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How can severe back pain be worse at night or when I'm resting?
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How can severe back pain be worse at night or when I'm resting?

hello dr. and other members...
it's hard to know where to start.  so i will list my current symptoms & brief past medical history.  i'm just curious if you have any thoughts or suggestions.  this back pain is really getting the best of me and affecting my sleep, therefore affecting my job and other daily activities.  thanks in advance.  amy

Current problems – not in any particular order
- Severe lower back pain:  has gotten progressively worse over last 2 – 3 months;   with the past 2- 3 weeks really affecting sleep, pain with sneezing, etc.
      o Mostly VERY low-back:  radiating to hips; very recently radiates to mid-back (1-2 days)
      o Much worse at night – cannot turn over; keeps me awake or wakes me up
      o Sneezing makes me fall to floor
- Headache:  ranging from moderate to severe over past several months
- Dizziness:  very “faint” feeling; sometimes even while laying in bed X 1 -2 weeks
- Severe muscle cramps/spasms over my entire body; progressively worse over past 2 months with 3 -4 episodes this past week
- Nausea:  Zofran seems to help; this seems to be an ongoing symptom for me, though is worse when my pain is worse or I am driving; X several months
- Fever:  very low grade – comes and goes; ranges from normal to 99.5 to ~ 100; has done this for almost a year
- Swollen inguinal lymph node:  goes up and down in size (pea-size to grape size) x 1-2 weeks
- Loss of bladder/bowel control two times in past 2 weeks:  was in bed
-       Alternate constipation/ diarrhea for several months
- Bleeding in between periods:  very light
- Occasional minor night sweats/chills;  ~ once a week for past 2 -3 months
- Insomnia:  basically because of such severe back pain or headache
- Pins and needle feeling in feet legs:  sometimes one leg, other times both; anywhere from 3 – 4 times a week to once a day for past 1 -2 months
- Itching over entire body:  usually at night or after a shower; for almost a year

NOTE:  had recent blood work done including re-check on thyroid, and no reported problems....

Current meds:
1. Levothyroxine 125 mcg qday (hypothyroidism)
2. Maxzide 75/50 qday (HTN)
3. ASA 81 qday
4. Nitro 0.4 mcg prn (prinzmetal angina)
5. Tramadol 50 prn (degenerative disc disease/ headache/ undifferentiated connective tissue dz)
6. Skelaxin prn
7. Midrin prn (migraine)
8. APAP prn
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5 Comments Post a Comment
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874521_tn?1375890587
hi amy..I'm no doctor but I will tell you what my dx is and I have most of you're symptoms.
I have lower back degenerative disk disease (DDD)
the pain radiates to my hips and legs, particularly the thighs
also the constant numbness with pins and needles type feeling
I have some bladder control problems particularly when I get an acute attack after bending to much or lifting...so far no bowel incontinence but was told this could happen also.
It took many doctors and finally an MRI and Bone scan to diagnosis for me.

The problem I suspect you have is similar to mine with DDD there is nerve inpingement in you're lower spine, and this causes the neuropathic pain symptons..

You can find alot more information abt this in the NEUROLOGY forum

Have you had an MRI?
Do you not take anything for pain control?
You need to get a proper diagnosis and pain help.
I was put on 1800mg of gabapentin(neurontin) and this is a wonderful relief with the nerve pain in my legs at the beginning but now after 3 yrs I'm going to need an increase because the pain is worse.
This march I was also put on 20mg of oxycontin.(after being referred to a pain specialist)..again this helps moderately with the legs but does help alot with the back...allows me to be able to SIT comforabley now where before I could only sit for half hour or less with out pain. This is because sitting is one of the worst things u can do for a pinched spinal nerve as it further compresses the nerve.
I originally also had worse pain at NIGHT when laying down, I was told this is because the spine may not be in proper alignment when laying down and again put more compression on the nerve or nerves affected.
I had no headaches no nausea no fever nor dizziness this could all maybe related to another condition??? Again I'm not a doctor
I can tell you that when in alot of pain nausea is very possible
also high blood pressure have you had yours checked lately?

I hope some of this helps, again check the forum I mentioned, I was able to find out alot of info there.

