Pain management...

[EEzycade]

Hey guys. So Thursday night I had an accident. I am in a power wheelchair and accidentally rolled off a curb, sending me out of my wheelchair into a faceplant on the asphalt. Banged my knee good. My sister thinks(she’s a massage therapist) thinks it is my meniscus that is causing unbelievable pain. What methods do you guys have(besides drugs, already on them) for pain management? Thanks so much. Also want you people to know that this forum has been a great distraction, thanks.

 

[annk]

If you already have the pain meds you need/can take, the only other thing I can suggest that I use myself is deep breathing and/or some sort of meditation.

Hope you're ok - a faceplant off a wheelchair sounds brutal.

 

[Scepticalscribe]

Hey guys. So Thursday night I had an accident. I am in a power wheelchair and accidentally rolled off a curb, sending me out of my wheelchair into a faceplant on the asphalt. Banged my knee good. My sister thinks(she’s a massage therapist) thinks it is my meniscus that is causing unbelievable pain. What methods do you guys have(besides drugs, already on them) for pain management? Thanks so much. Also want you people to know that this forum has been a great distraction, thanks.

I damaged my meniscus two years ago, a slight tear, and it was incredibly painful; I was on industrial strength pain-killers for a number of weeks, - and could barely walk - but was also on strong anti-inflammatories to reduce the swelling.

The dose was gradually reduced over a period of several weeks, from a few daily, to one every day or two when required as pain management.

However, the thing is, I needed a doctor to confirm what was wrong and to prescribe the appropriate medication.

I would really recommend that you see a doctor who can tell you exactly what is wrong and can prescribe pain-killers of an appropriate strength (something you won't be able to obtain over the counter).

Commiserations on the nature of your accident; it sounds awful, and the best of luck with your recovery.

 

[annk]

I damaged my meniscus two years ago, a slight tear, and it was incredibly painful; I was on industrial strength pain-killers for a number of weeks, - and could barely walk - but was also on strong anti-inflammatories to reduce the swelling.

The dose was gradually reduced over a period of several weeks, from a few daily, to one every day or two as I retired pain management.

However, the thing is, I needed a doctor to confirm what was wrong and to prescribe the appropriate medication.

I would really recommend that you see a doctor who can tell you exactly what is wrong and can prescribe pain-killers of an appropriate strength (something you won't be able to obtain over the counter).

Commiserations on the nature of your accident; it sounds awful, and the best of luck with your recovery.

The OP is already on pain meds, if I understood correctly, so I just assumed a doc has been consulted.

 

[Scepticalscribe]

The OP is already on pain meds, if I understood correctly, so I just assumed a doc has been consulted.

He didn't actually state that; I have pain meds in my cabinet, - over the counter pain meds - but not at the strength required for numbing the pain of a partly or fully torn meniscus.

Moreover, he wrote that it was his sister - who works as a massage therapist - who was of the opinion that this might be a torn meniscus. If a doctor had been consulted, I assume that this would have been confirmed, rather than something that is a matter of opinion.

Therefore, he may need to see a doctor to confirm, firstly, that this is actually a torn (or partly torn) meniscus, and secondly, to have appropriately robust pain-killers (and possibly anti-inflammatories) prescribed.

Mine were very very strong, and they needed to be, because this is a very painful condition.

 

[EEzycade]

He didn't actually state that; I have pain meds in my cabinet, - over the counter pain meds - but not at the strength required for numbing the pain a partly or fully torn meniscus.

Moreover, he wrote that it was his sister - who works as a massage therapist - who was of the opinion that this might be a torn meniscus. If a doctor had been consulted, I assume that this would have been confirmed, rather than something that is a matter of opinion.

Therefore, he may need to see a doctor to confirm, firstly, that this is actually a torn (or partly torn) meniscus, and secondly, to have appropriately robust pain-killers (and possibly anti-inflammatories) prescribed.

Mine were very very strong, and they needed to be, because this is a very painful condition.

