Treatments

For those of you who are in the pain-management stage, perhaps still waiting on a diagnosis or surgery, here are some of the ways I found to minimize my pain levels before I got an accurate diagnosis and the right surgery. Please discuss these options with your doctor.

Adaptations: These are the little tricks that I (and many others with similar neck pain, I'm sure) have developed in order to help prevent or lessen pain that is related to a damaged disc in the spine. Check out my page about this topic, as simple adaptations can make a big difference in an individual's life.

Medical Pain Management: This is obviously very important, also, as adaptations cannot prevent all of the pain associated with disc damage. As hard as it is to do, it is important for individuals to find a good doctor, no matter what kind,  who will help them to manage their pain. Personally, I have been to three different neurologists over the years, and not one of them has provided better pain management than my family doctor. I am very blessed to have an intelligent, humble, and helpful doctor, who is willing to learn about my diagnoses, both on her own and from my mom and me. (Her name is Dr. Janet Ciarkowski, and she practices in Frederick, Maryland.)

I know it is important to have a good neurologist who can help monitor your Elhers-Danlos or vertebral injury and recommend surgery if that is appropriate. However, sometimes the most helpful doctor is the one who treated you for a cough last winter. Be discerning, but don't be afraid to educate your doctor about your illness. If nothing else, he or she might use that knowledge to help someone else later on.





My Drug Shelf

• Pain Killers: In my experience, pain medication was a necessity. I never left home without it! I counted the number of different medicines in my purse the other day--There were eight, and I could name, spell, and pronounce every one of them! Anyhow, here is my knowledge about, and some of my experiences with, pain killers. Keep in mind that everyone's body reacts differently, and my experiences may not apply to anyone else. Please discuss these options with your doctor.

• Imitrex: This is a migraine medicine. I took it once, and it made my headache worse. (This was a solitary event, so it may not represent Imitrex accurately.)
• Celebrex: This medicine is made to treat arthritis pain. Because it targets swelling, it can really help with inflammation in the spine. This is a twelve-hour medicine, and it can only be combined with limited amounts of another over-the-counter pain medication, so I only use Celebrex in certain situations. I find Celebrex to be most effective for long days when I have a lot of activities planned. If I know that a particular day is going to give me a headache (like if I'm taking a road trip) I take this in the morning after I eat. It lowers my over-all pain for the entire day, and it helps to prevent a really bad headache from starting.
• Tylenol with Codeine #3: I used to take a generic form of this, but I found it hard to swallow (it wasn't coated.) When I did get it down, though, it helped a lot. However, when I was coming off of it, I experienced panic attacks... I'm not sure why, but I did. I don't take that one anymore.
• Darvacet: I used to take this one, and it worked really well, with limited side affects. Unfortunately, it's not on the market anymore.
• Lidocaine Patch: This is a sticky patch that you can place anywhere on your body for localized pain relief. I haven't found this to be useful just yet, but I am still trying it with different types of pain in various places.
• Compazine: This medicine treats pain and nausea, and it is typically used by those going through cancer treatments. During a trip to the emergency room, I was prescribed this because my headache was so bad that I was really nauseous. The doctor gave me more of it for later, and I used it in combination with an over-the-counter pain killer, but I don't remember which one. Compazine was a wonderful add-on to my other pain-killers, offering me the boost I needed to get through that cycle of headaches. However, it made me sleepy and gave me extremely restless legs, which was an awful combination! Once I was past the very worst of the pain, I decided it wasn't worth those two side affects.
• Ibuprofen (a.k.a. Motrin): I take this often, especially when I need immediate relief. It often is just enough to take the edge off, but sometimes that's all I need. However, make sure to eat with ibuprofen, otherwise it can damage your stomach and make you nauseous.
• Acetaminophen (a.k.a. Tylenol): I also take this frequently; it provides about the same amount of relief as Ibuprofen, and the two can be taken at the same time. I find it helpful, when I need to take both, to stagger this with Ibuprofen. Acetaminophen is a six-hour drug, and Ibuprofen is a four-hour one. If I take them an hour apart the first time, then they never wear off at the same time.

