Where to turn for pain therapy? | Arthritis Information

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I'm not sure what my next step is as far as pain management.  I have a rheumy who prescribes my rheumy drugs, and I've got a GP for infections and stuff, but my question is - who do I see for pain?  I have been getting by on some prescriptions from ER visits and doc visits from when I first got diagnosed, but they are running out.  I don't like to take narcotics too much, but sometimes they are a necessity just to get through the day.  I didn't think it would become an issue, but now that I'm going on a year since my diagnosis and this condition doesn't seem to be going anywhere fast, I think I might need to consider long-term.

I've heard of pain management docs, but how do you go about getting in to see one?  My rheumy and my GP are okay with what I take, but they just do not prescribe narcotics.  I don't want to come across as a drug seeker or an addict - I really don't take much - but I'm sure you guys know where I'm coming from.  I have three kids and a life - and some really painful joints!!  But I've also heard horror stories about pain management docs stringing people out.  My mom was a drug addict, and I surely don't want to go down that path.  I want to be smart about it, but I don't want to be a martyr either!
Hi Mom in LA. It was my GP who got me in to see a pain specialist, although my RD was the first to prescribe narcotics at a low dose.  They will not think you are a drug seeker, you are a mum in pain that needs to be able to take care of herself and her family, demand to see somebody, take control of your care, my pain control has been so much better since I saw my pain specialist, mind you I saw the (public system in Australia) specialist first and they were hopeless, now I have gone private, what a difference?  He is treating all of my pain (spinal, fibromyalgic, RA, OA etc) instead of just RA like my RD.  Good luck, Janie.  My Rhuemy prescribes narcotics. I find it very strange that yours does not. Especially if you ask for a script with say 30 pills and no refills to cover a 90 day time period, to just help out on your bad days. RA is very painful at times and pain really lowers the quality of our lives.

If the rhuemy says no, ask for a referral to a pain management doctor. Be polite and persistant....'drug seeking' is about people wanting to get high not those people who have a disease that hurts.
My RD writes for vidodin 7.5 with a fairly high quantity for the month. A bad day is everyday for me. I just started Remicade and hopes that helps. The ultimate goal my RD has for me is to get off the vicodin through a pain management doc. Maybe its just where I live, but the doctors around here are on high alert about pain meds.  Most of the doctor's offices have signs on the wall that say "We do not prescribe narcotics."  And the ones who do make you sign a waiver with all this mumbo jumbo about not doctor seeking, etc...  Its crazy. 

I asked my RD about a referral to a pain doc, and she looked at me like I was crazy and told me to talk to my GP about it.  I haven't done that yet.  They make you feel like a criminal just for bringing up the subject.
RNmomInLa2010-05-15 21:20:34Either ask your primary or your rheumy for a referral to the pain management doc.

You will probably want to ask for that referral sooner rather than later.  Pain management clinics tend to have long waiting periods.  When I was referred to my dr, the wait was close to 4 months.  Also, you will have to sign paperwork/pledges at any pain clinic.  They are very strict and have rules/guidelines that you will have to follow.

My Primary Care Physician does my pain medication prescribing. All other doctors will not but, they are all in the same hospital, but only Primary is allowed to prescribe pain pills. Also, don't let anyone make you feel uncomfortable about asking for pain pills. I am fortunate that my Dr. allows for discussion about the pain pill options and even allows for me to be prescribed oxycodone hcl because I told him that I didn't want to be taking all of the acetaminophen in all of the pain pills. Oxycodone hcl has nothing but pure codone, thus not overloading my liver with all those mgs of acetaminophen, somewhere between 375 and 500 mgs per tablet times 8 tablets per day at one time in my ra journey and that's a lot of acetaminophen. Just something else for you to consider and talk to with your narcotic provider.
Also, I think that the "doctor shopping" document is a fedeal something that all narcotic providers have to have their patients sign.  I actually got in trouble for admitting that i had ran out of "prescribed" pain pills and had gone to Canada and purchased some otc codiene tablets. I had a scolding from my PCP that told me that I must get all my narcotics thru him, showing me the document that I signed.
 
LEV
levlarry2010-05-16 07:37:35Hello, this has always been a touchy subject for me also. Our stories have some similarities, I also have 3 children and on top of taking care of them daily, I also watch my 5 year old twin nieces. My mom has also been a life long addict, so narcotics are very difficult for me to ask for, I always feel like people are thinking I am trying to get "high". I have come to a point in this disease where my meds are finally working but i have quite a bit of joint damage and my pain comes mainly from that. With day to day life I have come to the conclusion that narcotics are sometimes necessary and I am thankful to have a very understanding RD who will perscribe me vicodin. There is nothing wrong with asking for relief, our pain needs to be controled so we can live life and take care of our children. Good luck, Angel
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