My mother is 94, she has back pain, hip pain and knee pain due to sciatica and arthritis. She also has left shoulder pain. She has been to several doctors and had epidural, cortisone shots etc. NSAIDS are the only medications she can take which are not helping much. No one will give her a prescription for anything stronger like Norco which has helped in the past. She does use lidocaine patches. The only thing that works is just sitting all the time which she hates. The doctors have told her she needs to see a pain specialist, but she doesn't want to because in the past, they have not helped or made the problem worse. She is fixated on Norco as a solution.
I can tell you what has worked for my Mom. She has scoliosis and very, very bad arthritis in her lower back and knee. Her doctor okayed her for an elevated dose of Tylenol.
For the arthritis, she takes CBD in pill form. Creams and rubs did nothing. I did not try the oil since I was told it had a bitter taste and I knew that once my Mom associated the taste with the CBD, she would not take CBD ever again. I've been told that the oil is the best way to get the CDB into the body.
She also takes Aleve (yes, both Aleve and Tylenol). She takes Famotidine (aka Pepcid) to toughen her stomach lining because the Tylenol can burn a hole in her stomach. She also takes a minimum dose of Gabapentin (I have heard of some people having horrible, horrible side effects from Gabapentin, however, my Mom tolerates the minimum dose well. We were authorized up to a triple dose, however, we saw a change with just a single dose.)
We first had her on Advil and Tylenol, however, the Pain doctor, suggested using Aleve instead so that she only takes it 2 times a day instead of every 4 hours.
With only Aleve and Tylenol, it removed the sharpest of the pain, however the pain was still noticeably there. Then we added CBD to the mix and slowly increased the dosage. Since it is a systemic drug, we had to wait 2 weeks before deciding whether the dose should be increased or not. We got the pain down to tolerable. After about 3 months, we went to a Pain doctor to ensure that the concoction that we gave her was acceptable for long term use. And that was when we added the Gabapentin (helps her pain so that she can sleep) and the Famotidine.
My Mom had a problem with her shoulder and we tried the cortisol shots. It didn't help at all. So we worked with PT to help the shoulder. It still flares up every so often.
My Mom refuses to use ice and she cheats on her exercises. However, we are going on the 4th year of this concoction and she is now over 100 years old.
The pain is still there. Sometimes it is worse than other times (which I have found an extra dose of Vitamin C and a B Complex to help during these times), however, at least it is tolerable.
About the CBD, if your Mom is in a managed care facility, they might not allow the use of CBD. When my Mom was in a federally funded hospital (it was the only hospital that performed that specific kind of surgery), she was not allowed to take CBD. Thankfully, she was only in the hospital for 3 days.
I just read the post below mine. Food does have an impact on pain. A diet high in refined sugars (e.g. cookies) does seem to trigger an arthritic pain episode in my Mom. No cookie binges anymore....
Does she live on her own? Would someone be administering the Norco to her? It is very constipating, fyi. Very. Norco may create a fall risk for her. Also, docs are far less willing to prescribe these types of meds now. The pendulum has swung clean over to the other side.
But, I agree that going to the pain clinic is really the only option left. They will take her history to see what she's tried. I think meds like Norco are the last option but she has to have tried everything else first.
Make sure to have a discussion with your Mom prior to this visit so she knows there's a chance they may not prescribe the Norco. If that happens, what other options is she willing to consider? Alternative therapies like acupuncture? Or dietary changes (for foods that create inflamation)? New therapies come on to the market all the time so there may be some that she hasn't tried yet (and are age appropriate).
If she isn’t too afraid, ask her primary to order her an in home evaluation.
Do try the CBD oil. It works for many things.
If she qualifies for a hospice evaluation and gets accepted, she'll get lots of pain meds as needed for relief.
You can get her CBD gummies with THC online thru the mail that do help with pain management and make a person stop dwelling on the pain in general. Fivecbd.com is the website. 5:1 CBD to THC ratio is best imo.
Alternating heating pads with ice packs work best for nerve pain associated with sciatica since pain meds do virtually nothing to treat it. Ice is best, in my experience, for its numbing properties.
Wishing you and mom the best of luck with all of this. It's ludicrous to leave an old woman in pain like this, it really is. 😑
The only thc product that can be sent through the mail is delta-8. Dh picked up some at a convenience store and felt disoriented…and we smoke pot.
At 81 I can no longer take any NSAIDS due to a bout with diverticulitis; they are lethal for that condition. And yes, the aches that go along with being my age are here. They are a matter of staying active as I am able. That means gardening, walking, standing, strengthening and balance exercises and so on. Easier at 81 than 90s, but most seniors know if they stop moving that's it.
I can only say that often opioids are not the answer; they stop working; they cause rebound pain. And as a nurse I saw people learning to handle pain with meds found ultimately no more relief and a lot of problems for side effects. NSAID were my drug of choice before diverticulitis a decade ago. I stopped cold and have taken no pain meds since other than the rare headache. Honestly has not made my aches and pains worse, and has perhaps made them better. Or it's likely just resignation, hee hee.
There is no easy answer to being as old as we are growing to be now. I would ask to speak with doctor, if POA. I would ask for pain specialist if I had no good answers. Then it's a matter of doing the best you can.
Do know that palliative care often gives a lot more concentration on QUALITY of life, rather than quantity. They give better meds generally. My personal opinion here.
Things tend to fall into fix what you can, understand that some things can't be fixed, and a matter of living with them best you can. Sadly. I sure wish you both the best.
If you live in a medical marijuana state, I can only suggest to speak with one of their doctors about this. One of my elderly aunts has found great relief and enjoyment by eating a brownie every day. I don’t know what she has but she is bent over at the waist and is in great pain all the time, except after she eats a brownie.
She's not going to get addicted, and honestly? at 94, would it even MATTER?
One thing you can do is to sign her up for Palliative or even Hospice care. Then she will receive the appropriate medications for her pain. They usually go with Morphine, but my daddy was in Hospice and they gave him percocet--which is a pretty strong opiate. That was his choice until the last couple of weeks when he could no longer swallow the pills. Then it was liquid morphine.
CAll her PCP and ask for an appt to set this up. I believe (not sure) that a PCP is the first step in establishing this kind of care.
Actually, NSAIDS are not really effective against the kind of pain your mom has. In lederly people, they can cause bleeding issues, which opiates don't.
I hope you can advocate for your mother.
BTW, I took my mom to a pain specialist and he flat our refused her anything stronger than plain tylenol, which for her bone-on-bone knee pain was completely useless. She went to her PCP and he was more 'generous'.
Pain specialists are held to an even higher standard of opiate presciption than a regular PCP doc. (This comes from a discussion about this very thing with my DIL, who is an anesthesiologist.)
Good Luck with helping your mom. Chronic pain is awful.