• Antidepressants: Antidepressants are obviously used to treat depression, but they can also help manage chronic pain, even when there is no depression involved. I'm not sure about the exact science, but antidepressants affect Serotonin in the brain; serotonin is a neurotransmitter that gives us a happy, relaxed feeling. Therefore, antidepressants help to counteract the physical and emotional affects of chronic pain. Personally, 20 mg a day of Lexapro has made a huge difference in my life, helping to lower my overall pain and manage the emotional effects of chronic pain.

• Amitriptyline:  This was the first antidepressant I tried; my daily dose was only 10mg. (The level used for treating depression is 40-150 mg.) However, despite this low dose, it really helped to keep my pain levels down. I still had bad days, but the bad days weren't quite as bad as they had been. It also helped with my mood. I hadn't even noticed, but the daily pain had really started to get to me, and I had sort of sunken into a state of weariness, both physically and emotionally. I highly recommend Amitriptyline. My only complaint about it is that, when my neurologist took me off of it, it was really hard going for a couple of weeks. I experienced a lot of pain, fatigue, and anxiety. In fact, my anxiety attacks started when I was taken off Amitriptyline.
• Lexapro: This is my current antidepressant; I take 20mg a day for pain, and it helps a lot. I am definitely not pain-free, but with Lexapro, the overall levels aren't as bad as they were without it. It also helps me with other issues like anxiety, fatigue, and brain fog. Lexapro usually makes people sleepy, but I've found that it has the opposite effect on me, so I take mine in the morning to help me wake up.

• Others: It is common for those with chronic pain also to have other health issues, and I am no different. Here are some other medications with which I have experience because of these other issues.

• Alprazolam: This is a generic form of Xanax, and it is used to treat anxiety. I take this before especially stressful events, in order to prevent panic attacks, and I take it when I am having a panic attack, in order to cut it short. This is very effective for me, and it has prevented and stopped many of my anxiety attacks. Really the only side affect I experience is drowsiness, so I don't take it before driving or such things as tests, for which I need to be alert.
• Flexeril: This is a muscle relaxant, and it is wonderful. I have extremely tight muscles, especially in my shoulders and my back, and the tension makes my headaches worse. So on nights when my muscles are especially tight or spasming, and I know I can afford to sleep for a good ten hours (it knocks me out), I take this. When I do, I feel a good deal looser in the morning.

Massage Therapy: Another treatment that helps to relieve my headaches is massage therapy. As I mentioned, my back and my shoulder muscles spasm and tighten often, especially during the school year when I am sitting at my desk a lot. Because tight muscles can make neck pain worse and can cause tension headaches, I get a massage when I feel especially tight and don't think that Flexeril will be enough. I've been doing this for a couple of years now, and it has made a big difference in my tension and, as a result, my back pain and my headaches.

I highly recommend, however, that individuals with neck injuries be cautious when it comes to massages. Be aware of sensitive areas, like your neck and the base of your head, and speak up if the masseuse is getting too close or pressing too hard. Protecting yourself from pain is worth creating an awkward moment.

The masseuse will most likely require you to lie down on your back and your stomach, so that she can get access to your shoulders and your back. If you physically cannot tolerate this, massage may not be a good option for you. Personally, my massages last for thirty minutes, so I only lie in one position for about fifteen minutes. It still hurts me to lie on my stomach or my back, but I find that doing so hurts less now than it did when I first starting getting massages. It's as if my neck has become more tolerant over time.

However, because I was still uncomfortable in those positions, I often got a headache from the massage itself. If necessary, I take pain medicine to help with this headache, and sometimes I take a nap when I get home from a massage. I do not get massages on days when I already have a bad headache, as the muscular relief is then not worth the added pain of lying in uncomfortable positions. But on days when my headache is relatively low, I find that a massage helps my muscles to relax, and therefore reduces my headaches overall, even if I get a small one from the massage itself.

I am very blessed to have a kind, understanding masseuse, who is compassionate about my health issues. For anyone local, I highly recommend Cheryl Hamby. She works out of the Robinwood Medical Center in Hagerstown, MD. She also has her own massage business, which she runs out of her home in Greencastle, PA, named Cheryl's Therapeutic Massage.

Try to find a masseuse who works through a physical therapy office and is therefore well-trained, or get a recommendation from your doctor.