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What Causes Severe Back Pain While On Benzodiazepine?

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Posted on Tue, 4 Apr 2017
Question: Hi I had an epidermoid of the brain stem successfully removed 10 years ago but since have been taking a benzodiazepine sleeping pill. I stopped the benzo cold turkey 20 months ago but have had severe back pain since.
My question is ...would the removal of the epidermoid present with low back pain and the benzo was masking this? Or am I still in withdrawal from the muscle relaxing properties of the benzo?
I had other symptoms since I stopped the benzo , anxiety, tremor, nausea etc but these have gone and just the muscle pain left
doctor
Answered by Dr. Olsi Taka (55 minutes later)
Brief Answer:
Not due to the epidermoid.

Detailed Answer:
I read your question carefully and I understand your concern.

You do not have to worry about the epidermoid presenting with low back pain, it has nothing to do with it, not for the brain stem location anyway.

As for the possibility of benzos masking it by their muscle relaxing properties, given the relationship in time it is a possibility. I do not think it is a withdrawal symptom, 20 months is too long a time.

One third possibility might also be that it is a coincidence it started at that time, that it was bound to happen anyway due to chronic spinal arthritic changes which are the most common cause of back pain.
I think since it has been such a long time without you should have some imaging tests of the lower spine. You should also have some physical therapy sessions.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (9 minutes later)
Thank you, its a relief that the pain isn`t due to the epidermoid.

However I `ve seen my GP regarding benzo withdrawal ....and he told me `We`re aware that benzo withdrawal can last for years.`

I have had a CT of my abdomen ...all clear so am assuming the muscle pain is from the benzo w/d.As a neurologist you`ll be aware that the drug was calming my central nervous system, therefore now the benzo is gone the neurons are still to upregulate and for GABBA to attach to the receptors, which is obviously hasn`t yet! With benzodiazepines being strong muscle relaxers its no XXXXXXX my muscles are tight, as OTC pain pills do not work could you recommend pain relief that will not damage the CNS further but help with the pain please?
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Apart from over the counter drugs the others can cause CNS issues.

Detailed Answer:
It is true that withdrawal can last a long time however more typical symptoms are those of anxiety, irritability, tremor etc. Muscle pain and stiffness may also happen but less common and doesn't usually last that long after other symptoms are gone. Also it commonly affects other muscles, a little unlikely to have isolated back pain for 20 months as an withdrawal symptom. Can't rule it out, may happen, only saying it is unlikely for so long and one must think of other possibilities before labeling everything to benzo withdrawal. A CT of the abdomen is not done with the purpose of evaluating the spine, a lumbar spine CT is done for that purpose. However I am not saying that it is mandatory, major issues should be noticed on abdomen CT as well (if the radiologist was looking for spinal issues), considering physical therapy is more important in my opinion.
As for other pain pills the ones that do not act on CNS are acetaminophen (Tylenol) or non-steroid anti-inflammatory drugs like naproxen, ibuprofen, etodolac etc. But perhaps you've already tried those. Other muscle relaxants like Flexeril may be tried but that is not a long term solution only for a couple of weeks as it also has some effects on CNS. Other options include antidepressants or anticonvulsants, they are less harmful then bentos but still do affect CNS. There are also opioids but they may create dependence as well, not recommended.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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What Causes Severe Back Pain While On Benzodiazepine?

Brief Answer: Not due to the epidermoid. Detailed Answer: I read your question carefully and I understand your concern. You do not have to worry about the epidermoid presenting with low back pain, it has nothing to do with it, not for the brain stem location anyway. As for the possibility of benzos masking it by their muscle relaxing properties, given the relationship in time it is a possibility. I do not think it is a withdrawal symptom, 20 months is too long a time. One third possibility might also be that it is a coincidence it started at that time, that it was bound to happen anyway due to chronic spinal arthritic changes which are the most common cause of back pain. I think since it has been such a long time without you should have some imaging tests of the lower spine. You should also have some physical therapy sessions. I remain at your disposal for other questions.