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I have been seeing a patient who has several compression fractures for over 1 year. He already had a CASH brace and was taking Lortab for pain. Since he was taking 4-6 tablets of Lortab a day, I started him on 10mg Oxycontin BID. This was eventually increased to 20 mg BID. He still takes 1-2 Lortab a day for breakthrough pain. He has seen a spine surgeon and a neurosurgeon and was not a candidate for kypho or vertebroplasty. The patient has had physical therapy, a TENS unit, still smokes, ambulates with a cane, lives independently and drives.
I am trying to wean him off. He tried taking half a tablet (10mg) BID but did not tolerate it well. My understanding is compression fractures heal in 8-12 weeks. Should he still have pain from it? Is it okay to continue the Oxycontin or should I try to substitute with a non narcotic?
I am trying to wean him off. He tried taking half a tablet (10mg) BID but did not tolerate it well. My understanding is compression fractures heal in 8-12 weeks. Should he still have pain from it? Is it okay to continue the Oxycontin or should I try to substitute with a non narcotic?