... for degenerative disk disease,bulging disk,leg and feet pain,on your lower back helpful ? Doc has put me on dilaudid 4 mg 4 times a day, plus I get injections on lower back & neck 4 times a year. Sometimes I feel it works & other times no. Was wondering if there was something more stronger for the pain. Going on 4 months now on the dilaudid . Doc wants to give me a nerve blocker next, I don't even no how that works, any info would be great. Thank you
4 mgs four times a day of Dilaudid is a high dose. The next step up in pain control would be something like Opana. You may benefit from a longer acting pain med and then just add something for breakthrough pain. Opana has a long-acting formula, actually Dilaudid does as well. This way you would only take twice a day and if you had pain still you would add a low dose of another pain med. You might well find the long-acting is all you need. The injections you have been getting are probably steroids to reduce inflammation. A nerve block actually deadens the nerve so no impulse gets to the brain.
With the nerve block, they do 2 test injections which just numb the area. It is similar to a cortisone shot in that it is an injection in your back. If the test shots provide relief short term, then they will do the actual nerve block which is suppose to kill the nerve pain. Eventually the nerve will grow back in like 6 to 8 months so you would have to get it redone. This procedure did not work for me even though the test shots worked. But it does provide relief for many people so it is definitely worth a try
Exalgo is the long acting form of Dilaudid. I feel if a person has chronic pain and is taking medication daily, they should be taking a long acting med. Short acting pills should be for breakthrough pain or if a person only needs the occasional "as needed" dose. If you are using the hydromorphone every day then you should be on long acting. Otherwise, you are just "chasing" the pain. Using a long acting drug, you get a consistent blood level of medication which controls and prevents pain rather than chasing it. A good pain doc should know that a long acting drug is better when someone is taking pain meds daily. They are better in the long run because they dont saturate and flood the receptors like short acting drugs do. They keep a consistent level trickling in constantly to prevent pain and you wont have so many ups and downs that you do with short acting.
When you take a short acting, you get a burst of medication flooding the receptors and then a couple hours relief then it begins to wear off and you go a couple hours in pain before you can take another AND it trains your brain to equate that flood of opioid across the receptors (the "rush" or "buzz" you get) with pain relief. Long acting drugs pretty much keep a steady level going so you have continuous relief. You may need a ":breakthrough" dose to "bridge" until your next long acting dose or if you do a pain provoking activity. For me, if I do any heavy cleaning, mop or run a vacuum, I know I will need a "rescue" or "breakthrough" dose. You might ask your doc if a long acting drug might be beneficial to you.
I have very bad degenerative disk disease with 4 fusions so far and they had to cut the lining of my L 4-5 nerve root.. I take MS Contin 30 mg 3 x a day and I got hurt moving so my Dr changed me from Percocet 10 350 for break thru pain to 4 mg Dilaudid. It does not seem to even touch my pain. Can I take the extended release MS Contin with the long acting Dilaudid? We are not sure yet if I ruptured the disks above my L4-5 fusion but I can't use my right leg or lift it just like the last rupture. Thank You
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