Pain Management/Medicine Question-Please help me out!Need to know what to expect at 1st appt.Best answer 10 pt

Question

What can I expect at my first Pain Management appt? It is actually called pain medicine(that's the name of the clinic). I have a bulging disk at L-4 L-5 and it hurts constantly! I am currently on Lortab 10 mg, 2 per day...I do need more per day because I sit at a desk at work all day and it only makes it worse. I'm afraid to ask at my first appointment because I don't want to be labeled as a seeker. I think 4 per day would do me GREAT justice, as that was the amount I was on prior to moving and changing docs. What do they normally do at your first appointment? Is an epidural something they do for first timers? I'm awfully scared of needles....I would love to try anything else but an epidural. Any suggestions and please tell me what to expect. Thanks

Answer 1

At an initial appointment, as many responders have mentioned, you will have your history reviewed, it is a good idea to have copies of your records, and any MRI or CT scans which have been made, as they may wish to review these. They will perform a physical examination, emphasizing the affected areas.

Dependent on the results of your history and physical, and any studies, they will discuss your options for treatment.

These may include epidural or nerve blocks, adjustment of your current medications, physical rehabilitation, and possibly psychologic/mental health counseling support.

Pain management is usually a multidisciplinary approach, using many forms of treatment.

In my clinic we use the assistance of chiropractors when appropriate, physical therapist, aquatic therapist, psychiatrist/psychologist, nutritionist, acupuncture therapist, as well as anesthesia, orthopedics, neurology and family practice.

Chronic pain affects many aspects of the patient's life as well as the life of his family and those he/she associates with. What is going to happen at the first appointment is driven by the patient's needs, and not a formula designed at the pain medicine clinic.

I hope you have relief soon.

Answer 2

You won't believe it but I had an epidural today. It's my 3rd since April. I have a torn disc at L-4 L-5 touching the nerve running down my right leg. The 1st appointment will just be an interview and to set up appointments for ct scan. Have the epidural. It will give you relief for a while. If you are careful it or they will last a few months. They usually do 2 or 3 epidurals spaced 2 weeks apart. Your only other option is surgery. The numbing shots hurt the worst. You won't feel the big shot hardly at all. It's not that bad. I don't try to sugar coat anything if you know what I mean. It will be worth it. I feel your pain. I wish we could talk but this is the best I could do. Good luck.

Answer 3

I have had two spinal fusion operations and have been taking basically the same medications for 10 years so it must be acceptable.
10/500 hydrocodone 4 times a day
20mg Oxycontin 1 at night
350 mg. soma

Make a list of your concerns so you can make the most out of the time you have with the doctor.
Don't be afraid to ask them for what it takes to control the pain. If you don't tell them how you feel they can't prescribe the best medication for you.
Just don't ever get to the point that you start getting early refillls or start running out. Then you should seek help from your doctors and the two of you decide the best course of action to take.

Don't let the pain get to the point of impacting your life. Pain can cause depression, anger, fatigue, and so on. That why it's important to have the correct medication regime

I know what life with chronic pain is like so good luck and keep your spirits up. New things come on the horizon all the time.

Answer 4

Your first visit to a new clinic (any type of clinic for any ailment) will likely entail taking a history and doing a physical exam. It would be unusual to have any sort of procedure done on you for your first visit.

Procedures are very tightly scheduled, and they need to know your past medical and surgical history prior to doing any procedure on you.

A "pain clinic" is probably run by anesthesiologists, and discussing pain medicines at a pain clinic should not leave you labeled a "drug seeker." I assume you had either an MRI or a CT myelogram to show your bulging disk.

Some procedures that "pain management" doctors do include epidural steroid/anesthetic injections and facet blocks. The injections are usually a mix of steroids (to cut down inflammation) and a long acting local anesthetic (to decrease pain).

Answer 5

The 1st appt. is usually a consult to meet you, discuss your pain and devise a program for you . They may decide to schedule you for an epidural or some other type of pain management program. If they decide to do an epidural don't be afraid. You are given medication to help you relax and you feel very little. Be sure to discuss all this with the Dr. you meet on the 1st appt. It's your body and your decision what you want to be done. GL

Answer 6

My husband went thru pain management about 9 years ago for the same thing after his first surgery on L5. I don't remember him ever saying anything about an epidural but he did get a SNRB[ selective nerve root block..details at http://www.spine-health.com/topics/conserv/overview/inj/inj03.html#select] which unfortunately only helped him for about a week. The majority of his pain management was basicly just physical therapy, massage, walking laps etc. It sort of teaches you how to build up a tolerance for the pain. The thing about it is that after you complete your pain management they will then attempt to wean you off of the lortabs. I bet they didn't tell you that, huh??After 2 more back surgeries they finally put my hubby back on pain meds.But as for your fear of needles, don't worry they most likely will just do therapy at least at first.