How Do You Feel About the Pain Patch Duragesic?

Question: I am now 76, had polio when I was 4. Since post-polio syndrome (PPS) hit me, I needed a leg brace and walk with two canes. I can never remember a day without pain, but now it seems to have spread all over my body, not just my legs. My question is: How do you feel about the pain patch, Duragesic®, 12mcg to start. Since I cannot find a doctor who knows anything about PPS, my internist feels that this will help. I would just like to get an OK from someone who knows about this condition.

Answer: Pain control in people with post-polio problems is highly individualized because there is no one source of pain. I would NOT endorse the use of a Duragesic (fentanyl transdermal
system) patch for long-existing pain in a person with PPS because I think it is a “dead end” in regard to long lasting relief from pain. It is probably safe but can lead to dependency and
less tolerance and awareness of pains that it is helpful to be aware of (so the pains can be “honored and have actions taken on.”) I would definitely have a comprehensive
evaluation by a “post-polio expert or clinic” before trying to merely “suppress your awareness of pain” by using a Duragesic patch. There are many alternatives. Maybe “giving up”
regular walking and using a scooter for usual mobility would lead to a major reduction in pain levels. A thorough evaluation may tell you that and/or other alternatives. PHI’s Post-Polio Directory (www.postpolio.org/net/pdirhm.html) of clinical resources for post-polio survivors can help you locate regional options for an evaluation by a post-polio rehabilitation and pain control physician,
preferably a specialist in Physical Medicine and Rehabilitation. Good luck in finding help and relief.

Post-Polio Health (Vol. 28, No. 2, Winter 2012)