Chronic Pain

I'm sure there are HUNDREDS of posts asking this exact same thing, but hear me out. I have had surgery on my back for the removal of a pilonidal cyst on my tailbone six (count em, six!) times. Currently I am at school for horn performance very far away from home, had surgery a month ago, and the pain has not subsided one bit. I understand this is a chronic pain board and I don't mean to infringe, but given my experience with recovering from the other surgeries I do have a feeling I'm at least in for a longer haul this time in terms of dealing with discomfort than I have been before. (This was a more minor surgery than some of the others and yet the pain has lasted twice as long with no change in intensity.) Fortunately, the surgeon was very responsive to my needs in prescribing and doing all he could to help but a few days ago decided it was best for me to see a pain management specialist. Currently I'm on a very high dose of oxycodone imm release (not percocet or a combination medication) per day and by this point my tolerance is starting to get in the way of its effectiveness. I'm not searching for real medical advice here, I will obviously speak to the pain management specialist frankly and honestly but that said... what have you all found to be the most effective in your pain treatment? I am lucky that I have had a lot of experience with opiate based analgesics (legitimate medical experience, that is!) and know they tend to work well without making my mind too foggy. Fentanyl is the only one I react badly to and I have in the past been on oxycodone, hydrocodone, codeine, and one other that I can't remember at various points for minor and short term pain, but especially the past year and a half for all the surgeries. It's been so frustrating as a first year college student feeling like I can't concentrate because of all the pain I'm in and more importantly, I can hardly play my instrument due to the location of the pain (lower back, as I mentioned, my tailbone) and that's what I'm here to do. Any words of wisdom would be greatly appreciated; this is the first time I've ever had to deal with pain for such an extended period and the first time I've ever worried about how long that period might last....

I wish there were a simple answer to your question. Because everyone's body chemistry is different, what is most effective for one person may not be effective for another.

Often when you've developed a tolerance for one medication, switching to another type of pain reliever can help. For example, if you've developed a tolerance to oxycodone, switching to morphine might be effective. I'm afraid it's pretty much a matter of trial and error to find which medication, or combination of medications, works best for you. There are still quite a few different options available that you haven't tried yet, so hopefully your pain management specialist will be able to find the best one for you soon.

In addition to opioids, you might also want to consider a complementary treatment like acupuncture. Acupuncture can be very effective in relieving pain. There have actually been cases of surgeries done with no anesthesia – just acupuncture – and the patient felt no pain. Here's some more information in case you're interested: Treating Pain with Acupuncture

Good luck to you! I hope you're able to find adequate relief soon.

Karen

Thank you for your quick reply. Of course I realize everyone's body chemistry is different, I was mostly curious about what people have had the most success with (though I also realize there is no simple answer to that question, either.) The first thing I am going to talk to the pain management specialist about is switching medication. As you said, I know that while they're closely related, all opiate-based painkillers are still different enough drugs that if a tolerance is built to one, another may be far more effective. Should that not work, localized therapy is the next step. The reason I'm so focused on finding a helpful medication right now is that I'm currently at college without a car (though luckily my best friend has one) and the pain management specialized is roughly 20 minutes away. Up until a few days ago I also had to go to a wound care clinic every day of the week and that was truly hell for my school schedule. If the specialist can find a medication option for me it would be much more convenient than having to be at the mercy of someone else's schedule, at least for the short term. I really need a break after every day being so chopped up by wound care- I need to go to all of my classes for a while as a sign of good faith. I'm lucky all of my professors were VERY understanding, but like I said... I'm most concerned about finding some pain relief that isn't dependent on me running all over the world. Anyway, thanks so much for the information and thank you very much for the well wishes.