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Ask Anthony Bray, MD Your Own Question
Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10337
Experience:  14 years as clinician in the field of Family Practice
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i have a scoliosis and i am only in alot of pain mostly at

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i have a scoliosis and i am only in alot of pain mostly at night when i am laying down trying to fall asleep. none of the over the counter meds work. and i have insomnia already anyways. how can i get some good pain meds to help me with the pain so i can fall asleep?

Anthony Bray MD : Hello!
Anthony Bray MD : Well I think that with your chronic back condition that you would benefit from seeing your doctor....
Anthony Bray MD : I think that there are some prescription MEDS that would be likely to be helpful for you....
Anthony Bray MD : I would expect that a combination of Ultram( a moderate pain reliever--it is a partial opioid agonist with less problems usually vs the stronger narcotics with regard to being addictive and leading to dependency ) you would likely have benefit from a muscle relaxant...
Anthony Bray MD : i think that physical therapy techniques would probably be beneficial to you....
Anthony Bray MD : I think you would be best to consult an orthopedic specialist with regard to a good treatment program for your scoliosis . Z
Anthony Bray MD : The plan for you would need robe individualized to your needs....
Anthony Bray MD : I hope that this information is helpful for you! Let me know if you have further questions or information...
Customer:

i have tried ultram before in the military and they did very little for my pain. what would be the next pain reliever up? or is hydrocodone the next set. ? i have taken those before and they have worked very well in the past. i didnt have any of these problems until i got back from a 12 month tour in iraq as a gunner on convoy security, and all the military gave me was ib profeoun 800mg, and i was going through them like hot cakes . lol

Anthony Bray MD : Hi again,
Customer:

hello Dr. Bray

Anthony Bray MD : Yes in terms of potency the hydrocodone would be the next step up from Ultram...
Anthony Bray MD : this would be an option to try....
Customer:

thats what i figured

Anthony Bray MD : There are MEDS that help with chronic pain that may be used in combination if needed( Lyrica, Cymbalta, Neurontin) these work on the central nervous system and reduce the perception if pain....
Anthony Bray MD : it is generally better to use lower dose combinations ( Tylenol is a mild pain reliever r
Anthony Bray MD : ...that is often part if the mix ... It is component of regular pain relievers such as Vicodin for example....
Customer:

yes i agree, i go to the VA with all of these issues and they have tried everything and they just dont want to go to the next step and prescribe me narcotics. so im searching for a second opinion and a doctor that will subscribe them . i collect disability and everything but they just wont go to the next step .

Anthony Bray MD : With scoliosis there is a natural imbalance to the support muscles of the back that may lead to problems...
Anthony Bray MD : in the regard to this muscle pain component I think that a combination of physical therapy ( stretches, exercises, topical treatments and massage) pain medications and a muscle relaxant componant( I like Skelaxin as muscle raxabt that is less likely to produce as much drowsiness...)
Anthony Bray MD : I think that such a combined approach would give you the best results...
Anthony Bray MD : I see--- I understand --- I have had many patients that seem to have issues with the VA system... I understand a natural reluctance to give much in the way if ongoing narcotics though... This is difficult issue... Many people with pain needs but also many people that get into trouble with these MEDS ....
Anthony Bray MD : I hope that you find a good orthopedic specialist that gives you good care. I think that this is the main thing that needs to occur for you to get good ongoing care and reasonable results ...
Customer:

thank you for all the information and advice. it was very helpful. do you or do you know any online doctors that can write a prescription? or is that even possible?

Anthony Bray MD : I hope this conversation has been helpful for you! Let me know if you have further questions and I will be happy to get back with you !!
Anthony Bray MD : No it is not legal for us to prescribe to online customers... Also medical boards in each state would not support this type practice ....
Customer:

ok i didnt know that , thank you for all the information . very helpful

Anthony Bray MD : You need to be SEEN by doctor in his/her office and have visit documented ....
Customer:

have a good day

Anthony Bray MD : this is the only legitimate way to proceed ....
Customer:

will do, but not going to the VA thats for sure

Customer:

lol

Anthony Bray MD : Thank you and you as well!!
Anthony Bray MD : Take care and best regards XXXXX XXXXX!!
Anthony Bray MD : I hope that you find a good physician and get good results!!
Customer:

me too thanks doc

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