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What Causes Pain In Spine And Around Rib Cage With Mixed Connective Tissue Disease?

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Posted on Mon, 9 Jun 2014
Question: I've been having severe pain attacks, coming from my spine around to both sides of my rib cage, in the area of my breasts and with this comes a headache, nausea and vomiting. The pain is so severe, I can hardly breathe. I don't have a gall bladder any more, but sometimes this pain feels like a gall bladder attack. My gallbladder was badly scarred and it took several doctors, several hours to just cut through the walls, before removing it. I wonder if something else caused that and is still bothering me, today. I've had these attacks three times this week and a couple of times last week. They seem to come more often. I am on prescribed morphine, was 180 mgs/day, but I am only taking 60mgs, now. I am also on nitrostat and lisinpril, which I take when these pains start to hurt. I also have extreme gas, during these attacks, plus my blood pressure keeps climbing, forcing me to take two lisinprils to calm the pressure. What is wrong with me? I have been diagnosed, for the last 10 years with Mixed Connective Tissue Disease, but have stopped taking my other medications for pain and the inflammation, until I see a new doctor in July. Can you tell me what you may think is causing these pains?
doctor
Answered by Dr. Vaibhav Gandhi (3 hours later)
Brief Answer:
So you may need HRCT chest and PFT

Detailed Answer:
Hello,

I have studied your case.

Pulmonary hypertension and interstial lung disease are common with MCTD.
So you may need HRCT chest and PFT to look for breathing difficulty.
MCTD is associated with arthralgia and arthritis, so it may involve spine also leading to back pain.
Possibility could be lumbar canal stenosis leading back pain.
Another possibility of lumbar disc compressing nerve root.
Due to compression of this nerve root there can back pain.
I will advise you to do MRI spine.

For these symptoms analgesic and neurotropic medication can be started.
Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.
Physiotherapy like ultrasound and interferential therapy will give quick relief.
I will advise to check your vit B12 and vit D3 level.

For MCTD methotrexate may help you can start it consulting your treating doctor.
Many of my patients get relief by yoga pranayama and XXXXXXX XXXXXXX so you can also due that.


Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Take care.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaibhav Gandhi (45 minutes later)
Hello Dr. XXXXXXX XXXXXXX
Thank you so much for your quick reply and the information. I have tried to ask for an MRI, from my primary doctor, of 13 years, before she stopped her practice. Her answer was, "it would cost the taxpayers too much money!" So, I have never had one. Plus, it is my understanding a DNA test might help determine what is going on. I had seen a cardiologist, a few years ago, which my primary doctor said, I had a leaky valve, but she was so vague on it, and passed on to another subject.

I will ask my new doctor, who isn't taking new patients, until July, if she will do the tests you recommend. I hope she is caring enough to do these things for me, for I only have Medicare, for health insurance, right now. I am low income and am trying to support my blind & destitute ex-husband, taking him off the streets, with my low, disability income. I wonder if this is the reason why I can't get the MRI and other tests.

I did forget to mention, during the attack today, and the previous ones, my right hand turned blue, during the attack today. On the other attacks, my fingers on both hands turned blue too. I'm sorry if I failed to mention this, but my memory has deteriorated since being sick. I don't know if this new information is anything important to you, but maybe it will also determine why these attacks are happening. They are so intense in pain, I believe that is the reason for the vomiting. I can't afford to call an ambulance or go to the hospital, so I am depending on medications to keep me going. I truly hate taking anything, haven't all my life and don't smoke and drink, either. So, for all this to be happening to me, is beyond my belief.

I am copying and pasting all you said, to show to the doctor, in July, to see if she will consider these things. I hope it is okay with you, that I do this.

Please, I want to thank you for your time and consideration, in helping me. I only wished you lived in my area, to help me. You seem like a very good doctor and it would be a great pleasure for me to have you as my doctor.

Thank you, again for your quick reply and the information. I will have you in my prayers tonight, to wish you a great success and may you and your family, be blessed all your life....

Always,
XXXXXX
doctor
Answered by Dr. Vaibhav Gandhi (8 hours later)
Brief Answer:
Explained below

Detailed Answer:
Hello XXXXX,

As you described that during attack your hand turn blue indicate vascular occlusion.
Colour doppler will help to find internal occlusion along with clinical examination.

Thanks for your wishes.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Take care.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Vaibhav Gandhi

Orthopaedic Surgeon

Practicing since :1998

Answered : 5164 Questions

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What Causes Pain In Spine And Around Rib Cage With Mixed Connective Tissue Disease?

Brief Answer: So you may need HRCT chest and PFT Detailed Answer: Hello, I have studied your case. Pulmonary hypertension and interstial lung disease are common with MCTD. So you may need HRCT chest and PFT to look for breathing difficulty. MCTD is associated with arthralgia and arthritis, so it may involve spine also leading to back pain. Possibility could be lumbar canal stenosis leading back pain. Another possibility of lumbar disc compressing nerve root. Due to compression of this nerve root there can back pain. I will advise you to do MRI spine. For these symptoms analgesic and neurotropic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and interferential therapy will give quick relief. I will advise to check your vit B12 and vit D3 level. For MCTD methotrexate may help you can start it consulting your treating doctor. Many of my patients get relief by yoga pranayama and XXXXXXX XXXXXXX so you can also due that. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.