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Mid Back pain won't stop!

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Posted 8/28/2014 5:37 PM (GMT 0)
I am so tired of hurting! I had no injury to my knowledge, but my mid-back has been in muscle spasm for about 4 years. I've had x-rays and full back MRI. Things I've tried: chiropractic, acupuncture, manual manipulation, physical therapy, steroid injections, serapin & marcaine trigger point injections, heat, ice, massage, inversion table, trigger point therapy, varied muscle relaxers and pain pills, and Myobloc injections. The ONLY thing that worked was the Myobloc. But it only worked once; the second time wasn't nearly as effective. It's expensive, and now my insurance company won't cover it. I'm probably forgetting other things I've tried in the past four years.

Someone suggested Radio Frequency Ablation. I haven't seen anyone about that so I don't know if I'm a candidate. I cancelled my appt with the guy to talk about RF ablation. I heard he had a terrible reputation, so I didn't want to start something new with him.

My pain is constant, at least 1-2 on pain scale. My daily flare ups are 3-4, but at times it's more like 7-8. I work full time and don't get to take time off because I'm in pain. Because I hurt all the time, I don't want to exercise or anything else once I get home. I have to take muscle relaxers just to get comfy in bed enough to sleep, but once they wear off, I'm tossing and turning.

The only thing every doc can agree on is that it appears to be a muscle spasm that just won't let go. The pain is clearly right side, mid back, not at the spine. Sometimes it radiates a round and grabs a front rib. I just don't know what to do next!

Anyone have suggestions? Should I see a neurosurgeon? What about the ablation? Does that help for muscle pain that is not at the spinal column nerves?
Posted 8/28/2014 5:51 PM (GMT 0)
I had a similar problem in my thoracic region, nothing would touch it including about 2/3 of the things you have listed. I hate to say this but the only thing that helped was to fall on my ribs, posterior and crack a couple, very radical but 4months after healing it was all gone.

That led me to think that it was pressure on a nerve, such that it wouldn't shut up with the pain noise. Maybe a neurosurgeon would work, wishing you the best . . . Q
Posted 8/28/2014 10:47 PM (GMT 0)
Well Q has a great answer! When do you plan to fall and break a couple of ribs? :)

Have you looked at it from your front-gall bladder, kidneys, appendix? Scar tissue? If your MRI was years ago, could you get a current one to see if anything shows up now?

I'm just guessing as I'm sure you have already done. Stay with us here and others will join in with ideas. If you have any more history to share, it might help. Have you had any surgeries? Have you given birth? How old are you? Are you athletic?
Posted 8/28/2014 11:00 PM (GMT 0)
I'm glad you saw the humor in my post, Abilene. It did lead me to believing that a pinched nerve was causing the pain. I'd put up with this, no meds, for 20 years. It was an on the job injury in NV, heavy construction, so I did get an MRI and saw a neurosurgeon at the time. They found nothing so I just gritted my teeth an worked through t.

Lori, I've never heard of Myobloc,but I see it's used for the cervical area which may be why it only worked the one time. Best of wishes . . . . Q
Posted 8/28/2014 11:11 PM (GMT 0)
Quincy17, I rethought what I said and was coming back to change it, but you beat me. I'm sorry about my comment. Your honest reply to a plea for help was not funny at all. I'm glad falling and breaking a couple of ribs ended your 20 years of pain!
Posted 8/28/2014 11:36 PM (GMT 0)
Oh Abiline,
I took your comment just fine, you had no way of knowing that it was a serious tale but not meant for anyone to try and copy. I truly was amazed when that awful mid back pain was gone as I worked as a picture framer, bent over mid back all day long. Thank you for your comments any time . . . Q
Posted 8/29/2014 2:51 AM (GMT 0)
Lori -

From my experience:
First, do you think the pain is coming from the spine? That would be pretty constant and probably sharp. Or, is the pain from muscles spasming? That could be a little to the side of the spine itself and gets worse with activities like driving.

If it's muscle spasms a TENS unit can often bring relief. I slap mine on if I have to drive or ride a long distance. It can stop the spasms before they start. Carry an extra battery!

If it's pinched nerves at the spine, ablation may be called for, but first you want to do a test. The test is a facet joint injection. If that works for a while, some docs say even a couple of days, depending on whether they used just local anesthetic or added steroid, then the ablation should work. Sometimes, before going as far as ablation, the doctor does epidural injections. It depends on what the MRI shows as to where the pinch is happening. If your MRI is old you might ask for a new one.

