Nurses With Chronic Pain...How do You Cope?

[westieluv]

I have a history of neck injury from an auto accident in 2001. I have had cervical disc surgery in 2002 and 2008 and have a titanium plate in my neck. Over the years I have developed a lot of arthritis and stenosis in my neck and have never really felt normal, as in, completely pain free and not stiff or sore most days.

I had been working a telephone triage job from home the past few years which caused "pinchy neck" when I was on the phone a lot during a busy 8 hour shift, but it wasn't horrible and I just lived with it. Recently, though, I have had to find a job with healthcare benefits as we lost ours when my DH lost his job last spring and the triage company didn't offer any. I found a full-time position in a chronic dialysis unit working three days a week after applying for other telephone type jobs and not hearing anything. I figured, correctly, that dialysis would not put as much of a physical strain on my body as acute inpatient care or something worse, like LTC. Still, I do a lot of twisting and bending over the course of a day, not to mention being on my feet for 10+ hours, and it is taking a toll on my neck again.

After a long day in the dialysis clinic, I have extreme pain in the right side of my head and radiating through my shoulder and down my right arm. It is my right side that has always been affected by my neck injuries/surgeries, and it feels exactly the same as it always does when my neck gets bad again. Our healthcare benefits through my job will kick in on August 1, at which time I will make an appointment with the neurosurgeon who did my neck surgeries to see what I can find out.

So here is my question. Do any of you work with chronic pain, and if so, how do you cope? I really do not want another neck surgery, as I have already had two and it will only add to the long term stenosis and arthritis. Physical therapy helps for a short time until I have to stop it, then everything is the same as it always was. I am not a candidate for long term opioid or NSAID pain meds, as they cause severe nausea and vomiting with me, plus, I don't want opioids in my body AT ALL, anytime, and don't feel that a nurse should be working with opioids on board anyway, if it is even legal.

Is there any hope for me to work as a nurse pain free? Do they ever award disability for someone with chronic pain issues who cannot tolerate opioids, NSAIDS, or other pain meds long term? I can't quit the dialysis job because I have had too many jobs over the past few years, looking for "the one" where I wouldn't be in pain (thought I had finally found it with the triage job, but life happens, I guess) and I'm quite frankly, a job hopper now, plus, we need the income and benefits.

[amoLucia]

I understand chronic pain.

You didn't mention if you've ever consulted with a pain mgt practice. I was thinking some different types of short-term interventions might be possible while you're working. I'm unsure what's out there in the world of pain mgt, but maybe some type of simple, soft neck collar or an exercise/stretch approach could help? Modified acupressure, warm packs? The alternative stuff. Approaches that will provide really short term but immed relief. I'm sure you've prob dealt with a lot of tx.

Now I realize that finding the opportune time to break away while working will be a problem.

Wishing you all the best.

Re disability - TPTB will likely direct you to finding an alternative career like you may not be able to be a nurse anymore, but you might be able to do something else with career/voc rehab. But there are services out there that can help you file for perm disability.

[westieluv]

Thanks so much for your reply. Unfortunately, doing anything while at work would be pretty much impossible, as we are a busy 17 chair unit with three shifts, meaning that I am lucky to take a 30 min. lunch, much less leave the floor for any other reason. I wish that was an option.

I would have no problem at all working in a different field that is less physically taxing. I am going to set up an appointment with my neurosurgeon in August in hopes that he will order some diagnostic testing to determine why my neck pain and radiculopathy is so much worse again and hopefully he can direct me on disability/career change options based on the results.

Thanks again!

[silentwolves, ADN, BSN, RN]

Hi westieluv! I love Bostons!! and pugs, and frenchies, and rotties, ect..!!! I have had chronic low back pain since I was 12, from a sports injury. I also have chronic Lyme Disease, which leads to fibro, fatigue and migrating pain on a daily basis. I have been seeing a Lyme Literate Doctor for almost a year.

She just started me on Low Dose Naltrexone (LDN). You might know that it is an opioid antagonist, and in low doses is supposedly great for chronic pain. I am taking just 1.5 mg, and it has to be compounded at special pharmacies. I think it is helping, but I re-aggrivated my back injury in March at work lifting a patient.(manager insisted we didn't need a hoyer...). So I have been in constant pain from that until just a week ago roughly. Herniated my L5-S1 disk again. Saw surgeon, who said surgery wouldn't help right now, and have been doing physical therapy, while continuing to work, with lifting restrictions.

I'm trying to find a job away from bedside nursing, because I know this will happen again, and I cant keep up the pace of bedside nursing for too much longer!

Do you continue to do your physical therapy exercises once you're done with therapy? That's one of my problems, I let myself go, and end up back at PT with another injury... I'm telling myself now, that I need to keep up with core exercising, and that it will help with a lot of things: the fatigue, chronic pain, and maybe some weight loss!

I hope you can find some answers and a less physical job soon!

