odd how pain works

[Mark N]

I just went through an incredibly painful bout of grout and my pain meds just don't seem to do much for that pain. As bad as the pain is I know that my spinal pain is worse if I don't take my meds yet my toe and foot were keeping me up last night with no possibility of doing anything but focusing on the pain. An anti-inflammatory works well for my gout but it is amazing that my pain meds don't control the pain of my gout. Whether it is dental work or some other acute pain my body feels it while it doesn't feel the full force of the acute pain in my spine. How can the meds get my 8-9 pain level down to 2-3 on most days and yet let the acute pain hurt as much as if I wasn't taking any pain meds?

I suffer from gout when I don't watch my diet. It is especially bad in my big toe and foot and not so bad in my fingers. The bad episode last night was my fault for not keeping up with the pain and getting off my feet but I now have the gout under control. Last night was brutal though and it got me to thinking about our pain meds and how we still feel acute pain when it happens.

[Leeaelle]

I've thought about that too Mark! It's really weird! This past year, I had a LOT of dental work done ~ we're talkiing about several extractions in one day. Usually that pain isn't so bad, but with one extraction he had to REALLY wrench on the jaw and later that day my head felt like it was going to explode. The pain was excruciating ~ and just like you said, the pain meds weren't touching it, yet my spinal pain wasn't that bad at the time.

I guess like you said, we just focus on what's the MOST painful at the time, and more or less "forget" the other pain for the time-being, until the acute pain goes away. Must be the pain generators all move to the "new pain" and when that's gone, they run back to the 'old' pain. LOL But you're right ~ it's weird, and I've thought about it too. I hope that gout leaves you alone! Isn't there ever a cure for it? Bless your heart, you don't need any more troubles! Hugs, Lee

[Boxerlover]

My grandfather had gout and said it was very painful, ouch!! I know exactly what you mean. For the last year I have begun to have very bad joint swelling in some of the joints in my hands and the pain in that one small area can become so bad! I just look at it in amazement that my meds are not touching it. I too have taken advil for it and it works, but I am really not supposed to take any anti-inflams because of my stomach but once or twice is OK. My hubby just shakes his head;)

Melissa

[Mark N]

It is good to hear I am not the only one with this experience. I know that our meds hook up with the pain receptors and maybe our chronic pain uses up all the meds so there is not medication left for the acute pain. At least that is the way I picture it and it would explain why the other pains are so severe.

[Smithc]

Interesting. I have neck and pelvic pain. It seems for the most part, one or the other hurts. Whatever hurts the worst is what I feel.

Also, my pelvic pain (which is now contained to a few days a month after much treatment) screams through the meds I take. Sometimes I feel like I am wasting the pain killers as for some reason they don't seem to make much of a dent.

[slipnslide]

I can definitely relate, nothing touches the hip pain that shoots down the groin and into my thigh when it's at it's worst. I had one of those severe episodes last night, and it brought me to tears of frustration....nothing touches the pain. We take strong maintenance meds which sets us up for poor pain control in emergency situations:(.

Mark, I feel so bad for you. My grandmother used to suffer with bouts of gout and I used to feel so bad to see her in such pain (and swelling):(.

Kim

[Mark N]

Claire, sorry that you suffer with the pelvic pain as I know how bad the pain that breaks through our meds can be.

Kim, I have the gout under control now and as long as I do the right things I can keep it under control. I think you are right about the maintenance pain control setting us up for poor acute pain control. I am sorry that you went through your episode last night. I am fortunate that my severe episode just lasted the one night.

[suede]

Mark,
Sorry to hear you have been having such a flare, hope it passes soon.

I can sure understand what you mean about the pain and meds though.
My regular meds keep my pain at bay never pain free and some days not as well as others, Though last week I had to have my gall bladder removed after finding out I had stones which I had thought was a flare up of my ulcers, anyway my regular meds did not touch the acute pain that I was having with my gall bladder or my after surgery pain.

Maybe it is a good thing though cause other wise we might really miss a serious problem if our meds covered the acute pain.

Linda

[Smithc]

Though last week I had to have my gall bladder removed after finding out I had stones which I had thought was a flare up of my ulcers, anyway my regular meds did not touch the acute pain that I was having with my gall bladder or my after surgery pain.

Maybe it is a good thing though cause other wise we might really miss a serious problem if our meds covered the acute pain.

You are right about the missing a serious problem in our day to day life but what happened w/your after surgery pain? Is is not appropriate to get stronger meds coz of a chronic pain tolerance?

