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Have chronic neck pain. Take vicadin. Pain in more under stress. Suggest alternate method for pain management?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
i have chronic neck pain from a roll over MVA from 1997. The pain will get severe enough that it becomes difficult to check my blind spot when I am driving. When the pain gets bad enough, I will take a vicadin 5/500mg to assist with the pain, the problem is, I don't really feel that the anti_inflammatory portion of the pill is really helping per se.......but the narcotic portion is helping me ignore the pain. My neck will flare up about once every two months, and sometimes more when I am under stress. A 10/500mmg make me queezy and a 7.5/325 seems to be just right but are hard to come by. Is there a better/alternative method to my pain management than what I am doing? I am not interested in taking Hydrocodone or vicadin for the rest of my life to assist with this chronic problem? Is there a way to get a small dose of the narcotics without the antiinflammatory in them? I really don't feel that any muscle is inflamed, just a pinched nerve. Please advise.
Posted Fri, 30 Aug 2013 in Back Pain
Answered by Dr. K. Naga Ravi Prasad 29 minutes later
Hi, thanks for writing to XXXXXXX

I understand your concerns regarding your neck pain.

Any Analgesic medication taken over a prolonged period of time tend to produce adverse reactions. So practically speaking, there is no safe medicine that can be taken for years without experiencing side effects. The simplest form of analgesic with a relatively safer profile is ACETAMINOPHEN (Tylinol).

I suggest you to have an MRI scan of your cervical spine which will helps in assessing the exact pathology inside.

The general guidelines for management of neck pain are as follows -

* Rest: A soft cervical collar is advisable. It should not be used for more than a week or two as it may worsen the condition with prolonged usage.

* Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.

* Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.

* Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Moist heat can be useful.

You can also try RADIO FREQUENCY ABLATION which is said to provide good symptom relief in cases of chronic neck pain. The pain free interval usually lasts for 6 months to 2 years.

Hope I have justified your query. Happy to help for any further clarification.

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