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What causes severe lumbar pain and chronic fatigue post an injury?

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Posted on Tue, 26 Jul 2016
Question: After being in a high impact auto accident I've had ACDF fusion of C5, C5 & C7; continued neck, shoulder, hip, tailbone, lumbar pain and left side weakness and coordination issues. Was prescribed been on Cymbalta, hydrocodone-acetamenaphen and then lyrica was added because pain was uncontrolled. Fibromyalgia has intensified. Started having extreme sleepiness ( some days sleeping 16-26 hours a day but still feeling unrested), as well as, insomnia. Since beginning nuvigil getting hit and miss success and my pain meds seem less effective. Just received results of a Sleep study which showed No REM stage and less than .05% restorative sleep, 8.7% N1 and 91.7% N2 . Started Rivastigmine substituted for donepezil which caused fatigued, blurry vision, nausea and headaches even with nuvigil dosage. Two days into Rivastigmine, I awoke with excessive acid reflux GERD, intensified dry mouth and sore burning tongue, sucking of tongue and increased yeast infection. Hydrocodone-acetaminophen and 800 mg Tylenol have been ineffective in eliminating pain. Also am experiencing intense agitation and neurotic type feeling which were not symptoms I have experienced before. What could be the problem with me requiring so much treatment for pain, chronic fatigue, IBS/sleep GERD/Acid Reflux and this irritating constant movement of my tongue with dry mouth? Everything described initiated car accident injuries.
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Answered by Dr. Alexander H. Sheppe (15 hours later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

A potentially overlooked unifying factor that can intensify all types of pain and also accounts for your psychological symptoms is anxiety and depression. Typically these are treated with antidepressants, but you are already on two of these (amytriptyline and Cymbalta). I think many of your symptoms could be related to polypharmacy, as you are on many medications which are interacting with each other (causing GERD, tongue movements, dry mouth, and fatigue). I recommend avoiding additional medications and instead pursuing an equally effective therapy for anxiety, depression, and pain: cognitive behavioral psychotherapy. I would seek out a CBT therapist in your area. I also offer online text-based therapy on this website via my private link below.

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Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2238 Questions

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What causes severe lumbar pain and chronic fatigue post an injury?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. A potentially overlooked unifying factor that can intensify all types of pain and also accounts for your psychological symptoms is anxiety and depression. Typically these are treated with antidepressants, but you are already on two of these (amytriptyline and Cymbalta). I think many of your symptoms could be related to polypharmacy, as you are on many medications which are interacting with each other (causing GERD, tongue movements, dry mouth, and fatigue). I recommend avoiding additional medications and instead pursuing an equally effective therapy for anxiety, depression, and pain: cognitive behavioral psychotherapy. I would seek out a CBT therapist in your area. I also offer online text-based therapy on this website via my private link below. Please remember to rate and close this answer thread when you are finished and satisfied.