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livestrong's avatar

Pain medication isn't working, why?

Asked by livestrong (213 points ) July 6th, 2011

I have an uncle that had knee surgery a couple weeks ago. He was given Oxycodone for pain medication, at first it was helping but then it stopped working. The doctors took him off his crutches and the pain came back but this time the medication wasn’t working. In the beginning of the week the pain was so bad he wasn’t sleeping at all so he went back to the doctor. They said that everything looked great and that there was nothing wrong. The doctor gave him Dilaudid however, that isn’t working. Has anyone experienced this before?

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11 Answers

marinelife's avatar

It seems like something is seriously wrong. I would get a second opinion perhaps from a pain clinic.

JLeslie's avatar

Yes, something could be wrong, if it does not improve in several days, he needs it evaluated, if the original doctor finds nothing then seek a second doctor. I have a horror story similar to this, that is so unlikely I think probably not worth mentioning, but just lets say the patient should listen to his body. On a less scary note, sometimes it just takes a few days for some swelling to go down, and muscles to heal, and the patient improves again.

JLeslie's avatar

Have him try some Ibuprofen if it is allowed. He might be developing a tolerance to the narcotics/opiads? Although, I doubt it this fast.

livestrong's avatar

@JLeslie He had surgery June 14th and this has been going on since then. He’s seen 2 different Doctors. Both have said there is nothing wrong and there is no swelling. I have no idea what could be going on. He says usually he doesn’t get any relief until he does take the Ibuprofen on top to Dilaudid. But even this only allows him to get pain relief for the max of 3 hours if that. :/

JLeslie's avatar

Ibuprofen starts working about 50 minutes after taking it, and starts to wear off in about 4 hours, that is normal. Why not forget the perscriptions drugs altogether and take the ibuprofen if it is working? How much is he taking? 600mg? 800? Make sure he eats a little something when he takes it and drinks a glass of water, not just a few sips.

How long do people typically have pain after this type of surgery?

JLeslie's avatar

He can also take a combination of ibuprofen and tylenol, again forgetting the perscription drugs altogether. Ibuprofen is a muscle relaxer antiinflammatory, and the tylenol is a pain blocker, works in the nervous system. 600 ibupuprofen and 2 regular tylenols.

JLeslie's avatar

Ibuprofen is every 4–6 hours I think. Tylenol I don’t know off the top of my head. Read both bottles, and take the meds appropriately, but taking the higher dose of ibuprofen. Ibuprofen is regularly prescribed by doctors at 600 and 800 mg. Of course he can check with his doctor first if he prefers.

Cruiser's avatar

PT physical therapy is often more painful than the days right after surgery. Pain is the messenger he needs to be more mindful of the severity of his injury/surgery.

Kardamom's avatar

There’s a possibility that he is suffering from nerophathy, which involves damage to the nerves. Sometimes the nerves have been cut, and when you have nerve damage, your brain gets “wrong” signals and that is where the pain comes from. It’s really hard to treat. My father, who had heart sugery 2 years ago, has neuropathy pain in his chest (where the wound/scar is) from where they had to remove a large vein to use to bypass his blocked arteries, and another wound/scar all the way down his leg, where they took another long vein to use to bypass his blocked heart arteries.

He has been going to the pain specialty clinic at Kaiser for a year and a half and they’ve tried everything from pain pills, to pain killing ointments (specialized mixtures) as well as accupuncture and so far nothing has worked, but that is not to say that something might not work for your uncle, but you have to be very pro-active in asking for a pain specialist. There are also neuropathy forums online where other people talk about what they have tried and what worked or didn’t work for them. You might try that too.

augustlan's avatar

There are also some people, like me, who just don’t respond well to opiates. I can be up and walking around while on a very high dose of straight Morphine, and still be in pain. Let me tell you… that sucks.

On the upside, strong NSAIDs do work for me. Maybe he just needs to switch to another kind of pain killer.

Jeruba's avatar

Different pain meds work differently for different people. Hydrocodone does nothing for me, barely even takes the edge off, although my husband uses it successfully to manage his severe chronic back pain. Ibuprofen also helps him but simply doesn’t do it for me.

I’ve had to experiment with combinations to get something that eases things up for me. The strongest stuff doesn’t always work best.

There are still a lot of mysteries to pain.

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