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I seem to be able to manage my chronic low back pain with Oxycontin. The pain is tolerable and I'm able to put in my three shifts a week at work. My doctor says I'm not improving and would like to see me get off the drugs. Isn't not getting worse an acceptable result? I'm happy with it, but I can't seem to get that across to the doc. What do you suggest?
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More and more, patient satisfaction is becoming an acceptable outcome measure of treatment. However, when potentially addictive medications such as narcotics (e.g., Oxycontin) are involved, the physician recognizes that there are other factors to consider.
Besides the fact that these drugs can be addictive, studies show that sometimes patients don't get better in any other way. In other words, their function doesn't improve. They have an improved sense of well-being but it is chemically induced. Without the medication, pain intensity would lead to increasing disability.
Many physicians consider this a bandaid approach. It may make you happy for the moment, but it's not an acceptable long-term solution. A drug-free, pain free life is the ultimate goal. That may not always be possible with chronic pain problems, but until all other options have been explored, it is not considered the answer. Every patient situation is different with unique factors and variables to consider.
At your next visit, bring up this question to your physician while being open yourself to any specific ideas he or she may have to improve your pain and overall function. Sometimes it takes a multidisciplinary approach to solve a problem like chronic low back pain. Narcotics may play a role, but it usually isn't the only treatment.
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