELATIONSHIP. ANY ONE ELSE NOTICE THIS?

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Hi,

Sorry you are feeling so bad...hang in there, there is a lot of advice on this site and I hope you find some that will be of use to you!

What works for me are BOTOX treatments. Botox is a medically recognized treatment for migraines and neck pain and if your pain is like mine (see below) it could help.

http://www.migraines.org/treatment/probotox.htm

I get extremely severe migraines (throbbing temples with a stabbing pain in one eye) and my neck pain goes like this: neck is on fire, feels like there is a corkscrew in the back of my head twisting, grinding the nerves and something is constantly biting/eating away at the occipital bones in the back of my skull, head feels like it's in a vice and it's going to explode, eyes hurt/ sunken, feels like someone poured sand in them, shooting pains down my arms, numb hands and fingers. I tried several migraine and nerve pain meds and they didn't do anything for me so my Neurologist tried me on Botox. It's been a godsend, I receive injections in the muscles of my brow, eyes, forehead, side and back of the head, neck muscles, shoulders, etc, every 3-6 months. Even though I still have pain, the Botox diminishes the full on constant muscle spasms which in turn cuts some of the pain, without the injections I could not function. It is expensive, some insurance plans will cover the cost. I am fortunate that my insurance plan does.

I agree with everyone else re: pain meds. There is a huge difference between dependence and addiction. Anyone who suffers from chronic pain and takes pain killers is dependent on them...it doesn't make us drug addicts. We have pain.. real pain..it is what we are supposed to do.

I have been on pain meds for ten years, at one point they (the uninformed masses) got to me. I convinced myself I was a drug addict so I went to rehab and detoxed off of Oxycontin and Percocet..it was pure hell.. but I got off of them. After detoxing the Dr knew I still needed something for pain so he put me on Tramadol explaining that even though it had a narcotic in it it was a nonscheduled painkiller -- the least-addictive type of drug; Schedule I and II drugs have a high potential for abuse. ie: Oxycontin, percoset. Anyway... 2 wks out of rehab and on Tramadol I had such intense pain I thought I was going to lose my mind and I landed in the hospital, upon release the Dr. put me back on Oxycontin (it works).

Opioids for Severe Back Pain and Neck Pain
Opioids for Severe Back Pain and Neck Pain

Other people have said:
BJW Sea : One more suggestion regarding pain. I've learned over the years that the more I can do to turn my thoughts away from my pain, the less it bothers me. The more I rest, the less I hurt. You will always have bad days.On those days I rest more, & I use all my weapons against that pain: meds, patches, shots if necessary(cortisone is a blessing if you have arthritis or any other inflammation) biofeedback, funny movies-whatever helps.

I get my meds from a Dr at Multidisciplinary Pain Centre, for chronic pain patients they also offer eight week courses based on the teachings of Jon Kabat-Zinn, which combines meditation and Hatha yoga to help patients cope with stress, pain, depression and illness by using moment-to-moment awareness. I'm not sure where else these types of programs are offered but check your local area clinics, hospitals, pain centers etc to see if they are available. The class I took was free of charge.

I'm not one to preach but the course I took was great, once I opened my mind to it I learned a lot, not only from the literature that was provided in class but from my classmates as well, it's where I found out about mindful meditation.

Mindful meditation is what helped me find some peace, it helped me with my depression... I'm an optimist once again : ) I'll always have pain... but now I have a little bit of peace too : ) I highly recommend it.

Jon Kabat-Zinn (born June 5, 1944) is Professor of Medicine Emeritus and founding director of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Kabat-Zinn was a student of Zen Master Seung Sahn and a founding member of Cambridge Zen Center. His practice of yoga and studies with Buddhist teachers, led him to integrate their teachings with those of Western science.

Kabat-Zinn has made significant contributions to modern health care with his research which focused on mind/body interactions for healing, and on various clinical applications of mindfulness meditation training for people with chronic pain and/or stress-related disorders.

He has written two bestselling books:
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness

Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life (Hyperion, 1994).

His most recent book:

The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness, co-authored with J. Mark G. Williams, John D. Teasdale and Zindel V. Segal (Guilford, 2007).

Hope You Feel Better....I Wish You The Best!
Mali

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I have a bit of advice on Tramadol with antidepressants that involve serotonin. Effexor, Cymbalta, Paxil, and others can cause Serotonin Syndrome if mix with other serotonin increasing drugs. Tramadol increases serotonin levels. Lyrica, another medicine commonly prescribed for nerve pain increases serotonin. Death can result if you get to much serotonin. Make sure you get all these from the same doctor and don't take extras.

