16 responses to “Spreading pain with neuropathic features may be induced by opioid medications”

  1. Thank you for this—I have encountered this problem several times, and in the terminally ill this can be confusing but a switch to another opioid has always worked for me in this setting.

  2. Very informative narrative, I will definitely include OIPS in my differential of patients on narcotics presenting with an exaggerated pain response.

  3. Interesting !

  4. learned something new

  5. Still a little confused how to recognize and treat this pain presentation.

  6. I will definitely consider this approach.

  7. I practice in a remote rural community with many first nations people. Many of them seem to have lower back pain after MVS’s and uses opioids on an ongoing and frequently abuse basis. How can one practice real medicine if you are manipulated and abused to prescribe what the patient request. This is very frustrating to remote rural physicians. I find your article informative but not easy to implement. I wish I could conform.

  8. I will certainly consider this in this situation

  9. interesting – although practically speaking may be difficult to implement

  10. I have apatient with severe diabetic leg neurapathy on high doses of Journista who is developing widespread pain. He does not tolerate the adhesives in fenatanyl and butrans. How do I switch to methadone or is there another opiod you would suggest

  11. will be cognizant of this possibility, although I already will try to rotate opioids if one doesn’t seem to be working

  12. To consider, might be challenging to implement.

  13. I have encountered this clinical situation several times when asked to provide advice to disability managers regarding injured employees who experience spreading or escalating levels of pain and become totally disabled for work. This explanation makes more than a little common sense to me and I will definitely consider it in the future.


  14. very interesting. I have found some patients with this pattern, but was not aware that the opiods could be contributing to the pain. I will now try a different approach.

  15. very good advice. I will try it.

  16. This is a VERY rare phenomenon. I am sorry but this is just seems to be a trick to reduce opioid use. Nice try. The DEA intrusion into medicine has caused many pain syndrome patients to suffer. I believe there is a better way to get these medications off the streets. I say this because as a health care provider I have encountered many pain syndrome patients who are now unable to access the medications they need.

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