New to bone/nerve pain, what do you do?

So sorry that you are having this kind of pain. It does really suck. As you know I also have had so much trouble with my hip. Before surgery I had taken OxyContin, that didn't help at all. Then I went to Dilaudid, that didn't do a thing either. Since I had surgery, I have been on hydrocodone with acetaminophen. That is the ticket for me. I can function near normal on it. I think the key is what works for your body and I think it is trial and error. Also, for me, I don't want anything that makes me feel drowsy. I want to be able to function normal and be able to drive. I hope you find something that works for you soon. Pain is no fun. Best wishes.

Forgot one other drug. At one point I was put on neurotin. That does seem to work but I was so sleepy I couldn't do anything. So I didn't stay on that long.

Fitz, you certainly can say that it sucks. I take hydromorphone every 12 hours with Naproxen and Tylenol. Dilaudid for breakthrough. Works for me. Constipation is an issue. I function very well, I can drive etc. When I started or adjusted the hydromorphone, it takes about 48 hours to kick in.

Good luck!

Norco (acetaminophen and hydrocodone) worked for me when I had back and hip pain, but it made me sleepy so I used it sparingly and mostly at night. Luckily my pain wasn't *too* bad and I could live with it by modifying my movements and doing a lot of sitting still on the couch when not at work.

I hope you find something that works for you. It certainly does suck. Sending hugs.

Edited to say Naproxen (Aleve) works well for me for the less severe pains. The Norco was what I used when it got bad enough to warrant something stronger.

Cancer-related pain, especially in bones and nerves, can be exceptionally difficult to bear and tends to be very under-treated. I am sorry to hear you are dealing with it and hope some of the suggested therapies above, or something from the list below from my MBC Guide, is of help to you. Also please remember that assembling a Palliative Care Team may be a helpful option if you do not already have one in place.

I hope you find excellent relief very soon!

For General Pain:

• Strong Opioids medications include Morphine (Avinza, Ms Contin, others), Oxycodone (OxyContin, Roxicodone, others), hydromorphone (Dilaudid, Exalgo), Fentanyl (Actiq, Fentora, Subsys [an under-the-tongue spray] and others), Methadone (Dolophine, Methadose) Oxymorphone (Opana), and Tapentadol (Nucynta).Some others are:

• Targiniq ER, which was FDA-approved in 2014, is a new opioid that is an extended-release/long-acting opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate." Targiniq ER has properties that are expected to deter, but not totally prevent, abuse of the drug by snorting and injection. In addition, the Naloxone in Targiniq ER blocks the euphoric effects of oxycodone and helps circumvent the constipation that usually accompanies the ingestion of opioids.
• Zohydro ER is a new extended-release, oral opioid indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment.
• Hysingla ER is another strong opioid, which has the same active ingredient (hydrocodone) as Zohydro ER, the only other approved extended-release hydrocodone product.There are important differences between the two drugs.Hysingla ER has approved abuse-deterrent labeling, while Zohydro ER does not. Also, Hysingla ER is taken every 24 hours, whereas Zohydro ER is taken every 12 hours, and therefore comes in lower dosage strengths.

From: http://blogs.fda.gov/fdavoice/index.php/2014/11/additional-progress-on-reducing-the-abuse-of-opioid-pain-relievers/#sthash.DwMxtFrZ.dpuf

• Antidepressants. Certain medications called "tricyclic antidepressants" have been found to help relieve pain by interfering with chemical processes in the brain and spinal cord that causes a person to feel pain.Examples include Amitriptyline, Doxepin and Nortriptyline (Pamelor).Additionally, some people experienced a significant decrease in neuropathy-induced pain when they took a prescription antidepressant drug called Cymbalta (Duloxetine).

From:http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/basics/treatment/con-20019948

• Anti-seizure Medications. Certain medications such as Gabapentin (Gralise, Neurontin) and Pregabalin (Lyrica), which were developed to treat epilepsy, may relieve nerve pain. From: http://www.mayoclinic.org/diseases-conditions/peri...
• Nerve Blocks (including Epidurals): Specialized treatment involving the injection of a nerve-numbing substance may be used. This may help prevent pain messages traveling along that nerve pathway from reaching the brain.
• Pain Pump: A pain pump may be a viable consideration when oral and IV pain medications fail to control pain adequately.The pain pump is an implanted drug infusion system that releases prescribed amounts of pain medication directly to the pain receptors (nerves) near the spine.The entire system consists of a pump and a catheter. The pump, whose purpose is to store and deliver pain medication, is surgically placed in the abdomen. The catheter is inserted into the intrathecal (spinal canal) space surrounding the spinal cord. The catheter is then connected to the drug pump.The doctor fills the pump with pain medication using a needle. The pump sends the medication through the catheter directly to the spinal area where pain receptors are located. Patients return to their doctor for more medicine when the pump needs to be refilled.Before having the pump implanted, an epidural screening test provides a temporary evaluation period so that patients can determine whether the targeted drug delivery truly relieves the pain.It is worthy to note that the system can be turned off, or surgically removed, if eventually desired.One person with bone mets broke several ribs due to severe coughing and decided to have a pain pump inserted.She was also allergic to several pain medications, and has had no allergic reaction to the four the medications in the pump.After three years of living with the pump, she claims not to have experienced side effects such as drowsiness or constipation because the drugs bypass the digestive system, and the dosage is a fraction of the norm (since the drugs are delivered directly to the pain receptors). She has the pump refilled every two months and is able to administer an extra injection if necessary.In summary, she claims to be much more comfortable than she had been before she used the pump.More information about pain pumps is located at: http://www.medtronic.com/patients/cancer/device/wh...

