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That's not relevant to this discussion because I'm just asking for suggestions about talking to the doctor about pain meds.
Think a lttle deeper-- If you go to a doc because you have a sharp stick in your eye and he only suggests a pain pill, you probably oughta be looking for a new doctor.
You are assuming your pain is from this supposed fluid collection-- As Suzy correctly points out, it's highly unlikley that the pressure caused by an intra-pelvic mass or fluid is pressing on the sciatic nerve (although malignant invasion does happen), and even if it this fluid is pressing the nerve complex, you'd feel it as pain down your leg, not in your belly or back.
Something else is going on. Get a diagnosis. Figure out why you turned into a banana.
I have had low back issues for a long time. I started seeing a chiropractor around age 38. I was hit by a 6,000 pound SUV as a pedestrian at age 43 and my knee was crushed (not helpful; also made back worse). I used chiropractic and deep tissue massage. At one point my primary care was "housing" a pain management guy temporarily in his offices and referred me to him. Pain management guy gave me a prescription of about 200 muscle relaxers and told me not to come back without an exercise program (I had been in physical therapy 50 weeks and after that one year with a personal trainer and I had a history of a lot of running, hiking, cycling, etc.). Obviously things were disrupted by being run over. So, the first experience with Pain Management Guy Was Bad.
I had issues walking around 2015 as my right knee had also froze up on me. I went to physical therapy and they put me on traction (floated me in a pool with ankle weights). That was like a major reset for my back and helped for years. However, they told me not to go back to a chiropractor. So, I also lost my deep tissue massage guy. I had just been not dealing with it and at the beginning of the pandemic I picked something up wrong and pulled something. I have been taking extraordinary amounts of Extra Strength Tylenol almost non-stop during that time. I had to scale back and focus on taking the max instead of not paying attention and exceeding the max.
So, that was going on and then I slipped and went flying off the last couple of stairs in my house and my foot bent all the way back to my arse and it broke my left kneecap (same bad knee). So, since I was hanging out down with my orthopedic office and knew I was going to need physical therapy I started seeing all the various body part ortho surgeons to get physical therapy prescriptions from all of them. I realized I had never seen a back doctor (just chiro) so I saw one. She did give me the physical therapy I asked for. She went over my Xrays and she is sending me for an MRI so that she can send me to Pain Management. Her thinking is injectables. I have bone spurs (which I guess is typical for "someone my age.").
I think maybe the more successful route was to go beg for physical therapy and not pain meds. I did not even ask for pain meds for my broken kneecap as I knew I had to have my wits about me and I did not require surgery (which is when I think I really need the pain meds). I prayed I would not need surgery. I did not even go to the ER. I just waited for my ortho office to fit me in.
Don't tell me I have not experienced pain. Pain is my friend. It makes me know I am not dead.
“Pain is your friend, your ally, it will tell you when you are seriously injured, it will keep you awake and angry, and remind you to finish the job and get the hell home. But you know the best thing about pain? It lets you know you're not dead yet!” --GI Jane...
1) injuries (especially severe orthopedic injuries which never heal back to the oringinal, normal state) and other causes of altered mechanics put a strain on muscles, disrupting the normal, equal muscle tension around joints which results in pain and altered function.
b) Readers' Digest summary of the textbook of PT-- The goal is to do maneuvers & exercises that tighten up the loose muscles and lossen up the tight muscles around the affected joint.
3) Chiropractic treatment is an expensive massage, occasionally invovlving some pretty stupid and dangerous maneuvers. Your Signifnct Other can do a massaage for free. The nice thing about massage is that even a bad one is still good.
d) The hard part about pain managment is when the problem involves damaged nerves that can't be reversed by surgery....It's one thing to get hit in the butt by a fast ball, but there's no pain like the dentist hitting a nerve directly with the drill.
A pinched sciatic nerve caused by a pocket of fluid in my abdomen has given me stabbing pains all down my leg for the last month. The fluid pocket was evaluated a couple of years ago, and pronounced too risky for surgery, which seems to be the only therapy available.
Stretches, TENS machine, tylenol (I can't take ibuprofen), some pain killers my dentist prescribed when I had a root canal last year, heating pads, hot baths, rosemary oil; nothing makes a difference.
The pain ranges from "Oh, this isn't so bad" to "What are my options for suicide?" I've only left the house 3 times in the last month. I actually fantasize about a huge needle jabbing into my leg to relieve the pain. Maybe I'm a bit of a drama queen.
I have a doctor's appointment on Monday, and am hoping for at least pain meds (though I'll try any other options he may have). How do I negotiate strong meds?
I know it's tough to get opioids these days, is there something else that might help?
Ironically, I've discarded loads of post-surgery pain killers over the years. I don't really like the way they make me feel, but it would be better than pain.
Doctors generally are not in the habit of prescribing opioids thanks to the federal govt. guidelines. You need to go to a pain clinic where you can and will end up with pain meds. Thanks to my numerous operations I've been involved with pain clinics for many years and you will find some are really scummy while others are decent. The only way to find out is to try one or two. Good luck. It ain't easy getting help for pain
That's not relevant to this discussion because I'm just asking for suggestions about talking to the doctor about pain meds.
The problem is that walking in and just asking for pain meds will be a big red flag. Even pain management specialists will look for a treatable cause of the pain.
Having suffered from sciatica several years ago, you have my sympathies. I finally got relief by going to the beach, laying in the hot sand and swimming. After months of agony, it finally ended the constant pain. My sister has experienced relief with acupuncture. You may want to give it a try.
Saw doc today, he agreed with my previous doctors' diagnosis (some of you guys don't listen!) and we discussed options. I'm starting with gabapentin, which can help with nerve pain; if that doesn't resolve it quickly, he'll give me tramadol. He says he can act as the pain clinic, and doesn't require pill counts or frequent urine tests.
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