Severe Nightime Back Pain

[techmandf]

I am 29 years old and of average height and weight. I have had nighttime back pain for the last 3 years. It occurs usually on my right hand side in the upper lower back.  It wakes me out of my sleep and is very painful.  The problem seemed to come out of nowhere.  I have experienced back pain before but nothing like this.  I have been to 5 different orthopedic doctors, 2 alternative doctors, 2 chiropractors, and Gastroentonolgists.  I have had over 3 MRI's of my entire back as well as Ct scans of my abdomin (abdomen) and pelvis. The MRI's were explained different to me by different orthpedic doctors.  Some said I have degenerative disc in L4 and L5 and others tell me that is not true.  I have had two sets of epidural steriod shots, 4 different facet joint injections, 2 nerve blocks, 2 different rounds of Physical Therapy,  prolotherapy, and accupuncture.  I have been on oral steriods as well as enough muscle relaxants to kill a horse.  Nothing has worked. I still get up in the middle of the night usually after 4 hours of sleep with extreme backpain.  The only thing that helps is Hydrocoodne (although i have to increase my dosage now becuase it is not working as well), a hot shower, and walking around.  After about 2 hours of moving around or so I feel decent. Although some days the pain does linger, sometimes the whole day, but not usually.  No doctor has pinpointed the problem or helped.  I have had blood tests done as well. I did go to a gastro doctor and was diagnosed with Ulcerative Colotis.  I am currently being treated for this and thought buy now, if that was the cause I would see improvement.  I have been on the prescribed medication, Asacol and Prevacid, for 3 months now, with no improvement to my back symptoms. I even take Lunesta just to fall asleep now and I still wake up after 4 hours or so.  This pain also occurs when I sit or lay down during the day for to long, but not to the intensity of the night.  It seems that the longer I am dormant the greater the pain.  I am really at a lost on what to do next.  I am only 29 and do not want to spend the rest of my life like this.  If anyone has any suggestions, ideas, similar experiences, please help. Thank you.

[tanglewood]

Sorry you are having so much unexplained pain; I know how frustrating that is - it took several doctors more than a year to figure out my issues. I have no idea really what might be going on with you (sorry) and I'm not a doctor. Does a heating pad help? Muscle rub, etc.? Just a thought: are you a "techman" that wears any kind of belt with tools during the day? Is there anything you do during the day that could put a strain on your lower back? Then at night when the muscles relax you get pain? Just a thought. Main thing, be persistant with your doctors and don't give up. It could be something serious they just haven't found yet! My father had hip pain and limped for months before they found the tumor in his chest. Keep at it and keep searching - best of luck. You are way too young to be having these problems.

[techmandf]

Thanks! I have been trying to be persistance but it is discouraging at times.  Each doctor just wants to repeat the same things the doctor did I went to before them.  It's thoughtless, seems like they are following a standard procedure. They are all telling me the basically same thing.  I had to beg for blood tests and I really don't even know what they tested for excepts Lime's Disease, which I don't have.    No doctor has ever diagnosed me or even tried for that matter of anything.  I take that back no orthopedic,family practioner, physoatrist, or pain specialist has ever diagnosed or tried.  The gasto doc did diagnose Ulcerative Colotis, but told me it wouldn't be the cause of my severe back pain at night, morning stiffness, but it could cause fatigue and insomnia. All's I want is some answers.  Am I going to the wrong kinds of doctors? Is there another specialist I should see?

[tanglewood]

Maybe a neurologist could help you? I don't know. As advanced as medical science is there is still an awful lot they don't know. I hope you get it figured out. Let us know.

[techmandf]

Yes, I think I will make an appointment with a neurologists. I will post any progress thank you!

[crambone]

i too get the back pain at night,,,im fine all darn day,then when i go to bed,,,it starts,,and if i fall asleep on my belly,and try to role over,,it takes everything i can muster to do it!,,,ir if i fall asleep on my side with my arm up,,wow,,,it takes me 5 minutes to get that arm back down!,,,i dont understand it,but after being awake for just a little bit,im fine.
i too was wondering if there could be anything like gastro problems or something causing this weard back pain,,,it kinda started out of the clear blue on night,and never stopped since.
that was 3-4 months ago.
ive had ct scans exct,and they all show up fine...who knows huh?

[techmandf]

Well more orthopedic and Chiropractors with no results.   I have made an appointment to see a neurologist.  So fingers crossed that someone can figure out what the heck is going on.  Pain seems to be lingering longer and getting more intense at times.  Have trouble lifting my daughter and doing simple tasks, although somedays I feel better than others. I will post any results.

[RJ233]

Are you by chance sway backed? If you don't know what that is, the bottom above your butt curves in which actually makes your butt seem to stick out further? I am an it is actually a deformity. Most of my family has it and I just thought it was hereditary shape, not a curve that was not suppose to be there. Laying will make it hurt because it causes pressure in that part of the spine. Sitting long periods in some of the chairs can make it hurt.