You need to see an anesthesiologist pain doctor for injections if they are above lower lumbar area. Physiatrists are great with lumbar, but you should see the more specifically trained anesthesiologist for the trickier ones like thoracic and neck.

Surgery is a way last resort. Read the stories! I get a year or more out of ablations, months from other injections. I'm scheduled for some repeat lumbar ablations next week and looking forward to it.

I'm no doctor, just a patient who has been around the block too many times. When it comes to spine pain a real MD is the only one with enough training for me to trust.
Posted 8/29/2014 8:43 AM (GMT 0)
Well Quincy and Abilene a little chuckle goes a long way! Although I read the seriousness of Quincy's post I couldn't help envisioning Abilene's and hoping the poor OP wasn't looking for something to jump off of! You know the extinct in which we would go to find relief!

Anyway pinched nerve, internal organ issues all good possibilities so I'm thinking a good medical work-up and if nothing comes of it maybe taking that MRI to someone like Neuro to look at if it wasn't one that ordered it. Possible a new one even if that one's old.
Posted 8/29/2014 12:32 PM (GMT 0)
That was my thought exactly. Sure am glad Abiline has a good sense of humor cause that was one radical therapy. I knocked me self out and came to frozen to the steps . . . Q
Posted 8/29/2014 4:01 PM (GMT 0)
Wow. This is my first experience with any kind of health forum, and I must say I'm overwhelmed at the support! A little more background: I did have a partial hysterectomy in 2004, due to endometriosis. Then a full hysterectomy in the fall of 2008 when the endo returned, followed by an appendectomy in early 2009. (Why they couldn't just take it ALL when they were in there, I don't know!) I have never had trouble with my gall bladder, kidneys, etc. I have a very holistic chiropractor, and when she checks my alignment she says my liver "shows up" and then massages it. Recently I've begun to wonder if maybe there was still some endometriosis present and if it has attached itself to whatever is "leftover" inside, maybe my liver. My back pain started in early / mid 2010, so I guess the timing could be right for a relapse. My gyno did say it could come back, but that since he took all my female parts there was no further surgery he could do, that I would have to see someone else.

I have spasms sometimes in my liver area, and they can be quite severe. I always assumed I was bending incorrectly, but now I'm wondering if there is a link.

I used to enjoy walking a lot, and would walk 15 miles a week. But with this pain constant I really just don't want to do anything that could be called exercise. I work, clean house, cook dinner, etc, but these are "musts" in my life. I had lost 25 pounds early in my pain when I still felt able to get a workout. I have gained that back. Unfortunately the weight loss did not help my pain. I guess that's why I just gave up again.

As for other ideas: I am not convinced this is at the spine, since four different chiropractors have not been able to get rid of the problem, or even find a spinal issue to account for my constant pain. Every doc has agreed it is a muscle spasm. My x-rays show a slight curvature of the spine, probably from being drawn by the muscles. I do own a TENS unit and rely on it heavily. It offers no cure, but the vibrations keep me from noticing the pain as much. My spasm has no end, therefore it has no "beginning" either.

A neurologist did not take me seriously at all, and claimed she couldn't find any spasm, although it was clearly there at that time. She did order the final MRI (at least 3 years ago) to make sure there wasn't a tumor or something in the lower back pressing on a nerve. This was negative.

I have had epidural steroid injections in both neck and mid back, with no relief. Most of those have been from an anesthesiologist / pain management doc, but in the facet joints. I have had Marcaine and Serapin injections, again with no real relief. The only thing that did help was the Myobloc (Botox) that my insurance company no longer covers. ("A thoracic back spasm is not an approvable diagnosis." is what they told me.)

I do appreciate the humor guys. We need to keep smiling during all this stuff called "life". This pain is not all fun and games, but we have to laugh or cry! Thank you all for your suggestions!
Posted 8/29/2014 4:42 PM (GMT 0)
Lori, thanks for all your information. Dixie feels she is having pain related to endometriosis, even after her hystorectomy. She will come along to share her opinion with you.

Hope for an answer and a good resolution. It's been way too long!
Posted 8/30/2014 6:09 AM (GMT 0)
H Lori...You're welcome to read my experiences with endometriosis 20 years post hysterectomy.  I don't want to scare you, but encourage you to find a doctor who LISTENS TO YOU!  It's absolutely possible for the disease to infiltrate your liver.  In fact my liver shut down in 1994...I've never felt such horrendous pain.  It was determined at the research center that an endometrial lesion had blocked my common bile duct, causing liver failure.  The pain was unspeakable and near fatal.

