Question
My mother is in her early 80s.  She has severe scoliosis by MRI and disk problems at almost every level.  She often has severe back pain.  We scheduled her for injections but she takes Coumadin so the doctor would not give the injections and since she has had a prior stroke, no one is willing to take her off the Coumadin as needed for these injections. Do you have any other suggestions for pain management that can be done or taken that will give her some relief without causing problems with her Coumadin.

Answer
Hi Linda,
I found your question in our question pool and thought I may be able to help.
I would recommend that you consult a pain management specialist to manage your mother's pain. In this day and age with the medical advances we have there is no reason your mother should have to suffer untreated pain.
Talk to a doctor about other alternatives to Coumadin that will not interact with pain management. I am not familiar with Coumadin so I looked it up. It did list a possible interaction with narcotic pain medicines but I am not sure what the interactions would be. Talk to the doctor about the option of using a narcotic pain medicine, it may be that the possibility of interaction is small enough or mild enough that it would be an option for your mother. Doctors decide issues like that based on if the benefit outweighs the risk. There are many narcotic pain medicines, it should not be hard to find one that will work well for your mother with minimal side effects. One that you might want to look into is Fentaynl patches. Fentanyl is a strong, safe drug that has less of the usual side effects associated with narcotic pain medicines. It comes as a skin patch that is changed every 3 days. That is especially good for elderly people for several reasons, there are no pills to take so there is no problem with forgetting a dose or double dosing from forgetting that a dose had already been taken. It is even possible for a caregiver to change the patch every 3 days. They provide a constant 24 hour pain control.
A pain management specialist will be best to figure out the best way to manage your mother's pain. Most general practice doctors and other kinds of specialists just don't have the experience with pain management to effectively manage a special needs patient's pain.
I hope this helps. If you have any questions or need additional information please don't hesitate to ask.
Thanks
Tracy