I have some leftover oxycodon from a major back surgery last summer. 10 mg every 2 hours during the day. At night every 4 with advil mixed in. But I only have about 5 more servings of the oxy. But I will have to see a doctor, considering the pain is almost unbearable even with oxyxodon. Thx for the kind words. If you’re wondering how its torn or possibly torn from a fall. Since I don’t walk, my legs don’t straighten, they hardly go past like a 120 deg angle. So my leg was straightened. Ouch

 

[Scepticalscribe]

I have some leftover oxycodon from a major back surgery last summer. 10 mg every 2 hours during the day. At night every 4 with advil mixed in. But I only have about 5 more servings of the oxy. But I will have to see a doctor, considering the pain is almost unbearable even with oxyxodon. Thx for the kind words. If you’re wondering how its torn or possibly torn from a fall. Since I don’t walk, my legs don’t straighten, they hardly go past like a 120 deg angle. So my leg was straightened. Ouch

Mine was a fall, too, and, as I couldn't use my hands at the time, - it was a training exercise, - I fell heavily.

Initially, I just assumed that it was a problem of a very sore - which became an excruciatingly sore - knee, but, it didn't get any better over the following two or three days, was exceedingly painful, and I could hardly walk (an agonised hobble).

So, a visit to a doctor gave me a diagnosis, and some very strong medication (which was very necessary).

Seriously, you will need professional medical confirmation of your condition, and proper treatment for the condition and for the pain; possibly anti-inflammatories as well.

I was advised to keep the knee raised, and not to put weight on it, if at all possible.

In any case, that sounds horrible, - it must have been an awful shock and very distressing as well as painful; the very best of luck with it.

 

[Gutwrench]

Since I don’t walk, my legs don’t straighten, they hardly go past like a 120 deg angle. So my leg was straightened. Ouch

Yikes! Thinking about that makes me cringe.

I don’t have full ROM in one leg but not anything close to that severe. I’m about +5 to +7 degrees of extension and roughly 120 flexion. I think it’s still considered normal range for typical use, but it really isn’t. Any force pushing motion outside that limit can be excruciating. I still have 15 packs of 5 oxy in my drawer which I use sparingly.

I walk pretty normally with various degrees of a limp. But I’m not complaining. Best wishes to you.

 

[AlliFlowers]

Ice, ice, baby.

Seriously. It's amazing what ice can do. During the peak pain from my neuropathy, I used ice baths. I've recently started cryotherapy. While not covered by insurance, it has been an incredible help in many ways. (I'm even crediting it with my hair starting to come back after almost SEVEN years!)

 

[D.T.]

Get to a Pain Management doc/consult ASAP. They have a whole range of options, drugs alternatives (i.e., outside of your current meds, which may not be working / too much negative side effects, etc.), isolated acute pain interventions, more advanced physical therapy/massage.

 

[annk]

Just to clarify: were you asking about ways to deal with pain other than medication? It sounded to me like you were already on pain meds and wanted our experiences with other ways of dealing with pain.

That's how I interpreted your post, but I could of course be off base.

 

[A.Goldberg]

I have some leftover oxycodon from a major back surgery last summer. 10 mg every 2 hours during the day. At night every 4 with advil mixed in. But I only have about 5 more servings of the oxy. But I will have to see a doctor, considering the pain is almost unbearable even with oxyxodon. Thx for the kind words. If you’re wondering how its torn or possibly torn from a fall. Since I don’t walk, my legs don’t straighten, they hardly go past like a 120 deg angle. So my leg was straightened. Ouch

I’m PharmD with board certification in psych medicine (which includes pain management) and someone who has suffered chronic pain for almost 15 years from a sports injury.

I’d highly recommend not taking opioid pain killers that are not prescribed for the reasons other than their intended use. Opioids can interact with many other medications + alcohol, can cause dependence issues, and may raise red flags if your doctor puts you on a pain management program and you’re drug tested.

