Question
I have had chronic back pain for a little over two yers without a diagnosis until in September 08.  I was on Lortab 10 for a while and then my doctor put me on Morphine after an episode of severe uncontrolled pain.  At that time he began thinking that I may have RDS.  That was not a very comforting thought, but we moved forward with different injections that did not have the type of result that we were hoping for.  I saw a neurosurgeon who said that there was not a nerve issue.  My doctor began wondering if I had some psychosomatic issues going on, but I knew in my heart that something was wrong with the disc.  Finally, my pain specialist (I have been with the same clinic for almost the entire two years) suggested that i speak with the doctor that specializes in spinal stimulators.  Keep in mind that my MRI were pretty much normal.  The only thing my MRI did show was mild degeneration to the L4-L5 disc space. That was the EXACT same place that ALL of my pain originated from since the very day of my injury. Oh yes, I guess maybe you might like to know how I injured myself.  I am a RN and worked in an incredible children's hospital.  I honestly thought I would retire from there.  One day I had a 200+ lb 16 yr old girl who had just been transferred out of the PICU.  She was able to follow simple directions (or so her mother and she said) so when it came time to pull her up in her bed,she did not follow directions and my back stayed at the end of the bed.  The tech helping me did not have any trouble, but she is also stronger and bigger than me.  All that to say, when I went to see the doctor that specialized in the spinal stimulators, he told me that I was not a candidate, but did ask me to tell him my injury story again.  As I told him, he kind of looked like a light went off in his head. He suggested that I might have a torn disc.  The condition does not show up on MRI except like mild degeneration.  I had a discogram about a month later that confirmed the tear in the L4-L5 disc and then in Nov. I had fusion surgery done.  It has been a very difficult recovery as I have four children (11, 8, 5, and 3)and not a whole lot of support with takeing care of the youngest except for a friend that did a lot.  I am at a platue (SP?) with my pain level and it is not getting any better and it does not take much to throw my back out and land me on the couch for a few days.  I have had good pain control with oxycondone 15mg with the 50mcg duragesic patch.  I am taking between 15-30mg three times a day and sometimes four along with Baclofen 10mg with each dose of oxycodone.  The problem is that oxycodone is having a manufacturing problem and is not accessbile at this time.  I have tried Morphine ER with instant release for breakthroug that just plain stopped working about a week or so before my surgery.  What else is out there that might work like oxycodone?  I know a lot of drugs because I am a nurse, but when it comes to myself and these "grown-up" issues, I am clueless.  Any suggestions?

Answer
Hi Debi,

I've been on Oxycontin 20mg QID + i-ii prn for about ten years and in all honesty I have never found anything that works as well for me (and the docs do love to try different meds).  The only one that even came close was Ralivia (tramadol extended release) but getting the correct dose can be a challenge due to lack of exact equivalency levels so you'll have to play with it.

Wishing you all the best,
M