Pain meds don't work

Posted , 13 users are following.

I'm wondering if anyone else has had a similar problem getting any pain meds that actually help.

I'm 8 weeks post TKR & progressing very slowly so scheduled for manipulation.

I've tried Oxycodone, Dilautid & morphine (separately of course) with no relief. Apparently I'm unusual in that I have a very high tolerance to pain meds & therefore it's very difficult during PT or my own exercises to get the required flexion.

Has anyone had a similar experience & find any meds that work?

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  • Posted

    Hated taking the pain meds but they worked for me. By 8 weeks, I was off all the "heavy duty" drugs. Cannabis balm, topical spray and cannabis mouth spray helped me but not available everywhere. I resorted to wine, early off my meds. Beatbox of luck to you.

  • Posted

    I had Tramadol , co-codamol and diclofenac which worked fine for me . If you are in the USA the names will probably be different , google will give you the alternative names . Good luck , PT and exercise are very important , but very difficult if you are in pain . Over 19 and 17 years for mine , and had no problems with them .
  • Posted

    Hi Terri. I'm sorry your progress is going so slow. Isn't this journey a little crazy? I never thought it would be so difficult... You said you are scheduled for a MUA...what is your range of motion for bending or straightening??

    • Posted

      Yes, I certainly thought I'd be one of those exceptional patients that were all better in 6 weeks. Ugh! I can get to 90 with some pain & my PT can get me to a little over 95 with a lot of pain. Straightening is not an issue. I'm at or close to 0 almost since the beginning.

  • Posted

    Such a difficult issue and different for all of us. I moved off the 'heavy' drugs as soon as I could because of the way they made me feel ( and the constipation). Tramadol was a good choice for me and then I moved to Voltran which is an anti-inflammatory. I have a great deal of swelling, stiffness, and inflammation. For a short while I took both, the Tramadol at night and before PT. The combination worked well. It was just too hard on my stomach. I wasn't getting a lot of help from the doctors but researched on my own and tried several combinations. The doctor did not seem to mind prescribing what I asked for. I may have pushed it because I was so anxious to get off of the drugs. I am now taking an OTC, Aleve and although I am tempted to take the Tramadol occasionally I'm resisting ( but I will if I need to). As long as I can get through this, I will stay on this path. Also using a combination of heat and/or ice as needed. I am certainly not encouraging anybody to give up their pain meds, I am simply trying to find my own path. For me it is reengage in my life to the best I can and in order to do that I need to drive. I am 7 weeks post op. Some days I just want to pull the covers over my head. This is so much more difficult than my previous TKR 8 years ago. Best wishes to you in this journey.

    • Posted

      THAnk you. I don't think I would ever go through this again. My other knee better hang in. It's pretty crazy that none of these meds do anything for me. I'm only 125 lbs and take what most much bigger people would be knocked out from. I'm inconstant contact with pain management & they seem baffled. To further complicate things I have ulcerative colitis so I have to be careful with anti-inflammatories. Good luck to you too.

    • Posted

      What I decided it's kind of like having a baby. After the birth you say I'm never going to do this again! In time you forget the pain because it's worth it, so you have another. That was kind of how it was with the knee. The good news is the first one took some pressure off the other knee and bought me sometime. I never regretted it and I know soon I will feel the same about this one also.

  • Posted

    In order of strength (low to HIGH):

    - Ibuprofen / Tylenol

    - Tramadol

    - Oxycodone (Percocet) / Hydrocodone (Vicodin, Norco)

    - Oxycontin

    - Morphine

    - Hydromorphone (Dilaudid) PO

    - Hydromorphone (Dilaudid) IV

    - Fentanyl (patch)

    - Fentanyl IV

    You can mix the Percocet/Vicodin/Norco meds with a muscle relaxer like Flexeril.  That may help; check interactions with ALL of your other meds...even OTCs..  I'm also highly resistant to opioids by mouth (PO).  For my knee, Percocet 10mg x 2 plus a 10mg Flexeril just took the edge off.  Docs will NOT let you take Dilaudid home with you so I just had to grit my teeth.  Fentanyl is the end of the line.  Dilaudid is 7X morphine; Fentanyl is 100X...very, very dangerous stuff.  Usually hospital only.

    Or you can call Warner Brothers and have Wiley Coyote come by and drop the 16-ton weight he used on the Roadrunner on YOUR head...that should work...

    • Posted

      Thanks for the interesting info about the pain meds, Chico & the comic relief. 🤣

      Now I'm wondering if I've just been taking too low a dose of these meds. I'll have to have a very serious discussion with pain management since I'm concerned that if we don't figure something out the MUA will be a waste.

      My PT thinks I need something like Valium to relax me while he works on me. They've been resistant to prescribing it but I feel like I'll try anything.

    • Posted

      Of course, but I would try giving up the opioid since it's not doing much for me anyway & try the benzodiazepine for a day or 2 to see if it helps.

    • Posted

      Just read your post from 5 months ago. You really are a wealth of information. Thanks for that. It gives me some thoughts of what I need to talk to pain management about. Although I understand the idea of keeping ahead of the pain when the pain is constant (the first month or so), what about when the pain is mainly only during exercise & PT (& an occasional bad day).

    • Posted

      Yes, a regular med schedule really helps in the 1-60 day range.  Lots of people will make sure their schedule includes a dose one hour before PT...that helps.  But then you need to have someone drive you to PT...don't drive on opioids...not a great idea.  

      As time marches on, you'll be off the heavy duty stuff and down to OTC meds so staying on a regular dose of ibuprofen or Tylenol SHORT-TERM is very useful.  Most people are pretty much off of a regular med schedule in the 4-6 month range...maybe a little more for some.  Six months seems to be a big turning point for a lot of people as they're pain-free enough to start regular exercise to rebuild leg and core strength.  I'm 15 months with pretty much zero anything.

      PS: The "wealth" of this information comes from living with a pharmacist wife for 25 years and now married to a nurse with 30-years of experience.  They know a lot more than I do...

    • Posted

      Again, thank you so much for sharing your wealth of information. It really helps. I'm so glad I found this site.

    • Posted

       ibuprofen has absolutely no effect whatsoever on pain levels for me . . On the other hand, tramadol makes me feel vaguely cheerful, seems to give me more energy, and certainly helps  with the pain for a short period.  Just as codeine based medicines are not effective in people who do not produce the CYP2D6 enzyme, perhaps there is a similar cause for ibuprofen not working in people like me?  Do you know a reason perhaps?

       

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