Finding a good doctor IMO remains elusive.  I hope you continue to search for answers, and that your pain less tonight.  I'm so sorry you're suffering=(

HUGS- - -Dixie

Posted 8/30/2014 3:56 PM (GMT 0)
If your problem is mid back, maybe a tens unit would help?
Posted 8/30/2014 5:11 PM (GMT 0)
Thanks, Joan. The TENS unit only relieves while I wear it. Inconvenient for 24 / 7 wear.

Dixie- I did read your bio. Thank you for all your information. Just the fact that there is a possibility the endo can come back after hysterectomy has now raised the question as to whether my incurable back spasm could be related to my previous problems. At this point, I'm trying to figure exactly which TYPE of doc to see. My gyno can do no more, he told me that. Maybe a new MRI expanded past just the vertebrae to see if something is lurking would be a great idea. Again, trying to find which specialty to ask. Internist? Gastro? Or should I go straight for a neurosurgeon?
Posted 8/31/2014 10:41 PM (GMT 0)
Yes same here, tens does relieve pain when I wear it, have a bulging disc impinging on a nerve and also stenosis *narrowing of the spine.

Am going to look up ablation. NO SURGERY FOR ME!
Posted 9/4/2014 4:50 PM (GMT 0)
Well, I just spoke to my Ob / Gyn that did my surgeries. He said after all this time, there's virtually no possibility that the endometriosis has returned. Since I have no ovaries and I'm not taking any estrogen, it hasn't been "fed", so it just dies out.

I guess that's a good thing, but I'm back at square one with no other ideas as to what could be causing my back pain. Why is it so resistant to every treatment I've tried?!

I think my next step will be to consult a neurosurgeon. Maybe if I can get imaging of the muscles instead of focusing on the spine itself, the culprit can be discovered. The spinal imaging showed the usual stenosis and deterioration of someone with a history of back pain, but really showed no reason for this ongoing issue.

I'm tired of always being at "back at the drawing board" with every failed attempt. My frustration grows...
Posted 9/4/2014 5:05 PM (GMT 0)
Before going to a neurosurgeon I would get an updated MRI done. A lot of times if the MRI is over 6 months old the neuro's will say get an updated scan. It will save you time by having a new scan on board when seeing one. If you have some degeneration going on yes that can cause the pain. Another thing to look at is your posture.

Sometimes drs cannot always give us answers & it can be so frustrating. Take care.
Posted 9/4/2014 5:44 PM (GMT 0)
Lori...I just read your update with your gynecologist.  It infuriates me when (especially a GYN) misinforms women who have suffered from this disease.  I'm no expert, but I have life-long experience with this disease.  I have encountered more "specialists" than I care to count...most dismissed my pain as "menses" until it consumed my abdominal cavity and caused my liver to FAIL.  It should always be considered as a possible culprit when women who have battled this disease "present" with pain. Your pain can very well be a result of adhesions in/on the muscle.

I absolutely do not wish to frighten you, but ARM you with knowledge.  I cut and pasted a never-ending journal post upon reading that your doctor just told you that "endometriosis just dies out".  He's WRONG.  Your body can convert fat cells into estrogen, which can continue to feed the disease.  Please seek out an endocrinologist and have your blood chem panel checked for hormone levels.  That's a good starting place.  You will know within days if your estrogen levels are high.  If not, perhaps (and most likely) you are suffering from unrelenting adhesions attached to your organs and/or muscles. 

I don't claim to have the answers...just maybe what not to do!?  You shouldn't have to suffer needlessly.  Advocate for yourself until you get solutions, Lori.  I can only hope that what I've shared will let you know that you are not lost and alone in your suffering.

HUGS~~Dixie

Posted 9/4/2014 6:21 PM (GMT 0)
Stray dog- Who can order that MRI? I have a doc that I use for trigger point injections that may be willing, but he's associated with the opposing hospital than the one I usually use. Can I order it myself? I was assuming if I went to a neurosurgeon he'd order the test for me.

Dixie- You aren't frightening me, but I'm probably more frustrated now. I did read your journal and can't imagine what you have been through. (okay, well, maybe a little). I know you've had issued with endo for years, but did you continue to have problems after your hysterectomy? Is it now only the adhesions causing problems or are you having recurrences of the endo itself?

