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Suggest treatment for severe back pain

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Posted on Fri, 27 Jun 2014
Question: I need help. I am 40 years old, female 5'3", 229lbs, diabetic, Hashimoto's and Anemic (but have not been taking my supplements). 18 months ago, I damaged my back resulting in an extruded L-5 disc with a bone fragment pressing into the nerve cluster of my S-1 My activity dropped because of my pain, I used to walk 3 times a week but I couldn't anymore. I'm on oral diabetic meds, thyroid meds and muscle and pain narcotics (Ultram, Ultram ER and Robaxin for my ruptured disc). A month ago, the pain from my disc became intolerable 24/7 - I couldn't stand for any length of time, my usually high pain tolerance was not helping and I was in tears. I saw my spine specialist and they put me on Ultram ER. They also informed me I would need an MRI. I have an extreme case of claustrophobia, so I was panicking over the news. A few hours later, my emotions had risen to such an extreme, I felt unglued. I became upset over something minor and felt a snap somewhere in my temple, then my heart began skipping constantly and I was having trouble breathing. My daughter called 911 and EMS came. They said my BP was 212/140, I was having constant PVCs and my heart rate was 126bpm. I was taken to the ER where they monitored me for 7 hours. They did blood work and everything came back fine. My BP stayed at 135/73 the entire time at the E.R. I was advised to see a cardiologist so I did. The Cardio did an U/S of my heart and a Myocardial Perfusion Scan. His findings were, that there was no issue and my heart was healthy and I did not have high BP - he did say my heart rate was way too high but he didn't seem to know what to do to find out why. A few days after this apt, my resting heart rate is still high in the 90-110 range. And my BP has plummeted several times. 105/43 after experiencing severe pain with my back. And the last two nights, I have felt like I was drowning when I am falling into a deep sleep. I awake and feel like I can't really summon the energy to yell for help. It's as if I am powering down or shutting down. I felt my heart pounding in my cheeks on both sides of my nose. When I took my BP it as 116/70 and my bpm was 96. None of the Drs I have seen can figure out what is wrong with me. I need help, I am trying to stay calm through all of this but my family is terrified. I should say, I have been under an extreme amount of emotional stress for the past year and it did come to an all time high over Easter, about a week before my high pain began. Is this fallout from my anemia? Sleep apnea? Did I have a stroke and this is the repercussions? Why is my BP 160/88 in the afternoons? My Cardiologist's nurse said that only the morning BP was important to diagnose high BP and not to worry about the afternoon. Please help because I can't keep going like this. I haven't slept in two days, I've been in the ER, and none of the Drs can figure out what is going on.
doctor
Answered by Dr. Minhaj Syed (3 hours later)
Brief Answer:
ANXIETY DISORDER.

Detailed Answer:
Hi,

First of all since your backache is very severe,Please get an MRI SCAN & if this confirms clinical diagnosis of L5-S1 IVDP (inter vertebral disc prolapse) with S1 nerve root compression, then the treatment wil be PHYSIOTHERAPY / SURGERY (L5-S1 discectomy with nerve root decompression( to be decided by the doctor who clinically assesses you)

Hashimoto's thyroiditis usually presents as hypothyroidism (lethargy,laziness,dry skin,voice hoarseness, low BP , heart rate) But these symptoms do not match with your presenting symptoms.On the contrary these match with hyperthyroid features which is an uncommon association with hashimoto's thyroiditis.

Anaemia ,diabetes,is unlikely to cause sleeplessness, depression ,sinking sensation, helpless feeling. Hence these are ruled out as the causes.

The main problem that is troubling you is ANXIETY DISORDER wherein there are repeated attacks(called panic attacks) during which you feel as though you have no way out and that you are sinking , and this nervousness in turn causes high BP and heart rate.

ADVICE:
1) Please consult a psychiatrist who will be able to study your anxiety attacks and wil counsel you which wil help you to relax yourself and will also help you sleep better.
2)Once this is sought out , please consult an orthopaedic / spine surgeon who needs to clinically assess as to how bad your back pain is.
3)Also please keep a track of your blood sugar levels, thyroid profile and HEMOGLOBIN levels.
4) Green leafy vegetables is a good source of haem iron and hence will help in raising HB %
5)The MOTTO IS " RELAX & ONLY RELAX " to come out of this anxiety.

Hope, I have answered your question to your satisfaction,
Wishing you a speedy recovery.
Regards,
Dr.syed minhaj XXXXXXX
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Minhaj Syed (21 hours later)
Thank you so much, I feel much less anxious after reading your response and I have to say, your answers were more informative than anything I have been told by several physicians in over a week. I wish you were nearby so you could be my Dr! Thank you and keep up the wonderful work. The world needs great Doctors like yourself. With Respect.
doctor
Answered by Dr. Minhaj Syed (1 hour later)
Brief Answer:
Thank you for your compliment.

Detailed Answer:
Thank you for your compliments Madam.We are in this profession to bring a smile on your face.You are happy,this is the biggest compliment for me.Thank you.You can always keep in touch with me and feel that I'm your doctor who is always there for you.You should also thank Healthcaremagic group which has brought us together.THANK YOU ONCE AGAIN.

REGARDS,
DR.SYED MINHAJ XXXXXXX
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Minhaj Syed

Orthopaedic Surgeon

Practicing since :2007

Answered : 156 Questions

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Suggest treatment for severe back pain

Brief Answer: ANXIETY DISORDER. Detailed Answer: Hi, First of all since your backache is very severe,Please get an MRI SCAN & if this confirms clinical diagnosis of L5-S1 IVDP (inter vertebral disc prolapse) with S1 nerve root compression, then the treatment wil be PHYSIOTHERAPY / SURGERY (L5-S1 discectomy with nerve root decompression( to be decided by the doctor who clinically assesses you) Hashimoto's thyroiditis usually presents as hypothyroidism (lethargy,laziness,dry skin,voice hoarseness, low BP , heart rate) But these symptoms do not match with your presenting symptoms.On the contrary these match with hyperthyroid features which is an uncommon association with hashimoto's thyroiditis. Anaemia ,diabetes,is unlikely to cause sleeplessness, depression ,sinking sensation, helpless feeling. Hence these are ruled out as the causes. The main problem that is troubling you is ANXIETY DISORDER wherein there are repeated attacks(called panic attacks) during which you feel as though you have no way out and that you are sinking , and this nervousness in turn causes high BP and heart rate. ADVICE: 1) Please consult a psychiatrist who will be able to study your anxiety attacks and wil counsel you which wil help you to relax yourself and will also help you sleep better. 2)Once this is sought out , please consult an orthopaedic / spine surgeon who needs to clinically assess as to how bad your back pain is. 3)Also please keep a track of your blood sugar levels, thyroid profile and HEMOGLOBIN levels. 4) Green leafy vegetables is a good source of haem iron and hence will help in raising HB % 5)The MOTTO IS " RELAX & ONLY RELAX " to come out of this anxiety. Hope, I have answered your question to your satisfaction, Wishing you a speedy recovery. Regards, Dr.syed minhaj XXXXXXX