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well one thing is for sure, we are all suffering with a lot of pain. I am having trouble with the anti depressants, THEY are what is making me depressed. So much so that I actually have thought it would be easier to end it all. Needless to say, I stopped taking them!!! Depressed I am not, Frustrated is a better word for it. Frustrated because the doctors are worried about "loosing their license" or are just too burned out to give a damn. Did you ever think about how easy it is for someone who just wants the drugs for the thrill of it to get them. I actually heard someone in a checkout line talking about how easy it was to get "his doctor" to write a prescription for him. I'm thinking maybe if we scare the doctors we'll get better results. They will write a prescription or fill out our paperwork just to get us the heck out of their office. (He had just gotten out of prison, as he so non-challantly informed everyone). Unfortunately for me we are having a hard time finding any medication that doesn't make me violently ill, finding a doctor who really cares enough to treat me for the real issue and not depression, getting into see the specialist without waiting 6-7 months in between. When I have a "flare-up" that is the time I need to be seen, not 5 months later. I am learning that I need to be a real strong advocate for myself. I actually made my mind up that when I go to the doctor or specialist, if they seem to blow me off or are preoccupied I simply say "I'm so sorry I inconvienced you today, it is quite obvious that you have no real interest in helping so I will just leave now, however, please don't bother to bill my insurance for this visit as you did nothing for me that you should get paid for and I will make sure the insurance commisioner is aware of this so there is no question as to why you shouldn't be paid". You'd be surprised at how they can turn on a dime and become the most attentive physician you've ever seen. The thing is we have to stop letting them treat us like they are doing us a favor, we are doing them a favor by "employing" them as our physician. When we work for our employer, we are expected to "perform" our duties, well they should be expected to do something for us, that is what they are getting paid for!!!

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A couple pointers I found out by way of experience.
--The first Anesthesiologist/pain management doc I saw was big time into procedures. This is where the big money is at. I had a rhizotomy done on two different levels at two different times with little if any relief. They are for facet disease and do nothing for disc problems. Even if it does work the nerve regenerates in 6 months or so and you are back to square one.
--Tramadol does have modest effect on the mu receptors, the same as opiates but it's primary effect is to increase serotonin. SSRIs also increase serotonin. To much and you can end up in serotonin syndrome which is dangerous. It is only effective for mild to moderate pain. For me it had side effects that were not tolerated.
--If your pain management doc does not want to treat honest, sincere pain with opiates, get another doc. Vets treat or pets better than some docs treat people. Controlling the pain goes a long way toward alleviating depression.
--Do not beat yourself up over having to take opiates for pain control. There is addiction and there is dependence. The two are different. Granted, sometimes they occur in the same patient but mostly they don't. Before my surgery, I was on 75 mcg Durgesic changed every 48 hours and Percocet 10/325 3 times a day. Four months after surgery I had taken myself off all opiates. There is no need to be ashamed of being dependent on medicine that improves your life. Diabetics are dependent, heart patients are dependent.
--Knowledge will be your key to getting a more permanent fix or at least making life worth living.

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I personally felt the drugs and pain that I had long term caused my depression, especially the gabapenten. I got off ALL my stuff except for ibuphropen but then got the hives and they wanted me off it so just tylenol for me. I HAD to take the pain meds a few months after my surgery or i would not have made. it. I take prozac for the depression. My pain is so much better so that helps, pain wears you down as it did me. My new look on life, because my surgery was successful one year ago, it took 10-12 months to get my life back, I got off the pain meds accept for tylenol, and I focus on what I am grateful for in my life and I try to quit feeling sorry for myself because, there are may things because of my surgery and employment to feel crappy about. But putting things into perspective is making my life better. focus on what you are grateful for. Best of luck to you. :)

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Maidhealthy...you go girl. I am going to try that next time I get a physician who does not treat me with the respect I deserve. I feel that sometimes I let the Dr's get away with disrespecting me because I need them and my meds, but you have a good point.

My anesthesiologist/pain management doc is not big time into procedures and actually advised against a rhizotomy, explaining that the amount of pain I would have to endure during the procedure would not outweigh the benefits of the procedure, another Dr actually tried to force me to do it. In the end I declined and so I continue with Botox. Thank goodness Botox and meditation is working for me.. so yes I am thankful for that. I have come to terms with the fact that I will most likely have to take pain medication for the rest of my life and although I am not happy about it, I have accepted it as part of my life now. I have also come to the realization that if people accuse me of being a drug addict, so be it I'm not going to let it bother me anymore. I am not a drug addict nor have I ever been one contrary to popular belief and for those of you too ignorant to understand chronic pain and the people who suffer well_________ (fill in the blanks with the appropriate words), because you know what I don't care anymore what you think.

We all feel sorry for ourselves sometimes, it is normal for people with chronic pain, hell even people without pain do it so don't beat yourselves up. I have found that trying to have a positive outlook helps, that said........ it isn't always easy to do.

For those of you who have neck problems I highly recommend Botox..plus if it doesn't work for you it wears off in 3 months and no harm done..well...wait ** make sure you have an experienced Dr injecting the stuff...after all it is poison ; ) lol!

