Why do doctors hesitate to give pain meds?

[zamsci]

Just reading some of articles searching for clues as to why when I ask for vicoden or something for musle aches my doctor says up the prodonsine for few days and then we will slowly taper down. I am doing this and some how I am still having joint pain and at night its real uncomfortable. I guess I don't force the issue because I feel like maybe he has good reason and I don't want to become pushy. (plus its a holiday and I to wait) I feel like if my remy just gave me what I ask for I don't have to second guess my pain. NOT to mention he is VERY HARD to reach perhaps i'll my regular doc. Just light weight fusherated.

[AnM]

Zamsci,

Hey. I'm sorry u don't feel well, & hope u do feel better at least some real soon!!

Are u on any other meds., other than the Pred.?

If your rheumy hasn't put u on any other meds. n only the Pred. I would discuss w/ him/her about that. There are other meds. that can help w/ the Lupus n the sx.s as Joint pain. & usually is started, so u can try n get off the Pred.

Anyways, also, some doctors don't like to px. pain meds. they just get like that sometimes. :rolleyes:

But, I would reccommend going to a Pain Management Doctor- they specialize in that, so they will help out w/ pain offering differ. things that may help for each individual. & they can do different things, meds. n other things other than giving pills that may help.

That can help greatly while on other meds. or waiting for meds. to kick in. Many of us go that route, as docs. are not always keen to handing out pain meds.

Take care, n hope this helps,,
Alicia :coffee:

[bananawear]

Hi Zamsci, most of us definately need something more than prednisone for pain relief. Often dr.s will try a muscle relaxant and/or anti-inflamatory med for the joints before prescribing a narcotic but sometimes a pain medication does have to be added in.

Alicia is right that often a pain management specialist can be the best to know what the right mix of meds is the best to help with what your specific set of symtoms is and also know what can work the best with your other meds.

Are you also taking plaquenil? Sometimes it can take 4-6 months for the plaquenil to kick in fully and for you to begin to see an effect of that med to start working and dr.s will use the prednisone to taper during that time. You still need something though to relieve your pain and should not feel pushy by asking for it. Be sure to tell your doc how your pain is affecting your day to day living like if you are having trouble sleeping or can't do things you used to be able to do.

Take good care- Chris

[raggedyann1]

zamsci,

I think your doctor is trying to get the lupus under control. For many, many lupus patients narcotic pain medicine is never needed. As Alicia and Bananawear have suggested, your rheumy may need to add more disease modifying medications and also an anti-inflamm medication.

Lupus and other diseases are approached differently with pain control than someone who has a bad back for example. The pain is being caused by the disease so it is telling your rheumy that you lupus is not undercontrol. If he gives you vicodin and your pain goes away he may not get the information he needs to know if the disease is active or not.

The additional problem is the DEA is breathing down pain mgmt doctors throats at the moment. This makes all doctors leary of any narcotic pain medication. The rules changed in january of this year and almost every single medication that is used for pain is being monitored now on a national computer system. In the past it was only the schedule II narcotics. I am not completely aware of all the rules but since I am on schedule II, the muscle relaxers and the anti-d used for sleep and pain is tracked on the computer system.

Take care,
Karen

[zamsci]

Thanks for that. Yes I am on Plaqunil and Prodsine. I believe the real problem comes with over soing myself sometimes I have 2 girls 1years and the other nearly 3 years old so you imagine how busy I am! I guess I am still getting to know my body it seems if hurt myself minor way it hurts in a major way. I am always hitting something, pulling, tugging, and grabbing things which before never use to be a problem but now I get what seem like callaus on my hands from the little things and my feet !! :sick: I f go shopping at the grorcery for longer than few minutes I am in pain. Plus both girls have a head full of hair which gives me hand pain. NOt to mention we just got a puppy :cry: . (My husband says it for protection :unsure: ) So I guess I'm not in severe pain and I would like to take something other than vicoden for pain because it really just makes me sleepy and that kills the family time but so does the pain. :( Its only been 4 months since I've started treatment and have been diagnois so I guess getting to know what will hurt later and how to ration my pain killers would help. thanks for your imput

[mcemp]

First of all it must be highlighted that pain / narcotic meds are addictive and also very poisonous.
Secondly, if lupus is under control then the pain is too, so it is vital to manage the disease in our case rather than just the pain.

[kurlykim]

Hi Zamsci,
I do also fell at times that pain med would help but I have stuck with motrin.When I think of the long term issues that can come from pain meds I get worried. Everone is diffrent my mom has taken demoral as a lupie and has liver problems. Do less on the days you dont feel well. Take naps. Try to lessen the load until your flare passes. I have two girls with alot of hair too use no more tangles and keep it well conditoned. Soon you will be feeling better when the meds fully kick in.

[raggedyann1]

Zamsci,

Since you have only been on the medications a few months the plaquenil has not reached peak benefit yet, which probably explains why he keeps giving you more steroids when you are telling him about your pain.

I would tell him all the stuff you just told us, he may not realize how very bad it is and might then give you a prescription for a NSAID. which is non-narcotic.

About Narcotic pain meds. They are NOT ADDICTIVEwhen used for pain. We do become physically dependent on them but that is NOT the same as addiction. The link below is to a pinned message in this section that has a l ink to a long article explaining the difference between dependence and addiction.

So anyone reading this thread please DO NOT think you will become addictied to narcotic pain meds.

http://www.thelupussite.com/forum/index.php?showtopic=21039

Take care,
Karen

[hannahgirl]

;) Hi karen was right and I agree with her about the narcotic pain meds. my dr also told me that if you are in PAIN you will not become addicted. being dependent and addicted are two separate issues. I take narcotics because I have to for pain. I have tried everything else and they did not cut the edge off my pain so I take what my dr tells me. I say listen to your doctor and be well informed as a patient. Hang in there. it will get better, nanci