Undiagnosed Chronic Low Back Pain

Hello. I am new to this site, but I hope that one of the knowledgeable and caring folks in this room can help shed some light on how I should move forward.

I am 33 years old and started experiencing low back pain in my early twenties. Also in my early twenties, I injured my left shoulder shoveling heavy wet snow. I never sought help for the injury because I did not have insurance at the time.

As the years went by, my lower back and shoulder pain had become more prevalent - moderate to severe only a couple times a month, then once a week, then a couple times a week. Still, I just established some "limits" for myself and got into the habit of stopping what I was doing when the pain started to get really bad. I would call it a day and hang out on the heating pad or have a hot bath (or alternating both) until it passed.

Last September, I hurt my back pulling well-rooted plants from the garden. It was impossible to move in any kind of twisting motion and it hurt to lift the milk out of the fridge or my purse off the passenger seat of the car. I went to my Family Practitioner (who I had seen twice prior to this visit - both for common cold/flu type symptoms) - she asked about any previous injuries and I mentioned the shoulder was the only thing.

She said she could "see the swelling in my back" during a physical examination, ordered a round of X-rays, and gave me Vicodin 500mg because I told her I needed something for the pain. The Xrays showed nothing other than muscle spasms in my neck, which I am not sure is at all related to this issue.

A few months later, I was still in severe discomfort (primarily in the lower back - I had become used to the pain in my shoulder) and continuing on (2) of the Vicodin per day (less than the (4) I was prescribed to take daily). She asked me to see an orthopedic, which I did, and all he wanted to talk about was my shoulder. I thought this was odd, but I started to think maybe the weakening or injury of my back was related to the shoulder injury in my doctor's mind.

He ordered a shoulder MRI, which showed bursitis, and treated me with a cortisone short - this was back in May of this year. Shoulder feels better, but low back pain is still there and more prevalent than ever - it has now become a daily thing where I wake up and it hurts, I drive into work and it hurts worse. I stretch multiple times a day to the best of my ability, I try to eat well, I am normal weight, and I am fairly active (or at least I used to be before all this). I have continued on the (2) Vicodin a day through all of this and it doesn't make me feel great - I feel a little queasy and a little tired, but I have learned to control these side effects by making sure I eat a full meal and take them about (8) hours apart.

After the shoulder MRI and a few more months of the Vicodin regiment, my Primary couldn't understand why I was still in pain and ordered another MRI on my thoracic spine and lumbosacral spine. My insurance denied the LS MRI because "it didn't pertain to my symptoms". So I did the thoracic MRI (which had been approved) - it came back negative - and my Primary seemed annoyed at this point saying "its not in your back" when I have told her all along the pain is in my lower back - not in the middle. I feel like she didn't hear a word I said and has been only focused on my shoulder this whole time. When I nicely mentioned that to her on my last visit, she looked back in her records and said "oh, there's the visit where you came in for low back pain - I see now". This was June and the last time I saw her -

I was so angry when I left there. I have spent in excess of $6,000 (which I didn't have to begin with) this last year on xrays, PT/OT, shots, MRI's, doctor visits, and prescriptions. I still have no answers and she hasn't heard a word I have said. The last visit in June, she referred me to a PM doctor in the same hospital affiliation, but I was so angry that I never made the appointment, I just kept calling in my Vicodin refill once a month and she has been filling it - until this time. The request was denied.

It is the only thing that has gotten me through so far - she has given me a bunch of other drugs to try -most of which made me literally sick to my stomach. There is one - gabapentin - that she gives to me but it makes me so tired and loopy that I can't function at work, where it is critical that I am on my game 110% of the time.

I called this PM this morning to schedule an appointment - I'm not sure what else to do. The receptionist said the nurse would be pulling my xray and MRI results to review them, and then they would call me to make an appointment. So, I guess I am waiting to hear - at least I have a bunch of Advil and the gabapentin in case it gets worse.

Any advice on how to proceed would be greatly appreciated. Maybe this is normal procedures......maybe not? I am new to doctors - barely had stitches my whole life - and I am not sure how to handle this. I just feel like this entire year has been a waste of time and money, and I'm still in pain every day looking like all I want is medicine. I would rather just have my old body back and not have to deal with any of this. This is my new reality, though, and I just need some advice. Thanks~

I have made some paragraphs in your post to make it easier to read. Some of members have tracking problems when reading. Thanks.

Post Edited By Moderator (straydog) : 9/2/2014 5:11:28 PM (GMT-6)

Hello & welcome to the chronic pain forum. Sorry to read that you are continuing to have some health issues that seemed to have got worse over time.

First off, from the incidents you have described above, any of those could cause issues with your shoulder, your neck & your low back. I know someone that reached in her refrigerator to get a gallon of milk out & she blew a disc in her back & had to have emergency surgery. People tend to think they have to do some big physical activity to cause problems such as what you are dealing with & this is simply not true.

I think it is time to get a new primary care physician. It is a shame that you have spent a lot of money out of pocket & still not have a dx to know what is going on with your low back. I am really surprised she continued to rx pain meds for as long as she did though. With you being new to pain mgt, it is a very strict & rigid program that we endure to get treatment. Primary care physician's do not want any part of taking care of a patient with chronic pain because they do not want the DEA breathing down their necks. The DEA pretty much controls all of this & with the new rules & guidelines in place we are all sent to pain mgt drs for care.The drs are afraid if the DEA & I think they would rather deal with the Mafia at their over the DEA any day of the week.

I think it is worth getting an appt with the pain mgt that she recommended. All PM drs require a referral from another dr.. We have to sign what is called a Contract with a PM dr. This means that you agree not to dr shop, you will not accept pain medication from other drs, random UA's to make sure that you do not do illegal drugs or drugs in your system not prescribed by him/her & pill counts. This is a quick run down of a Contract. Most of us have undergone different types of injections for low back pain, it is all part of pain mgt.. If you do not like this pain mgt dr, then look for another one to be referred to.

Do you have any idea how far down the spine your last MRI went? You need copies of the written reports of your MRI's. Copies can be obtained at the facility where they were done. Do you have private insurance, I know you have spent a lot of money out of pocket?

Hang in there.

Mandi usually injections are part of pain mgt so this would most likely be something the dr would recommend. Sometimes they work & sometimes they don't. I very good website that is accurate & reputable is SpineUniverse.com. as it deals with spine issues.

Keep us posted on how you are getting along.