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Severe back pain, headache and loss of sleep. Family history of spinal issue. Proper diagnosis?

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Spine Surgeon
Practicing since : 2002
Answered : 322 Questions
Hi, I am in my 50s have had back issues since age 15 (both parents had issues, one scoliosis, the other spinal stenosis, both my brothers on disability). but unlike my family I refuse to stop being active, i have my own horse, built a useful (excellent) gym in my home to help me decompress my spine, etc. but not without medication over the past 15+ years to ease , the spasms in my neck & shoulders-- they are so severe that i will shake my head, cry, ask family members to step, stand, crack my back, lie on inversion table, the list goes on, including a chiropractor for most of my life, during 5 pregnancies & long after...after years of suffering i managed with exercise and 2 mg lorazepam at bedtime. after relocating, i got a new pcp who just stopped the lorazepam, brand new md just passed his boards-he refuses to fill it and it has worked for 15 + years with no side effects for me other than relieving my agony by up to about 75% at night and during the day, it must be just enough lingering that i dont pull my hair out. now without it, i have NO quality of life, dont know where to turn. i've never had addiction problems and am in good standing as a XXXXXXX care provider myself. (S1,L4,L5, if i'm not mistaken- ligament/ back of my neck bulges out now and then (so painful). spasms are causing headaches, loss of sleep, I am not staying with the new PCP, he was rude and as embarassing as this is, i felt as though he treated me like a drug addict from off the streets, rather than a human being (i am much aware of the drug problem i was the one adm. narcan to the overdosing fools while working 911) .let me add this--years ago my chiropractor (once a boston red socks playerin the 60s) took my films to a seminar to pass it by a few surgeons-their advice was not to hve surgery unless i got to the point i coulnt get out of bed. another time i had films done at my new location before seeing a new chiropractor (where i relocated) and she asked if i had been in a serious accident ) just fyi anyway, i have never had this problem in my life. where do i turn? I dont have images on hand and i was never given an MRI as promised after a serious buck off a horse where i had a mild concussion and cracked the helmet. (15 feet up according to witnesses ) few days later my daughter noticed my entire back below shoulder area -echymosis. another time was a nose bleed 12 hours non stop -they had to baloon , cocaine packs (again, the ibuprofen had to be) this is health care south of boston - if your helmet breaks it's a clue of the mechanism of injury . but it's too bad i moved south out of the boston area - would like to be treated as i treat others, at least for my back... (dont go by age 56, i can out do all 5 of my adult children at just about anything ;) ok I am in fear i will be treated badly like this newby md and i have never experienced this before . i dont want to be categorized as a drug addict i just want an MRI, a doctor who is experienced and beleives in himself to have a rationale as i do --it works for me so why do this to anyone? it's ok to bleed to death or go into surgery with higher risks - why not have an MRI ? but i dont have a doctor :(
Posted Thu, 7 Mar 2013 in Osteoporosis
Answered by Dr. Rahul D Chaudhari 1 hour later
Welcome to XXXXXXX Thanks for providing the detail information.
You have stenosis and scoliosis. Have you consulted a spine specialist ? Its good that you are quite active however my only concern is if you can get rid of the pain medicines. When it comes to back problem medicine never gives long lasting solution. As a spine specialist my approach would be different. I would intent to pinpoint the pain source. How bad is the scoliosis? Any xrays taken? There are non surgical remedies such as physio and pain blocks which may reduce the need for medicines.
I would suggest to consult a spine specialist and if he feels no active intervention needed, then you can get a prescription from him. Thanks.
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Follow-up: Severe back pain, headache and loss of sleep. Family history of spinal issue. Proper diagnosis? 9 hours later
Hi Doc, thanks for replying to my scattered question-i was going close to a month without sleep and struggling to stay in one place to type. my apologies. i found a few weeks of ativan in the back of my safe late last night and have to say i woke up without spasms , slept well and feel like my old self again but they will get me by long enough to take your advice to find a spine specialist.

I had xrays done here and there from when i was in my early 20s. I do not have scoliosis or stenosis (at least i have never been told this) that was my family hx (both parents). we seem to have something in the family line that is similiar, (spasms in the upper neck that sets off the shoulders and lower back seems to have a few vertabrae that arent quite lined up.

I remember going through PT when i was 18-20 years old 3x week , wearing a soft collar, I have done just about everything.

I am not on pain medicines otherr than ibuprofen and when i noticed bruising from normal walking around the house, or being helped up a ladder, etc., that was when i asked for it because when i cut the ibuprofen down i was in agony again.

I believe before i started the lorazepam (please note; i take this only at bedtime and it seems to carry me thru 24 hours, wouldnever take this in day, never.) 15-20 years ago in addition to the spasms I was having a lot of belly swelling , unbearable, went through GI tests, all negative. I was put on lorazepam as nothing worked for ulcers, guesses, a lot of trial and errror with too may in patient out, massage therapy, etc., i needed to work and take care of a family. I was also put on neurontin but i ended up getting out of bed one night and walking into my door (NO thanks) i dont want to be trying different medications anymore. I was originally started with lorazepam tid. (15-20 years ago) after everything began settling down i took over my own health and got myself into a system that worked for me. it took a few years and after a few years of going here and there I had to find my own way.

I was doing fine for almost 15 years until i switched PCP to where I live. I have no idea where all my films would be over that many years but i could look to see if any are stored here or call for my records. I did go to a spine specialist about a decade ago if I remember correctly I didnt bother because the idea of physical therapy came up again and i have been through that. I have a gym in my house and can hang upside down if need be not to mention the therapy if XXXXXXX massagge does give a lot of relief but not once therapy ends. within a hofew hours it all starts up again. lorazepam doesnt appear to act as a pain med it just relaxes the muscles to a point they dont start balling up into spasms and i have never had a need to increase the dose over so many years-- i have decreased them from 3mg tid to 2mg at night only. How would I go about to ask for an MRI and actually get to have one done? I am curious as to your take on lorazepam since it works for me. I already have my own opinion from my own experiences but might add I also have seen the positive effects it had on cardiac patients prior to transporting them interfacility.

there is no doubt enough pain will raise blood pressure and stress can induce cardiac problems so when i say i have my own opinion, they are well thought out and have many rationales.

i do understand about pain medication, although personally I believe that is more of an issue for people who dont understand pharmacology, (use vs abuse) . this is best done for therapeutic results with the lowest possible doses of a combination rather than one drug. i wouldnt want 100 % relief in fear i may be injured by not having those warning pains to know my limits.

this is why I am asking about the blocks - I would be masking or not?

*** how exactly would a pain block stop muscle spasms and if so for how long?

It is clear that i cannot change my anatomy,. do not want surgery as long as i can manage unless I am unaware of less invasive procedures. ,

not presently on "pain pills" to speak of --unless lorazepam is considered a pain med. it has worked the best via it's muscle relaxing effects in my opinion but would like to hear your take on my regime since it was working to my satisfaction to get by. just curious for a more clear opinion.
Answered by Dr. Rahul D Chaudhari 9 hours later
I understand your situation. You dont have spine issues other than back muscle spasms. Definitely Lorazepam works for the spasm and I usually prefer for my post operative patients for short period of time.
I would consider you an exceptional case as you understand the fine line between use and abuse. its good that you have decreased the dosage over the years. You have very valid points. I would still suggest to consult a spine specialist to make sure there is nothing wrong in the spine and I think your problem is more generalised issue rather than local spine problem. Please consult a psychiatrist also as you may be type A personality person.
I agree with your decision if such a small dose is keeping you well.Thanks.
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