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| Thoracic Back Pain |
Question:
I've been dealing with a pair of chronic pain problems for a couple years
now. The first being low back pain. The reader's digest version is that I
hurt my back in the early '90s playing racquet ball and have had problems
every since. Initially I did a year of physical therapy, chiropractic
adjustments and massage therapy and was able to get back pretty close to
normal. This occurred when I was an undergraduate. I graduated from
college and went into graduate school and began working as a part time
police officer [Yes, there is such a thing. And, Yes, I went through the
academy and had all the same training as the full time officers.]
While working as an officer I started to develop leg problems which gave me
problems at work, but I was mostly able to work around it.
While all this was going on, during the same period in the '90s I started to
have intermittent burning pain in my forearms when I was typing. It slowly
got worse and I saw legions of doctors throughout the years who told me that
is was tendonitis, gave me some pills and sent me on my way.
This "tendonitis" never got better and I the pain would come more often,
hurt more and stay longer. The doctors basically said I would have to live
with it and I just assumed they were right since they were, of course,
doctors and therefore knew everything. [I learned better later].
On Easter weekend of '96, I had the flare up of the gods with my arms and it
lasted for about a year. About an 8 on the pain scale and NOTHING would
make it go away. To make a long story short, I lost my law enforcement job
[The department I worked for is a great department, but I had to leave
because I couldn't drive, write, put on my seatbelt, etc.] because I was
basically useless as an officer since I couldn't use my arms. I spent a
year or so messing around with doctors in my local area and the pain kind of
subsided a bit on its own. The local docs gave me basically the same wrong
diagnosis' and useless remedies [sometimes counter-productive ones]. Some
of the docs were concerned and helpful, but over their heads and some of
them need to not be doctors anymore. You all know what I'm talking about I
suspect.
About the time the arms went on me, my back got a whole lot worse and I had
lots of leg tightness, pain and back pain. The doctors in town couldn't
help me much at all. I took all the meds, did the physical therapy and even
went to the local coven of anesthesiologists for many epidurals, SI
injections and even a sympathetic nerve block. I had one SI injection that
worked well and eliminated some back pain which is gone to this day, but
most of it remained.
Seems like I was stuck in medical hell for about a year and a half before
some lowly resident told me about the University of Iowa Hospital and
Clinics spine center and the doctors there. I called and made an
appointment and talked to a very nice spine surgeon who actually knew how to
listen. He did what all the other surgeons did which was to tell me there
wasn't anything surgical that could be done, but said I would benefit from
the two week residential program for low back pain patients. I posted the
details about that program in a response to mscarlett so if you haven't read
it yet, it should be on your server in time. The bottom line is that the
program *worked*. I still have low back pain and some leg symptoms, but I'm
well enough that with continued exercise and management on my own. I should
be able to lead a normal life. But my arms were still a problem...
During the time I was dealing with the back and leg pain, I got fed up with
the local doctors and went to the Mayo Clinic's Hand Clinic to get help.
Again in an attempt to make a really long post much shorter, the doctor
there took about five minutes to tell me that all the local doctors were
wrong, but he wasn't sure what I was dealing with either. I took about
another year of dealing with the hand clinic and the vascular medicine
department to determine that I had Thoracic Outlet Syndrome. Eventually, I
had two first rib resections done at the Mayo Clinic. The last was done in
October of last year. I've been doing rehab on my shoulder and arms since
then and have been slowly improving. My goal is to try and return to law
enforcement and, while the jury is still out, it's not looking as remote as
it used to a year ago.
In two weeks I will be entering a three week residential program through
Mayo's chronic pain clinic. It's a program that isn't as specific as UIHC's
program, but I had two chronic pain patients stop me in the clinic when I
was running around with the information folder and tell me how it had
changed their lives. One was a back pain patient and one was having
problems with headaches incident to a stroke. I guess we are all alike when
we have chronic pain and get some relief. We want to help as many other CP
patients as we can with our new knowledge.:)
As far as the specifics go. My symptoms were mainly in the arms and
consisted primarily of burning pains in the forearms and fingers 4 and 5. I
had hand coldness and during the Easter Flare-up (tm) the pain was so bad
that I couldn't use my hands for much of anything. I think I will always
live in fear of repeating that episode again.
Pain medication didn't do anything for me, but the docs in town were just
giving me anti-inflammatories which I now know was about as effective as
sugar pills. I was put on Elavil initially by the Mayo doctors and that
didn't help me with pain, but it did make me sleep 10 or so hours a day. If
you are a cp patient and have problems sleeping, I'd recommend asking your
doctor about it. I hear the same sleep benefits from other patients who
have used it.
I'm just starting on Neurontin and am very hopeful that it will help with
the pain. Right now the pain is under control in my arms, but it still
flares up a bit from time to time. Just like it did in the early '90s.
It's hard to say what will happen in the future, but I'm hoping that the
medication will prevent a repeat of past problems. They have started me at
300mg and will work me up to 900mg over the next couple weeks.
It's been a multi-year nightmare with my arms and back, but I'm hoping I'm
at the end of all this and I can start to reclaim my life. I'm only 27 and
am going to have to fight this battle for life. I can accept that now [Sure
couldn't that first several months. People still can't understand howpeople
like use can live with high levels of pain for years]
I've been able to start working out in the last couple months to improving
my upper body strength which is something I wouldn't dare do a couple
yearsago and I actually was *running* about four weeks ago. Two whole
miles!
Of course, I strained my Achilles tendons because I was so excited about
being able to run that I forgot to watch out for "mundane" injuries like
muscle pulls. Aren't we exempted from such trivial injuries? I think we
should be ;)
I'm interested in hearing from people with neuropathic pain [I've already
spoken to a really nice RSD patient from ascp] to see what sort of meds have
worked in pain reduction or what other methods have worked. If the
Neurontin doesn't work, I want to be working on a back up plan.
I'd like to know if there are any
other TOS people out there. I should
make a T-Shirt that says, "Tanned,
Resected and Ready" for those of us
who have had the surgeries done.
Answer:
I am sorry to hear you have had such
a tough time, but I am glad to hear
that you have taken the "bull by the
horns" and done all you could to educate
yourself and your doctors.
I really agree with you on the Elavil. I have said for many years to my Doc, I
can handle the pain or I can handle no sleep, but I can't handle the pain and
no sleep together. Finding a medication that is specifically meant to help
with sleep can to a world of good for any cp paintient.
A good fact sheet is at :
http://www.ninds.nih.gov/healinfo/disorder/thoracic/thoracic.htm
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