[spy88]

I've had left leg sciatica for over 4 years including a discectomy in Dec of '02 that didn't work. Also leg/foot cramps and RLS. Been taking Endocet 10's ever since but they've done less and less for quite some time. After looking at the latest MRI, my neurosurgeon said "..live with the pain or have the disc (L5-S1) removed." As expected, I'm not very interested in having this procedure so have done considerable web searching for alternative meds to the Endocet.

In my search for scitica pain meds, I've found the usual opioids but also some clinical trial drugs listed on pubmed.gov which is a service site of the National Library of Medicine and the National Institute of Health. Searching drugs.com, there was little to no info relating to their uses as a sciatic pain reliever but have the potential for dependence.

I know if I say I'm NOT hooked on Endocet, I'll get slammed one way or the other. All I can say is I take 2 at work and work only. No weekends, days off or vacations. Not before work and not after work. In the past 4 years, I've been off work for up to 3 months (twice) for a different health problem (muscle wasting in my upper left chest, back, shoulder, arm and hand) without taking one. The only exception I occasionally made was my weekly round of golf. As a "golf-a-holic", I admit I'm hooked on this game! Once every 3-4 months I'd take one prior to a round so I could get thru it without almost needing a wheelchair when done. Now I just suffer thru it because of its lack of "punch".

And so you all don't think I'm only interested in meds for my sciatica, I've also just ordered the "Lose The Back Pain" package I came across (losethebackpain.com). Seems logical enough to try and has a money back guarantee.

So my options at this point are 1)continue with meds until I 2)receive this lose the back pain concept and see if it works and/or 3)have the operation---in this order. Now if anyone can shed light on a med better then Endocet but not an opioid, I'd really be interested to know about it. Or is there nothing there to report?

Thanks for reading and any help.

[Cats Meow]

Nobody gets slammed here that doesn't deserve it, and that's only for being abusive to other members. Welcome, you sound like many people here, so your in good company. I'll try and answer your questions tomorrow, I've been on here tonight for far to long, so hang tight.
What clinical trial drugs did you look into?

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[mpvt]

Your very fortunate that you can use this opiate to it's advantage and I say if your able to use it the way you saqy you do then why stop.If it does the job and it doesn't alter your lifestyle then you've got it made brother,good for you.Let us know about those experimental meds you tried,we are always looking for the next thing here, you know.....Dave

[spy88]

quote:Originally posted by mpvt

Your very fortunate that you can use this opiate to it's advantage and I say if your able to use it the way you saqy you do then why stop.If it does the job and it doesn't alter your lifestyle then you've got it made brother,good for you.Let us know about those experimental meds you tried,we are always looking for the next thing here, you know.....Dave

Sorry Dave, never said I'd [u]tried</u> any alternative drugs but asked for info concerning alternatives to Endocet. I stated exactly how I used/use Endocet after 4 years, but as all know, the body builds up a resistence to a point where you either continually increase intake of the drug or move up to the next level in pain med. I'm at the point where I must do one or the other.

quote:What clinical trial drugs did you look into?

Cat, the list I came across went back several years and included Opana, Percodan, all the Oxys/Hydros/Roxis, Levoraphanol, Fentanyl, Suboxone, Gabapentin, Pregabalin, Buprenorphine TDS, Caffetin, etc. Many showed promise in the studies but almost all oversight Drs admitted further clinical tests were needed that included many more subjects and over a much longer time trial (many were with less then 100 subjects and less then 1 year in length). Don't think I saw any trials/results newer then 2004. Some of these drugs are listed in your link to the Opioid Coversion Table but some aren't and again, TY for the info.

Again, my basic question is what is the next drug up from Endocet? Or should I try 1 1/2 tabs twice during work instead of the 2 I'm now taking?

And to clarify my first post, I will admit to the very important side benefit Endo does for me. That is the ability to cope with the public (a must in my job) that I'm terrible at without the edge off my response(s) to their childish actions/statements toward me. (I deal P in a LV C). Many times, I've been one word from getting fired for biting back at a player. This is why when I'm not at work, I'm in no desparate need for pain relief as my free time is spent either at home or on a golf course. All the little things we all have to do to get by in life---shopping, banking, errands, etc. that require walking/standing---I'll just do regardless of the pain build-up. Usually the case, I'll put them off until I have to do them then rush home to my zero G chair.

Again, thanks for listening and any help offered.

[Cats Meow]

The next step up from Oxycodone/Acetaminophen could be Oxycodone in instant release, to get you away from APAP which is useless and detrimental for long term chronic pain patients, it is available up to 30mg, other steps up could be MS Contin or Oxycontin so you'd have controlled release.
Other drugs that may help your condition, you may want to look into work on the nerves, such as Lyrica or Neurontin.
You have legitimate, documented disc problems, so you have no reason here to explain or rationalize your use of pain medication, unfortunately dependence is a fact of life with opiate therapy, it sounds like you have a good handle on it. Tolerance is another fact of life, and you certainly sound under medicated, if you've been at the same dose for a year or more, your doctor should bump you up.
I can certainly understand your reluctance to undergo another surgery, having one failed one already, the chances don't sound good, and as a whole the success rate is far too low, I've read 88%. No one I've talked to are better off and most are worse off.
I agree with your options, surgery should always be the last choice.
Like you, I have a rotten L5 S1 disc, I know where you're coming from.

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[mpvt]

If this is chronic pain then any quick release opiate like percocet,tylenol#4 ect aren't going to work very well.You need to be on a sustained release opiate like ms contin,oxycontin,duragesic patch.These pain killers keep a steady level of the opiate in your blood stream there by eliminating the high and lows of taking quick release every 3 hours.......Dave

[spy88]

Thank you Cat and Dave for your suggestions. Will do some research on those given and suggest the change with my doctor.

Again, much thanks!