Good luck with tests and pain control
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Avatar_f_tn
I’m sorry for the late response.  Thanks for writing to me!
I have degenerative disk disease as well.  That was diagnosed a few years ago.  So I totally understand the horrible pain you have as well!  Also, obviously due to the degeneration, I’ve had severe back pain before, but not this severe, and not at night – it was usually relieved by rest or laying down.  This is what it driving me insane.
To answer some of your questions:
I had an MRI done last week.  It showed 1) worsening of the DDD 2) abnormal signal intensity between L4 & L5 – suspicious of Diskitis and 3)  incidental finding of large (>7 cm) ovarian cysts, multiloculated, bilaterally – suspicious for possible solid areas on right ovary
I have a transvaginal and pelvic ultrasound scheduled for tomorrow to further investigate the cysts more thoroughly.  I suppose this could theoretically be the cause of the back pain as well.  I had some major trouble with cysts in the past – but nothing so painful as what I’m experiencing now.
Unfortunately, I am allergic to most narcotics.  In that I have to go to ER due to shortness of breath, lips/tongue swelling, etc.  The meds I CAN take for pain don’t even come close to touching it – but I guess it would be worse if I was not taking them.  I’m seriously considering finding a good chiropractor, but have been putting it off because of horror stories.  I understand that there are wonderful ones out there – I just don’t want to end up with the QUACK!  lol
I do have hypertension – fairly controlled on my BP meds.
I just might ask about the Gabapentin if we run into a dead end with the cysts.  I am willing to try anything at this point!
Again – thank you for your reply and sorry it took me so long to write back!  
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Avatar_f_tn
I’m sorry for the late response.  Thanks for writing to me!
I have degenerative disk disease as well.  That was diagnosed a few years ago.  So I totally understand the horrible pain you have as well!  Also, obviously due to the degeneration, I’ve had severe back pain before, but not this severe, and not at night – it was usually relieved by rest or laying down.  This is what it driving me insane.
To answer some of your questions:
I had an MRI done last week.  It showed 1) worsening of the DDD 2) abnormal signal intensity between L4 & L5 – suspicious of Diskitis and 3)  incidental finding of large (>7 cm) ovarian cysts, multiloculated, bilaterally – suspicious for possible solid areas on right ovary
I have a transvaginal and pelvic ultrasound scheduled for tomorrow to further investigate the cysts more thoroughly.  I suppose this could theoretically be the cause of the back pain as well.  I had some major trouble with cysts in the past – but nothing so painful as what I’m experiencing now.
Unfortunately, I am allergic to most narcotics.  In that I have to go to ER due to shortness of breath, lips/tongue swelling, etc.  The meds I CAN take for pain don’t even come close to touching it – but I guess it would be worse if I was not taking them.  I’m seriously considering finding a good chiropractor, but have been putting it off because of horror stories.  I understand that there are wonderful ones out there – I just don’t want to end up with the QUACK!  lol
I do have hypertension – fairly controlled on my BP meds.
I just might ask about the Gabapentin if we run into a dead end with the cysts.  I am willing to try anything at this point!
Again – thank you for your reply and sorry it took me so long to write back!  
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874521_tn?1375890587
thats unfortunate that you have problems with pain meds as they can do wonders.
I'm also a member of the PAIN COMMUNITY forum and a few over theresome use the TENS unit that gives an electrical impulse and most say it helps alot if you have a good unit. So that maybe a consideration for you.
If you are trying the gabapentin (this is for nerve pain such as sciatica)...I am now on 1800mg but I think that will be increased again for me and I don't think my pain is as excruciating as you'res(maybe without the meds it would be??)
take care and I hope you can find some relief.
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Avatar_f_tn
i've heard good things about the TENS unit - will look into it very soon.

my ultrasound (pelvic AND transvaginal) results came back this week:

BILATERAL OVARIAN CYSTS found
uterus measures:  9.2 x 3.8 x 4.9 cm
endometrial stripe:  echogenic, measuring 1.0 cm
right ovary measures:  4.9 x 1.9 x 3.1 cm
left ovary measures:  6.9 x 4.0 x 5.1 cm
left ovarian cyst:  complex, containing septation, measuring - 6.1 x 4.0 x 5.1 cm
normal appearance of right ovary w/ small follicles (< 4.5 cm) identified
comparison is made to prior ultrasound (10/22/08) same complex left ovarian lesion was present at that time - only smaller
cystic neoplasm needs to be excluded.

so i now have an appointment with a cancer center here in town for friday to find out when i will be having surgery for the cysts.  i believe they will be removing the cysts on both sides, and doing a biopsy on the complex one found on the left ovary.

i'm a little nervous, but i'm also hopeful that perhaps these cysts are the cause of my back pain that is causing me such turmoil at night.  maybe when they are removed, i will get some relief!

thanks again for your replies.
amy
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