10mg of oxy every 2hrs is not appropriate dosing for that medication- especially if it is OxyContin (time release, versus oxycodone which is instant release). If you’re only getting 2hrs of relief it’s an indicator this is not appropriate treatment. Oxycodone should give at least 4-6hrs if relief and OxyContin at least 8-12hrs generally speaking.

How long ago was the accident that caused this knee pain?

I can definitely sympathize with the impact on life chronic pain has. I’d highly suggest talking to your doctor about underlying issues and seeing an experience, qualified pain management specialist. There are many other medications beyond opioids and NSAIDs that may be helpful in mitigating your pain.

Outside of conventional treatments like physical therapy, message, hot/cold treatment, injections, and medications, many people find meditation helpful. Some people find acupuncture helpful. Many people with chronic pain see a therapist given a strong relationship between the psyche and pain perception. Typically stress, anxiety, and depression will make pain worse, and pain can also induce these states, so it can be a viscous cycle.

To be blunt, Depending on your condition, it’s also important to recognize that 100% pain relief may not be feasible. In many cases the goal is reaching a manageable level of pain. You should identify how the pain is impacting your life and what it’s preventing you from doing. From there you can set goals of what you want to accomplish and track the progress you make to see how effective the pain management is from a more objective standpoint.

It’s also worth noting if you’re had a lot of opioid pain killers in the past, you may have “opioid induced hyperalgesia” which is a fancy way of saying you perceive pain as more severe because of past opioid use.

PLEASE, see a medical provider to determine there are no underlying issues and to appropriately treat the pain. Best of luck.

 

[EEzycade]

Just got an X-ray. Fracture of the femur close to the knee. They’ll splint it, prescribe some drugs, and I’ll go home.

 

[A.Goldberg]

Just got an X-ray. Fracture of the femur close to the knee. They’ll splint it, prescribe some drugs, and I’ll go home.

I didn’t realize this was such an acute injury, usually “pain management” in casual medical vernacular implies chronic pain, though technically it does include acute. I’m glad you got checked out and are on the mend.

Makes sense though. No one should be in that severity of pain from a simple bump on the knee. A meniscus injury only would have been likely if you twisted your knee (usually right or left- the way the knee doesn’t bend). Bone damage seems most likely if it was just blunt trauma and no hyperextension of the knee.

A fractured femur is no joke though- it’s an awfully big bone to break and reportedly extremely painful, often requiring surgery... and in some cases it can be life threatening due to large nearby blood vessels. This is exactly why people should seek medical attention! I suppose if there is any upside, given you use a wheel chair the functional impact is less and recovery will be easier.

It sounds you may have a supracondylar femur fracture which is a fracture at the distal end of the thigh bone, just above the knee. This injury is often associated with falls and older people with osteoporosis. As you may know, people who use wheel chairs are prone to osteoporosis due to the lack of weight bearing activity. Other conditions and medications can also exacerbate the risk of osteoporosis. You may want to talk to your healthcare providers about minimizing bone loss (usually through diet and exercises + assess any meds that may decrease bone density) to help prevent future injuries, if you aren’t making efforts already.

Best of luck in your recovery. The acute pain should hopefully subside quickly and things will be all healed up in a few months.

 

[Scepticalscribe]

Just got an X-ray. Fracture of the femur close to the knee. They’ll splint it, prescribe some drugs, and I’ll go home.

I'm delighted that you managed to receive medical attention - and, above all, a formal diagnosis of what has been troubling you.

Now that the problem is known and identified, it will be a lot easier to prescribe medication to treat it and deal with the pain.

@A.Goldberg has written two excellent and thoughtful and interesting posts, well worth & amply repaying a close read.

Meanwhile, the very best of luck with your recovery.

 

[EEzycade]

It'll be six weeks since the accident on Thursday. Happy to report that my recovery is going well and new bone is growing. Should be back to normal within a few weeks

 

[Scepticalscribe]

It'll be six weeks since the accident on Thursday. Happy to report that my recovery is going well and new bone is growing. Should be back to normal within a few weeks

Great news, thanks for reporting back to let us know how you are getting on, and hopefully, you will continue to recover well.