I wish you all less pain and happiness and hope that throughout the day, everyday, you may find at least a few moments of peace.

Mali

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Hi , glad i found this site. Nov.17 2010 I had c-2&3 fused. Been in pain since whiplash accident ion July29 2008 . thinking about getting therapy and being put on some anti depressants. Have gone without painkillers , because im a recovering addict . But the pain is catching up and the painkillers when taken properly do help. after surgery so far pain has been worse . although no more tingling up the side of my face when i turn my head. and my hand does not start to shake when looking in a certain direction But the fricken pain is making me lose weight and wont stop. Im starting to keep open mind to painkillers. Without them i think im turning into a bitter thinking and feeling erascible bastard! 3 girl friends in 6 months bladder cancer on top of this . and a really slow home building economy. will confer with my psychologist about seeing a psychiatrist for some meds! ive been through all the pt and trigger point injections and facet injections to no avail the pain marched right through it all!

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Here's wishing all a very Happy New Year! As usual, everyone has good intentions for the New Year early on. Here's hoping you all can continue to keep your chin up throughout the new year and not just in the beginning. That being said, here's to us sufferers.... what a difference taking a stand for ourselves can make. Remember, YOU ARE IN CONTROL!!! It's your body, you live in it so you know what you are feeling. Doctor's are working for us not the other way around. I know they are tired and over worked but that is not your fault, that is what they chose to do. Make sure you stand up for yourselve and get what you deserve! Your the only one who will. Take care and keep the FAITH!

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does anyone know of a website we can talk and ask questions about are neck issues? Compare notes etc.

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In regards to the post from the user who stated that his doc is reducing his meds due to new federal guidelines, the doctor isn't lying. As a nurse, I know that the regulations are changing. Many doctors are getting nervous about prescribing narcotics. It is getting more difficult for them to prescribe certain meds. My advice, see a pain management specialist.

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I feel for you and your chronic pain. It's so miserable. I know that for me, relaxation helped a ton with my neck pain. My physical therapist in Boulder has this helpful video -http://mindbodyphysicaltherapy.com/2011/01/walking-meditation-for-calming/
I don't know if you lean this way, but Ialso found a lot of comfort in connecting to Spirit, whatever that means for you. It's comforting to realize you are not alone and there are things to be learned from this trauma.

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You may never be PAIN FREE,,,, I have had 3 fussions and still in pain. what you want to look for is quality of life ,,, do you still drop things and can you sleep, walk, play with your kids,,, and are your hands going numb,, if you can do some of the things I said here,, and can live with the pain as a side effect you may want to consider that. if you can't talk to your doctor heart to heart tell them what you can and cant do,, in combination with what they can and can't do.

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Neurontin(Gapentin is the generic) caused my sister to have suicidal thoughts. She was prescribed this to help with the nerve pain of her MS. Fortunately, I have not had the same problem. Anti-depressants do help somewhat with the pain. Finding the right one is the trick. I do have severe depression. Was on Zoloft for years. Recently changed to Effexor which seems to be more effective. Have noticed a slight decrease in pain which has improved my range of motion some. It is all connected. Less pain =increased movement=less pain.
Talk to your doc. I am very fortunate to have a great family doctor and pain management specialist. I still have alot of pain. I know it will never go away completely. But the 'dark thoughts' are gone.
Good luck!

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Now almost 6 years since 3rd lumbar 9-hour procedure (fusion of L1-2, L3-4, L5-S1 with hardware) following years of major pain including dependence on wheelchair and scooter for many months, heavy opoids and inability to lay down-slept in lounge chair or wheel chair. First 2 fusions done via XLIF and 3rd via AXIAL procedures(goggle them-wonderful advance in lumbar surgeries). 4 weeks later i was walking again; still had pain but relatively mild and needing low doses of oxy. 2 years later, due to continuing degenerating spine, used same surgeon who did 'hammer & chisel' procedure and had to fuse C2-C6 with rods and screws! Now have almost NO head movement and developed severe occipital neuralgia requiring major increase in drugs via anesth/pain management doc in specializing group practice. they keep close eyes on drug use with monthly urine testing & 'bring in your latest prescription bottle with label' to make certain i am not selling my drugs! I have NO problem with them insuring their prescriptions are being used correctly and expect them to remain in practice. However, l lost more than 25 pounds and had no interest in food or eating. very frustrating to my DW who claimed she took on MY interest and was eating too much!!! My doc finally put me on antidepressants. Started with Cymbalta but i had no benefit from the drug and just about every side effect and discontinued after 5 weeks. He switched me to Elavil(generic), low dose, gradually increasing to 20mg/day and. lo and behold, my appetite has returned and i am no longer thinking about ending things... Daily pain varies from about 4 up to 8 on scale of 1-10, often depending on how foolish i am to try doing things that i KNOW i should not do!.

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