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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Intense Back Pain Despite Taking Fentanyl For Herniated Disc On L4?

Just started fentanyl 12 much yesterday morning.The Pharmacist told me that I may experience more pain to start with and he was right.A lot of pain last night and today.The dose will go up every 3rd day. My question is this is a pain killer, why even if it is a low dose that I should hurt more. Very bad lower back due to herniated disc sitting on L4 nerve, facet arthritis,Osteoarthritis.Degeneration disc desease,Stenosis of the whole cervical spine Fibromyalgia,Meds Neurontin- Nortriptallyn, Tylenol for arthritis,zopiclone for sleep.Highly sensitive to loads of meds
posted on Thu, 21 Jul 2016
Twitter Mon, 9 Sep 2019 Answered on
Twitter Wed, 11 Sep 2019 Last reviewed on
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General Surgeon,  's  Response
Hello,

* Poor response to Fentanyl can be part of multiple issues as

- tolerance from the previous usage

- receptor down-regulation which makes receptor less likely to respond to Fentanyl

- pathological load of disc compression overweights the analgesic benefits

- underlying stress, anxiety and uneasiness may be part of other autos immune-related conditions to be evaluated with expert neurologist does

- exacerbating factors as liver P 450 levels, co-prescription of many of the molecules.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Bhagyesh V. Patel, General Surgeon
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What Causes Intense Back Pain Despite Taking Fentanyl For Herniated Disc On L4?

Hello, * Poor response to Fentanyl can be part of multiple issues as - tolerance from the previous usage - receptor down-regulation which makes receptor less likely to respond to Fentanyl - pathological load of disc compression overweights the analgesic benefits - underlying stress, anxiety and uneasiness may be part of other autos immune-related conditions to be evaluated with expert neurologist does - exacerbating factors as liver P 450 levels, co-prescription of many of the molecules. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhagyesh V. Patel, General Surgeon