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Posted 2/10/2009 9:16 PM (GMT 0)
 

Hi everyone,

This is my first time posting on a site like this but I've been in pain for over a year now and I don't know what to do.  I suffer from chronic back pain that builds over the course of the day and radiates from my butt all the way to the middle of my back.  The pain centers around the spinal cord but is especially painful in the muscles.  I have had no physical accident.

I have run through orthopedists, neurologists, chiropractors and they've all tried things that do not help.  I've had an MRI of my entire spinal cord and brain, with and without contrast, no lesions at all and no significantly bulging discs.

My pain reaches its pinnacle about 4 - 5pm and is much better with movement, standing, and physical exercise.  Sitting down at the computer is the killer.  I'm also suffering from a lack of sleep which doesn't help things.

Here's the kicker, painkillers kind of touch my pain but benzo's knock it out entirely (xanax, ativan), what is going on?  What is this?  I can't stay on benzo's forever and I don't know what to do.  My last neurologist wants me to try Pristiq, an antidepressant, but I'm not depressed.  He maybe thinks this is a form of chronic muscle contraction syndrome but this usually starts with a headache, which I don't have.


Does anyone have any idea what is going on?  Thank you in advance!

Posted 2/10/2009 9:44 PM (GMT 0)
GarMo,
First off, welcome to the Forum.

Many different types of medication are used to treat chronic pain: NSAIDS, steroids, narcotic pain meds, benzos, muscle relaxants, anti-convulsants, anti-spasmodics, anti-depressants, anti-anxiety -- I've probably still missed a few. It doesn't necessarily mean you have that condition; your doctor may be using it off-label. That is a very common practice, but only your doc can tell you why he recommended one treatment over another.

It sounds like you are getting pretty good care. It might be worth it to try physical therapy or osteopathic manipulation therapy (OMT), since you want to avoid meds & apparently aren't a candidate for surgery. I have done both of those for muscle pain & they made a huge difference so I was able to get off the benzos & muscle relaxants I was previously on.

The other option is to try a Pain Management Specialist. Sometimes they can do trigger point injections into the muscles. Injections won't cure anything, but may offer some temporary relief and allow you to take a short break from the benzos.

I know the pain clinic I go to offers all the adjunct treatments in their office -- PT, OMT, acupuncture, biofeedback, etc. so my pain management doc can put together a plan that includes all of those plus injections and medication when needed. Not every pain clinic works like that, but I know I was really glad to find one that does.

I do hope you find something that works for you. A lot of times there just aren't any tests that show what's at the root cause of the pain, but the pain is very real and symptoms can usually be managed.

best wishes,
frances
Posted 2/10/2009 10:12 PM (GMT 0)
 

Frances,

Thank you very much.  The pain clinic route is the only one I haven't taken yet.  Staring at this starter pack of pristiq knowing full well it's side effects are going to make me jump out of my skin.  Still, life could always be worse.  Thanks again,

G

Posted 2/10/2009 11:13 PM (GMT 0)
Hi, GarMo,
I also want to welcome you to the HW forum for chronic pain. Frances has already given you some great info. If the musicle relaxants alleviate the pain, and your tests don't show anything significant, it sounds like muscle possible tightening to irritate or compress a nerve when you're sitting. I don't know how much you have to sit in your work, but if it's a lot that could be a problem. I'd also evaluate your chair closely, getting some advice from your physical therapist, and maybe you need to use a cushion, make sure you ergonomics are good, etc. That may not take the pain away completely, but it may help. I can't sit anywhere without cushions anymore.

I can tell you the sooner you can take care of developing nerve pain, the better!

Hope this helps some.

PaLady
Posted 2/11/2009 12:05 AM (GMT 0)
Hi PaLady,

Thanks for the response as well. Yes, I have to sit for most of the day so this becomes brutal towards the end of the day. And it does seem like its muscular as the benzos are quite effective. I'm going to save the pristiq for the weekend so I can still be functional this week and see what happens. I've heard HGH can be extremely effective for chronic muscular back pain as well so maybe this is an option?

My ergonomics are great though, they did a study, new ergo chair, everything on that end is fine.

Thanks again, I am hopeful that I can overcome this somehow.

G
Posted 2/11/2009 12:51 AM (GMT 0)
Is there any way you can vary your duties so you're not sitting so long? Because I can tell you firsthand that sciatic nerve pain can ruin your life, and if you can calm it down now with some adjustments, that's better than ending up on disability later because you can't sit at all without a ton of meds.

I had someone do a study on my workplace at the part time job I was at and it was a joke. I knew way more than they did. I'm not saying that's the case with you, but try some things on your own - getting up more, stretching, walking, different cushions (something to sit on as well as back cushions)....you may find some combination gives you relief. But our bodies aren't meant to stay in one position for most of the day, although our employers don't often care about that!

PaLady
Posted 2/11/2009 12:58 AM (GMT 0)
Have you tried a back brace?
My neurosurgeon had me fitted for one last January. I don't wear it all the time, but it does help. Gives my muscles a chance to rest. Maybe that would be a possibility for you to wear for the last hour or so of your work day. You can't wear them all the time or your muscles will atrophy which would just make the problem worse, but maybe it could help just to get you through the worst part of your day.

Also, have you tried those ThermaCare heat wraps? They are great for relaxing muscles & stay warm for a long period of time. You definitely need to check with a doc before using them long-term, but mine okay'ed it and they really do work very well. They're a bit pricey, but if they do the trick for you and you itemize your medical deductions on your taxes all you need is a doctor's note & you can write off the expense (at least save you a little money).

PALady also makes a good point about not sitting all the time. I got an adjustable workspace so that my computer screen tilted & part of my desk with my keyboard and mouse moved up so I could work standing whenever I wanted. If you work for a mid- to large-sized employer that kind of expense should be covered by them as part of meeting ADA requirements.
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