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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Medicine For Lower Back Pain Despite Fentanyl And Dilaudid?

I suffer from chronic pain due to lower back pain that has been diagnosed as piriformis syndrome or sciatica. I have a .025 mcg fentanyl patch and 4 mg dilaudid up to 3 x daily for breakthrough. My pain has begun to worsen at night to the point that it awakens me. I've tried sleep medication to help me sleep through it but it does not help. Once the pain starts, I wake up. Is there something else that my doctor can do to help me just sleep through the night? He doesn't want to give me any other narcotics but until I receive a proper diagnosis, what can I do?
Mon, 24 Feb 2014
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Orthopaedic Surgeon, Joint Replacement,  's  Response
I am not sure if you have checked your diagnosis withMRI. This is the best investigation to confirm if you have sciatica. After confirming your diagnosis we can focus on analgesics. I would prefer gabapentin or amytryptalin over drugs which you are taking. If drugs are not effective physiotherapy and surgical solution is also available. I hope this answers your query. Feel free to question an thing else. Take care.
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Medicine For Lower Back Pain Despite Fentanyl And Dilaudid?

I am not sure if you have checked your diagnosis withMRI. This is the best investigation to confirm if you have sciatica. After confirming your diagnosis we can focus on analgesics. I would prefer gabapentin or amytryptalin over drugs which you are taking. If drugs are not effective physiotherapy and surgical solution is also available. I hope this answers your query. Feel free to question an thing else. Take care.