Can a regular GP do a blood chem panel for hormones or do I need a specialist?

I just can't help but feel every doc is missing something that is hiding in plain sight. My pain is nothing compared to most of you here, and I'm thankful it's not worse for me, but it has my frustration level high, and it's been high for four years now. Even pain when it's low on the scale can wear you down when it's constant 24 / 7. When every doc tries for a few months, then shrugs his shoulders and says he's out ideas, see ya, this just gets old.

I keep asking for the little bit of Vicodin or Valium that they will give me (after looking at me like a druggie) just to get something to take the edge off while I work a full time job! They won't give more than 30 pills at a time, so I make them last, sometimes for months because I don't want them thinking I have an addiction. I don't- I just want relief. I have never once called in sick with my back pain. I do what I have to do. The only things I don't do are the "optional" things like exercise or even some fun stuff that I miss doing. I used to walk 15 miles a week. I used to ride my motorcycle all summer, and I haven't been on it in 4 years.

I'm getting tired of keeping a smile on my face and pretending I'm fine.
Posted 9/4/2014 6:28 PM (GMT 0)
Lori...Did you read my newest thread about my recent attempts to seek help?  I posted some of my journal for your benefit.  I saw 8 or 9 specialists across 3 states last Fall.  I'd hate to see you go through that.  If your GP is willing to order the blood panel, go for it.  At least you'll know if you're feeding the beast?

HUGS~~Dixie

Posted 9/4/2014 7:01 PM (GMT 0)
I apologize, Dixie. When I responded before, it must have been your original thread that I read. I just finished the new one, and I am frustrated FOR you! How horrible to have doctors treat you that way. I hope you are reporting him to the Board in your state. Irresponsible treatment and behavior!

Thanks for your support. I am just so ready to cry I can't stand it! My husband hears me cry in pain during the night. Once my Zanaflex wears off I toss and turn trying to get comfortable the rest of the night. I take two 4mg tabs at bedtime. This is the only med that is so sedating that I can't take it during the day. All I have for daytime is either Vicodin or Valium. Neither really does more than take the edge off, IF it's that successful. They won't give me anything stronger or even switch out to something else for a while to see if it helps.

We are getting ready to take a week of vacation, something we haven't done in over 13 years. I'm hoping I can sufficiently relax enough, that if this IS truly only a spasm then maybe I can relax the crap out of it and come back to work strong and healed. But I know reality won't work that way.

Thanks for all the support and help. At least there's someone out there taking me seriously. My best to you!

Hugs back!
Posted 9/4/2014 9:37 PM (GMT 0)
An MRI has to be ordered by a physician, our primary care can do this.
Posted 9/5/2014 3:07 PM (GMT 0)
It's hard when you don't know which doctor to go to for help. I hope your primary is able/willing to order the blood chem panel to check for hormone levels AND the MRI. Then you may have a better idea which direction to go.

Enjoy your vacation and REST your pain away!
Posted 9/7/2014 3:10 PM (GMT 0)
Had the cortisone shot on Thursday. Pain was unreal. Friday pretty bad too. Yesterday was okay (I did some housework) but today ... it is coming back.

Woe is me, another drop in my bucket of you know what!
Posted 9/10/2014 9:01 AM (GMT 0)
Hi,

I haven't posted (or even lurked) in a LNG, long time, but I popped in tonight sine pain is most certainly on my mind.

I have had a long history of back problems, and surgeries, along with the continued pain....so your post touched something and I wanted to give you a glimmer of hope.

I finally found a really good PM, who could not believe all of the procedures I have undergone and asked the right questions. Although he did try oral gabapentin (sp?) and found I could not take it, he gave me a combo "cream" that works miracles for me. I. Mean the literal pain that was driving me almost insane and bring me to tears every day was gone almost immediately. It's a compounded mixture of gabapentin, lidocaine, and Robaxin. It was originally a different muscle relaxer, but unfortunately I have many allergies. If you rub it in and give it a few minutes, it stops nerve pain in its tracks. And.....my insurance paid for it (all but a $50 copay). Despite problems with the oral version, the topical gabapentin is no problem at all for me.

You may want to ask your Dr about compounding a topical for you too. They don't seem to have as many issues giving topicals and this one really helps me, so perhaps you can find relief too.

I wish you well
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