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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Vicoden Safe For Facet Blocks?

I have extreme back pain caused by curvature of the spine, bulging disc, and stenosis. The only help my Drs are giving me is Vicoden pain meds and a procedure called "facet blocks" that does not decrease the pain. I was recently seen by a neurosurgeon and he is not recommending surgery. My friends have had bulging disc and have had successful surgeries. The vicoden is causing embarrassing gas, constipation (which caused a severe drop in blood pressure and a trip to ER via Paramedics) and makes me fatiqued all day long. What do you reccommend I do?
Tue, 24 Jun 2014
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General & Family Physician 's  Response
Chronic severe low back pain is best treated in a multidisciplinary manner that takes into account the specifics of how you experience the pain. Conservative measures for chronic back pain like regular exercise (especially swimming and pilates), use of heat and cold packs and "deep heat" creams can make a big difference. Formal physical therapy, or self-administered stretching and strengthening exercises are also useful. Cognitive Behavioral Therapy has also been show to be effective in chronic non-Cancer pain management. Pain medications should focus on simple analgesics around the clock and long acting opiods if necessary. Short acting opiods, especially in combination with acetaminophen (like Vicodin), should be avoided except as a treatment for severe breakthrough pain as they often cause a rebound effect whereby you feel even worse pain when their effects wear off. I would recommend you seek the help of a multidisciplinary Pain Clinic in your area and collaborate with them to develop a structured plan for rehabilitation and for managing the pain.
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Is Vicoden Safe For Facet Blocks?

Chronic severe low back pain is best treated in a multidisciplinary manner that takes into account the specifics of how you experience the pain. Conservative measures for chronic back pain like regular exercise (especially swimming and pilates), use of heat and cold packs and deep heat creams can make a big difference. Formal physical therapy, or self-administered stretching and strengthening exercises are also useful. Cognitive Behavioral Therapy has also been show to be effective in chronic non-Cancer pain management. Pain medications should focus on simple analgesics around the clock and long acting opiods if necessary. Short acting opiods, especially in combination with acetaminophen (like Vicodin), should be avoided except as a treatment for severe breakthrough pain as they often cause a rebound effect whereby you feel even worse pain when their effects wear off. I would recommend you seek the help of a multidisciplinary Pain Clinic in your area and collaborate with them to develop a structured plan for rehabilitation and for managing the pain.