I hope you did not have to suffer needlessly; even though I know lots of folks who do, unfortunately.

[Mark N]

Linda, you are so right about not masking other problems. I have often wondered how much early warning I miss on other problems because my pain meds cover the pain up but this acute pain shows I probably not missing much.

[suede]

Smithc
I was fortunate that my surgeon wrote a script for me for vicodin for after my surgery with my asking for anything. Though I am on a dose of 150 mg of morphine a day normally with no BT meds, so the script he wrote worked well for my after pain.
But the morphine did nothing to touch it at least that I could tell it may have helped more then I knew...
I feel very lucky to have not had to suffered more as you said there are many that do.

Mark,
I find it so strange how our body reacts so differently to pain meds, I know when I was having pain from my teeth the Oxycontin and vicodin I was on didn't touch it.

Linda

[simby]

hi Mark,
it IS odd that our meds don't seem to block acute pain.
I am reminded of this as i have two (yes two!!) very bad, very painful teeth right now.
I know its true for me - all i have to do is hit my thumb with a hammer or stub my toe. Yet the meds are the same we would take for acute pain.
It almost seems like a different part of the brain might relay chronic pain as opposed to acute.

hugs,
sims

[Mark N]

sims, I have wondered if chronic pain is handled by a different part of our brain or if we just use up all the meds on chronic receptors and no meds are left for the acute pains we have. One of these days more research will be done on pain to understand better how our meds work and how our pain is transmitted.

[Kathi49]

Mark,

I was doing a little bit of research and I have to admit it is too deep for me. But from what I read there is mu, kappa, delta and nociceptive (sp?) receptors in the brain. I think Steve would be a better one to explain this because as I said, it gets too involved for me to figure out. ;) Plus, it is my own opinion that opiates don't always work for various TYPES of acute pain. I know they didn't touch the nerve pain in my neck. The ONLY thing that worked for that before fusions was a shot of Toradol. Then, later, injections or a round of Prednisone. Btw, since you mentioned Gout and uric acid, isn't there or aren't there medications to combat that? I don't mean as in the pain or inflammation but for the uric acid itself. Or is it just a matter of diet? Sorry, I am really rambling here and haven't researched it enough. :o

Oh, and what I wonder about and have for a long, long time is this...

What in the heck happens after a hysterectomy??!! LOL! My friends and I SWEAR that our pain increased tenfold after having this done and we haven't been the same since. Now, I know hormones play a role. But I wish I could find a study that actually speaks to WHY this happens OTHER than hormones. Because I also know of people who do just fine without any hormones. So, in my opinion, SOMETHING happens...we just don't know what.

Okay, I will shut up now. :)

[Mark N]

Kathi, there is medication for decreasing gout but mine is a mild case that occurs just when I am not careful about avoiding pork and shellfish. I would rather change my diet than take another pill;).

Are you talking about more overall pain following a hysterectomy or more specific pain. Either way it seems like cutting the nerve endings are going to change our nerve system. I think that is evident in phantom pains with amputees.

I think doctors are making some progress in pain research but I think they are missing understanding the nerve system itself. We have nerves that cause reactions before the signal gets to our brain. It is a complicated system that I just don't think enough research has been done. After all the old saying is that pain never killed anyone is contrary to reality but it shows the attitude we have as a society to pain. Oh well, it isn't something we can solve here.

[marijo]

I am far from understanding it, and so are all of my doctors. Mechanically I am doing very well. The physio today was amazed at my movement, which has always been good....but very painful. Its not so much mechanical. Well I can separate the mechanical from the neuralgia, which takes over my whole trunk and makes my flesh and skin burn. Nobody can deal with that, other than make me so comatose and zombie- like, that I don't care about anything any more. Also I am now having to change my jamas twice a night just about, because my ability to control body temperature, has disappeared and getting worse. its not hot flushes cos I dealt with that 10 years ago roughly. I wake up literally wringing wet, and five minutes later am freezing. I'm convinced its either thyroid which is not yet stable, or nerve related. Way to lose weight!! Imagine if I had to sleep with anyone. They wouldnt last long as they would end up wet also!!
I can understand why people get so depressed when they have nerve pain, because it is so difficult to treat, and so so never ending. Theoretically I am doing very well, so long as nobody mentions nerve pain, not even my pain management consultant, as he ran out of ideas a long time ago. All they can prescribe are anti depressants, and they make you feel worse mentally.
But I remain....optimistic!