For Bone pain:

• Bone Cement
• Infrared Heating Pad
• MRIgFU Ablation Therapy (ExAblate)
• Other Current Non-Surgical Ablation Techniques

• Cryoablation
• External beam radiation
• RadioFrequency Ablation
• Radiopharmaceuticals
• Stereotactic body radiation and stereotactic radiosurgery
• Other techniques

• Strontium 89
• Surgery

• Bone Cement: One option to strengthen and stabilize a bone is to use injections of quick-setting bone cement or glue called PolyMethyl MethAcrylate (PMMA).When PMMA is injected into a spinal bone it's called "Vertebroplasty" or "Kyphoplasty."This treatment helps to stabilize the bone and relieve pain in most people.When bone cement is injected to strengthen bones other than the spine, it's called "Cementoplasty." Sometimes, it is used along with surgery, radiation, radiofrequency ablation, or other treatments, depending on the person's medical situation.A person with spinal cord compression, an infection, or in poor health might not do well with this treatment.

From: http://www.cancer.org/treatment/understandingyourdiagnosis/bonemetastasis/bone-metastasis-local-treatments

• Infrared Heating Pad, which uses infrared technology that can penetrate several inches deep into the body for pain relief and relaxation.One woman wrote that she tried using the Infrared Heating Pad on her back for intense pain from bone mets and her back pain almost completely subsided.

• MRIgFU Ablation Therapy (ExAblate).This type of therapy significantly reduced pain in 67% of patients who received the treatment. The device uses numerous small ultrasound beams designed to target a tumor within the bone, heat it and destroy it.ExAblate was approved by the U.S. Food and Drug Administration as second-line therapy for palliation (relief) of painful metastatic bone tumors. The first-line therapy is typically radiotherapy. The response to ExAblate appears to be as good as radiotherapy, which was notable because it is very unusual to see a second-line treatment with a response rate that is as high as first-line therapy. From: http://www.sciencedaily.com/releases/2013/06/130602144337.htmand : http://www.insightec.com/bone-mets-pain.html

• Non-surgical Ablation Techniques: The term "ablation" usually refers to the removal of harmful substances from the body. In this context, placing a needle or probe right into a tumor and using heat, cold, or a chemical to destroy it is called ablation.Ablation may be used if only 1 or 2 bone tumors are causing problems.

Current non-surgical Ablation Techniques include:

• Cryoablation, which entails using a very cold probe that is put into the tumor to freeze it, thus killing the cancer cells.
• External Beam Radiation, which is a very common ablation technique.
• RadioFrequency Ablation (RFA): Radiofrequency Ablation uses a needle that carries an electric current.The electric current is delivered through the needle to heat the tumor to destroy it.RFA is usually done while the patient is under general anesthesia.
• Radiopharmaceuticals: Substances called radiopharmaceuticals are given through a vein, and they use low levels of radioactive material that has a strong attraction to bones.Once in the body, the particles travel to the areas of bone metastasis and release their radiation.This treatment doesn't require a hospital stay, and the patient will not be radioactive after treatment.From: http://www.mayoclinic.org/diseases-conditions/bone-metastasis/basics/treatment/con-20035450

• Stereotactic Body Radiation and Stereotactic Radiosurgery are more complex therapeutic options.Stereotactic body radiation works well on spinal lesions that recurred after standard radiation.This procedure allows for treatment while avoiding the spinal cord.Stereotactic Radiosurgery (SRS) is a form of radiation therapy that focuses high-power energy on a small area of the body. From: http://www.1uponcancer.com/2014/11/17/palliative-radiation-for-cancer-pain-2/

• Other techniques utilize alcohol to kill the cells, or other ways to heat the tumor (such as Laser-Induced Interstitial Thermotherapy).After the cancer tissue is destroyed, the space left behind may be filled with bone cement.

• Strontium 89 (under the brand name Metastron) is an older therapy that has been used to treat painful bone metastasis accompanying breast cancer.Once injected, Strontium 89 is selectively taken up by the bone tissue surrounding the metastasis.The body treats the strontium as if it were calcium, putting it into the bone surrounding the cancer.The Strontium 89 then bathes the tumor with radiation while sparing all the normal tissues in the body.Strontium 89 emits beta particles which kill the cancer.The tumor shrinks, thus relieving pain.The development of painful new tumor sites is also slowed or eliminated.From: http://www.princetonradiology.com/physicians/articles/soffen_3-29-96.html

• Surgery: Surgery to remove a primary bone tumor (one that started in the bone) is often done to try and cure the cancer.But often the purpose of surgically treating a bone metastasis is to relieve symptoms and/or stabilize the bone to prevent fractures.Bone metastasis can weaken bones, leading to fractures that tend to heal poorly.An operation can be done to place screws, rods, pins, plates, cages or other devices to make the bone more stable the bone and help prevent fractures.If the bone is already broken, surgery can often relieve pain quickly and help the patient return to their usual activities.If the doctor cannot surgically reinforce a bone that has metastasis, a cast or splint may help stabilize it to reduce pain so the person can move around.

Robaxin as a Medication for Bone-Specific Pain:In addition to the items listed under "Pain Medications" in the beginning of this section, a drug called Robaxin (Methocarbamol) was praised by one patient with bone pain.Robaxin is a central muscle relaxant used to treat skeletal muscle spasms.She wrote, "Someone recommended an unlikely drug to me which has had excellent effect on my bone pain and general aches and pains.It's called Robaxin, which may be worth asking to try because it has helped me a lot. I can't take the Oxy's and Percocet and Vicodin. They make me vomit and become dizzy. Robaxin has helped me a lot."

bestbird always great info thanks.

I have had hip pain and leg pain that sounds similar to yours but not as intense. I am on hydrocodone 7.5, and take 1 to 3 a day. My favorite non med things to do are Epsom salt bath and a well placed nap.

Good luck

Mary