Kate

[HoneybadgerFTW]

I have herniated discs and chronic back pain, I have tried what seems like everythingand then a chiropractor friend of mine reccomended an inversion table. Seriously changed my life. Just a few min a day have helped my pain levels more than everything else..

I hope this helps, good luck to you.

[Cricket183, BSN, RN]

I too am a chronic pain sufferer. My initial injury was a herniated disc at C4/C5 for which I had a cervical fusion. I had the unfortunate complication of developing Reflex Sympathetic Dystrophy (RSD) aka Complex Regional Pain Syndrome (CRPS). I continued to work for about 18 months and tried a myriad of treatments--PT, nerve blocks, epidural injections, spinal cord stimulator, etc. Some were completely ineffective, while others worked at least temporarily. I eventually ended up going on disability when symptoms spread from my neck, right arm & shoulder to my entire upper body and the RSD/CRPS started affecting my heart (SVT, tachycardia), stomach (gastroparesis), and causing bone marrow depression. I was very fortunate that my disability was approved the first time and I did not have a long drawn out battle of appeals. I've been on disability now for 8 years. I started a new treatment regime just over 2 years ago (ketamine infusions) and hope that it will eventually allow me to return to nursing on a part-time basis. (However, I'm beginning to wonder if that is a realistic goal.) Unfortunately, there really are not a lot of good options out there for nurses with chronic pain. I was 38 when I was diagnosed, 40 when I went on disability. I still feel like I have a lot to offer the nursing world and yet my body has completely failed me. Last Fall (2015) I was set to take a RN refresher course and renew my inactive license, In May 2015 I suffered a spontaneous fracture of the tibial plateau as a complication of bone loss associated with RSD/CRPS. Then suffered a nonunion refracture four months later requiring surgery and 12 weeks NWB and up to a year recovery. I'm approaching that one year mark (Sept 17) and finally walking normally again. Maybe by Spring 2017, I'll get to take that refresher course.

[waterstarjen]

I, too have chronic pain issues. I have had some back issues for about 18 years. I have been an LPN since I turned 18 and am now 43. In 2011 I hurt my back again and saw a wonderful neurosurgeon who had me back to work quickly. I even was able to continue working while receiving epidural steroid injections, I scheduled them to coincide with my long weekends. I was fully functioning by September, this started August. I never had any restrictions, just some help from my dear CNA's. Then in April '12 I had a confused patient who was trying to walk, alarms going off everywhere. I went to try and get her back to her wheelchair, when she started to fall. No one else responded to her alarm. She started to fall and grabbed on tight to me which caused me to twist severely but I was able to get her back in her chair safely. Needless to say, it hurt my back, badly. I made out an incident report, then tried to continue working. Within 30 minutes of performing my duties, I could barely walk. I told my supervisor and she told me to continue until she could get someone to replace me. The incident happened at 7pm, the beginning of my shift. With the help of my CNA's pushing me in a wheelchair and pushing the medcart room to room, I finally finished around 11pm. My supervisor finally let me go and took over my unit. Needless to say, I filed a worker's comp claim. Long story a bit less long, it went to court a year later after the worker's comp lawyers were counter-suing me for the care they had provided me with, and I settled. Their reason was I had a previous back injury and this injury was related so it wasn't a worker's comp claim. Their doctors stated I would never be able to work as a nurse again. He even recommended pain management due to the fact that I could barely walk, I had to use a wheelchair to get around the doctor's office at the hospital. Worker's comp made me wait 7 months!

It has been 4 years and now I have facet arthritis, spinal stenosis, severe degenerative disc disease that has spread to the disks above and below the original site. I have been denied Social Security Disability twice, technically 3 times, and now have a hearing scheduled after waiting 15 months. They claim i can work but I have lifting restrictions of nothing over 20 lbs. I'm on MS Contin 15 mg 3 times a day, not to mention that I have also developed fibromyalgia, so I am on Tizanidine 8mg 3 times a day, Gabapentin 800mg 3 times a day as well as Duloxidine 60mg twice a day and Klonopin 1-2 Mg's 3 times a day a needed.

They think I can get another job, if not with nursing then somewhere else like Walmart!! Not to mention I live in a small county of 27,000 people and not many jobs. It's Walmart, the small hospital that also covers all the doctor's office's, or factory jobs! In the counties around me it's the same job opportunities but retail as well. No one will hire me with the restrictions, let alone my meds! I'm hoping the hearing will finally settle this. It's been so hard on everyone around me. My marriage of 18 years is in its final days before the divorce goes through. I've had to move in with my mother, who is on social security and was barely making it with me and my daughter moving in. I'm now on special exemption welfare and food stamps, and my welfare is only $142/month. My soon to be ex, is whining about paying child support especially since it has to go through the state now.

Anyways, sorry this just poured out of me, I hope you are at least able to stay at your current job. I have been so disappointed with the medical field and the care they provide to their own employee's.

God bless, and I hope things work better for you than they have for me.