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Suffering from back and neck pains. Having vitamin B deficiency and taking vitamin B12 injection. Done with MRI and bone scan. Advise?

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General & Family Physician
Practicing since : 2007
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My wife is suffering from back and neck pains for more than years. We have consulted ortho and neurologists and recently consulting an XXXXXXX medicine specialist to diagnose the causes of pain. The only abnormality as per the doctor is vitamin b12 injection course with iron, calcium tabs. All other lab tests for blood, sugar, esr, blood picture seems fine.
We also have done mri and a bone scan which has no issues. Tried physio therapy which in turn increases the pain.
Visited a rheumatologist as well, but no benefits so far after following his medication over 2 months.
Scared that pain is getting chronic and we need better advice and direction to diagnose the root cause of this constant pain
Posted Sun, 8 Sep 2013 in General Health
Answered by Dr. Lohit K 1 hour later
Brief Answer:
NSAID, Muscle relaxant, Pregabalin, Exercises.

Detailed Answer:

With the history, I wish to give my best opinion to manage the pain.

Your wife's all blood and radiological investigations are normal. So the chance of inflammation and any spinal cord problem are ruled out.

According to my experience with my patients with similar symptoms, I suggest you to try the following
1. For neuronal pain continue taking B complex involving B6 and B12. Along with take pregabalin as this may help in reducing neurological pain and help in nerve regeneration.

2. Calcium supplements. At her age the deficiency is less common but can give her for a month to prevent pain from any bony cause.

3. Analgesic with muscle relaxant. Ask her to take NSAID like aceclofenac with Tizanidine daily before sleep. This will help to relieve pain and also relaxes muscle. I had seen improvement in many of my patients with this.

4. With all the above ask her to do regular 30 min muscle relaxing/stretching exercises. She should have only required calorie of food with plenty of water. Yoga will also help her.

Hope these will help her. If you have any queries feel free to ask me and I will be glad to answer them.

Wish you and your wife a very happy life and good health.

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Follow-up: Suffering from back and neck pains. Having vitamin B deficiency and taking vitamin B12 injection. Done with MRI and bone scan. Advise? 37 hours later
Thank You for advice.

My wife earlier had followed Pregabalin with Bcomplex for 3 weeks after which she discontinued sinceshe was not comfortable with too many medicines. Well, we can start this medication again but just wanted to let you know that she does not have any nerve pain as per neurologists diagnosis. Please confirm if we can still have this medication safely.

Is the second medicine "aceclofenac with Tizanidine", a pain killer. We do not want to opt for pain killers as they are commony known for their long term side effects on liver functioning. Can we do away with this medicine, please suggest.

Also, can you please advice the medication in a prescription pattern (like days/frequency/after or before food).

And a last request, can you help us in approaching any medical body who can do better diagnosis/reserach. We are tired of going to individual specialists at different hospitals in Hyderabad. We are not sure if its fibromyalgia or any other pain as suggested by some doctors. We have ruled out thyroid abnormalities by going for thyroid lab tests as well.
Answered by Dr. Lohit K 10 hours later
Brief Answer:
Can take pregabalin with B complex, Aceclofenac 7d

Detailed Answer:
Hi Thanks for the follow up question.

1. You can continue Pregabalin with B complex for another 1 month to look for any improvement. No problem in using it.

2. You can take aceclofenac with Tizanidine every night for a week with all the other life style modifications. These drugs are not for chronic treatment.

3. Due to the guidelines I can help you to discuss with your doctor to manage your disease. I am not allowed to prescribe you without examination. You can discuss with your doctor on these for prescription.

4. Usually I prefer teaching hospital for complete management. You can select the known medical colleges/corporate settings for your management where all the specialists work under one roof.

Hope these answered your query. Wish your wife a speedy recovery and good health.


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