Chronic pain in from osteoarthritis & stenosis

You need to find a pain doctor, not your regular doc. The backlash to the opiate crisis has caused the DEA to crack down on opiate prescriptions, so regular docs are nervous about prescribing them. Pain doctors are not as nervous on that issue. I mean no disrespect, but given your age and, as you said, your final days, I would think a pain doc would be ok with prescribing an opiate.

The person is too old to receive any narcotic meds that might harm him unnecessarily due to the liability on the doctors part. Yes it’s unfortunate that he cannot find adequate pain control. I have to ask how long has he been seeing his doctor as a patient? He may also consider asking his doctor for a referral to palliative care for his pain control and end of life planning.

You need appropriate pain meds from a pain med doc. Tylenol will not cut it. Can you try Celebrex in the meantime - it helps with inflammation and pain. Maybe 100mg 2x a day. Have you ever used lidocaine patches on low back - numbs the pain a little.

Some people swear by a combo of Tylenol and a Nsaid…there’s a new drug—Suzetrigine by Journaux—stronger than otc meds, not as strong as opioids.

@nycmusic Thank you.

Thank you. Will try this.

@nycmusic Journavx does not work for chronic pain. I tried it. As I understand it, Journavx works on acute pain pathways, which are different from the central nervous system pathways chronic pain sufferers develop.

@jcoleary. Only available with a prescription in Canada.
Our healthcare system seems to enjoy seeing people suffer.

@jcoleary thanks for that info. The good news is there are efforts to alleviate pain without narcotics…….what things have helped you the most ?

@nycmusic The thing that helped the most was the pain pump I had implanted in me. It changed my life for about six months. Unfortunately, I have a congenital defect in my spine that causes degeneration in it faster than normal, so pain from further degeneration began to override the pump's effectiveness. Mine has a mixture of Dilaudid, Baclofen and Bupivacaine (kind of like a local anesthetic), though it did not have the Bupivacaine in it during the time of my best relief. It was added to help my pain when it got worse again. As I am sure you know, Dilaudid is a narcotic. However, the dose is low, and very little of the pump's medication gets into the bloodstream, though a little does, so there are some side effects but far less than taking them orally. My dose on the Dilaudid is 0.9mg/day, and the pump delivers medication constantly throughout the day. Also, there are other, nonnarcotic medications that can be used. I looked at Prialt (ziconotide), which is made from a snail toxin and, I believe, is more like a nerve agent such as Gabapentin. However, the potential side effects, such as psychosis, scared me since I cant take, Lyrica, Cymbalta and Gabapentin due to side effects.

When the pain pump began working less and because my Dilaudid dose was at the upper end of microdosing (max 1.0mg/day) I made my second attempt with implanting a spinal cord stimulator, but this time using paddle electrodes instead of the inline variety. That has helped some. Between it and the pump, and with walking and PT exercises, I am doing OK compared to a few years ago, but still am quite restricted in my activity and still get significant pain almost daily.

I am happy to answer any questions.