Use of Opiates for long term chronic pain

[kdkae1]

Dr. Towfigh,

You are completely right about opiates. I have been seeing a pain management doctor for over 2 years for chronic groin pain. After several RFA’s procedures, will little success, he put me on a Butrans patch weekly and vicodin prn. The Butrans helped alot to begin with, but I was gradually increased from 5mcg to 20mcg weekly. Once what worked so well only gives me minimal pain relief and I now use Vicodin at least twice daily. I need it more but I can’t work and function properly when I take it. Dr. Chen redid my right inguinal hernia in April and found a recurrent inguinal hernia and an open hernia in the abdominal wall. Just recently he redid my left side and found a recurrent inguinal hernia and a “new” femoral hernia. I feel much better than I have in a long time but still have residual pain on the right side. I noticed in April when prescribed percocet and ibuprofen that once I stopped percocet 1 week later, that the ibuprofen provided me more relief than the opiates had in the past. Opiates help some for post op pain, but not well for me as I had developed a tolerance to them. Chronic opiate medication should never be used long term as the side effects are many, to include constipation, which can cause future hernias. I have found that ibuprofen at higher doses work better. I noticed in one of your articles that you use a combination of tylenol, naprosyn, and homeopathic medications. Could you tell me what you use for chronic pain other than opiates. Thank you.

[drtowfigh]

Use of Opiates for long term chronic pain

Thanks so much for this!
I am a big advocate of non-opiate pain medication. For hernias, this pain is mostly inflammatory, so I recommend and prescribe mostly anti-inflammatory medications. In fact, most of my patients are started on this regimen prior to surgery, to help reduce the inflammation from surgery.

I recommend the following anti-inflammatory regimens:
– Ice
– Naproxen
– Arnica 12C
– Bromelain
– Alpha Lipoic Acid
– Super B complex
– Ginger
– Turmeric

Except for the Naproxen, almost everyone can take these medications with little to no side effects. And they work!

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