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    Suggest treatment for severe back pain

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Posted on Mon, 2 Jan 2017 in Digestion and Bowels
Question: Over the course of the last 5 years of my life I have indulged in drinking and drugs. I would say at a moderate high level. For instance one evening would be almost a bottle of vodka and 2grams of cocaine, pack of cigarettes and these evenings would happen about 2-3 times monthly. While I would be recovering from these binges I would eat and drink pretty much anything. This has all stopped now. At this point I'm experiencing dull pains on the left side of my abdomen. These pains come and go. I also have lower back pain however I cannot tell if this is related to the pain on the front side or if this is the result of something else. I have a desk job and so I'm constantly seated. Another symptom I noticed I am really sleepy after eating a meal. My father is diabetic also. From my own assessment I believe this may be a pancreatic issue due to having consumed high amount of alcohol and drugs. I first started noticing this pain after I had done some cocaine and thought that it might have been a bad batch to which my body was reacting, I'm not sure if this is the case. I've had these pains intermittingly for the last 2-3 years. My lower back pain has been around the same time also. As mentioned I have quit the bad habits and am committing to a proper diet. I'm just interested in knowing what I'm dealing with and what I should prepare for. Thank you.
doctor
Answered by Dr. Matt Wachsman 37 minutes later
Brief Answer:
several points.

Detailed Answer:
Pancreatitic pain is anything BUT intermittant. It is caused by pancreas damage which releases pancreatic enzymes that cause pancreas damage that release pancrea....yeah, you get the point, it isn't going to stop easily.

Then, what else is in the area....there are muscles and tendons, mostly you would know if that were a cause of pain because positions, movements, and touching particular parts would trigger the pain.
Then there is stomach/duodenum with ulcers. which are also precipitated by drugs, alcohol and cigarettes. The pattern of the pain is more variable than pancreatic pain and often is changed by eating.

Then, there is the AORTA. Dissection of the aorta causes intermittant pain before it kills you. mostly.

A simple ultrasound would be able to look at most structures and be rather pleasant and not very expensive. Likewise simple blood tests of liver enzymes, and getting a blood pressure check and simple exam would all be rather helpful.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Matt Wachsman 19 minutes later
Hello Dr Wachsman,

Thank you for taking the time to answer.

I'm gathering from your response that the probability of this being a pancreatic issue is unlikely given that I'm experiencing these "dull" pains intermittingly?

If that's case and we consider an ulcer, is an ulcer likely to hang around for that long? Also when I was drinking I would feel my left side aching more after I drank, is this symptomatic of an ulcer issue?

I monitor my blood pressure regularly and it is normal, 120/80. I had a full blood test done, nothing came back abnormal then again I'm not sure whether a standard blood test would check for liver enzymes.

I've learned to respect my temple. It is with a heavy heart that I ask for counsel.

Thank you.

doctor
Answered by Dr. Matt Wachsman 1 hour later
Brief Answer:
yes, quite right!

Detailed Answer:
Pancreatitis is theoretically possible, but it really is a constant dull pain and usually requires hospitalization!.

Ulcer is much more common, has the same risk factors, and the pain can vary much more than pancreatitis. You can't say someone doesn't have an ulcer!

While a standard blood test wouldn't show pancreas, liver, or bleeding (ulcer), a normal blood pressure really makes aortic aneurysm unlikely. I guess in theory the bp could be elevated with the cocaine enough to make an aneurysm, but that's unlikely. Hepatitis is theoretically possible. Gallstones aren't that rare either.

So, liver functions and the ultrasound still hits all the possibilities even most of the really weird ones. Well, a back problem in the middle of the back hitting a nerve might not show. Nearly all disk disease is lower and is the buttocks down to the legs and not the abdomen, but higher up the back the nerves that go from around the diaphram go around to the front of the abdomen. I've seen it once, recently, when the person had vitamin D deficiency and the bones were thin and collapsed. Yeah, pain in the back but about mid back, and it went around front on the left. BUT, it also changed with position and moving the back. Simple x rays showed a collapsed vertebrae.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matt Wachsman 2 hours later
Hello Dr Wachsman,

Understood, I know what steps to take next.

Thank you very much and wishing you the best for the holiday season.

kindest Regards,
doctor
Answered by Dr. Matt Wachsman 6 minutes later
Brief Answer:
You too.

Detailed Answer:
Antacid today will be zero risk and potentially show quite a bit.

We're always here for you!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3704 Questions

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