You can take a pillow or 2, fold them over and put them under your knees. The idea is to make your back lay flat against the bed, taking off the pressure from that section. My physical therapist told me to do that and I sleep with something to help me flatten my back. Hope this helps you out. You can check out spine deformities on the web to see pictures of the different shapes.

[dana007]

Hey, I have chronic pain myself and thought I'd comment and ask some questions.

How is your pain level while you are awake? You never mentioned this (or I missed). How does your pain progress throughout the day, when is it the best, and worst?

What I have learned about now knowing why my pain exists is learning to embrace the fact that this is the way it is NOW and you have to deal with it NOW. I'm not saying that you have to think you will be like this your life, but you have to learn to cope with it until the day they find it out. Have you been to a massage therapist? A lot of back problems are muscular. I've been told myself by my chiropractor, that if your pain increases the more you rest in a certain position (like me, the more I sit the more my hip hurts) the reason is because of a lack of strength in a particular area. Ask your chiropractor about this, and also ask for exercises in how to improve the weakness. I really advocate yoga for everyone and it helps in so many ways. The only thing I know for sure is that inactivity makes us worse. Unless you have a severed spinal cord, exercise is good for everyone :) Make it a habit everyday, pain or no pain, you need to get in the mind frame of tackling your pain-- hey, I know what it feels like to to have no pain control and not even be able to fall asleep the pain is so bad for nearly 8 months straight-- zombie state I was. You have to get yourself in the most prime condition so you can say "I've tried everything" and the rest is up to the universe. Exercise can help make your mood better, its a distraction (this helps TONS), you can be more social, enjoy the sun, helps with sleep-- and you know it helps with your back. Endorphins make you feel good. Exercise also improves your cardio and helps your muscles move in the correct way. You need to find exercises and stretches to target your core. If your back is sore, it means insufficiency in your abdomen as well, as it holds up your back. I have tons of good stretches and core exercises if you want them, just ask. I've been through a ton of PT in the last few years for weaknesses and pain. I lost over 100 lbs and the weight put a great deal of stress on my body and hurt it. I feel a lot better now with exercise. Any time I feel bad, I go exercise, really.

Watch your posture. Are you a sloucher? What kind of surface do you have on your chairs/couch? How about your bed? how old is it? What kind of pillow do you use? I use an ortho pillow suggested by my chiropractor. Always sleep on your BACK, this is the best posture for it, with a pillow underneath your knees for support.

Do you have orthotics for your shoes? I suggest this greatly! Speak with your chiropractor about them. when one thing is out, the rest is too, and vice versa, so if you can fix any abnormalities in your feet it will certainly help your back.

Make sure you're eating a well balanced diet with lots of fruits and vegetables, high in low fat protein. Use food for fuel, especially when you exercise, you need more!

I'm only 25 and because of the pain I was encouraged to see a psychologist, as they can help with relaxation techniques, and just pure venting when you are frustrated (I know you are because its frustrating to not know what's wrong) and I'm actually really enjoying my time to go see my psych. now-- it took a while for me to accept it was a good choice for me, but not many people understand how I feel, and its good to hear every now and then that I'm doing ok for the struggles I have in my life, and I'm trying hard, and its noticeable!!

make sure you stretch every morning and every night  before bed. I was encouraged to do the same sleep pattern every night, like having a shower/bath every night before bed. Have you tried taking muscle relaxants before bed? I understand the frustrations of having to increase your narcotics because they don't work as well after a while. I hope you take my suggestions seriously, because this is seriously the suggestions I've had for myself from my practitioners instead of them flat out telling me "we have no answers".

PS: there doesn't always have to be 'something wrong' on an MRI or CT scan for people to have pain. Many studies show that there are a ton of people with ugly looking MRIs in which doctors would think the people would be crippled and they have no pain, yet others that have pain with nothing on the MRIs.

I would write a pain journal and write the activity you are doing, or just did, time of day, and level of pain, what you ate, etc, for a month and see if there are any correlations.

Message me privately if you ever want to talk. I wish pain didn't exist except to prevent us from doing dangerous things to ourselves...
Dana

[techmandf]

I went to a neurosurgeon and had yet another MRI, this time from a machine that does higher clarity images (HD if you will)    Upon reviewing my images he said my only option would be to get Spinal Fusion Surgery of L4 and L5 to try to reduce the pain. He originally said I would need a discography first, but after looking at the MRI, we seemed to have skipped that step.  Is that normal?  Is the surgery something I should consider? I am only 30 and looking to get out of pain first and foremost, but going back to most my normal activities is also important (including, playing and picking up my daughter, mountain biking, hiking, tennis, etc.)

Anyone ever had Spinal Fusion surgery?

Please let me know the advantages/disadvantaged.

If you would share your stories with me.  I am battling whether this truely is my last option, or should I continue with pain management and wait to see another doctor.  I guess getting a second opinion would be a good thing.

Anyway pain is still there all throughout the day. The pain is intense when I am not moving (sitting), and at its suuuper intense at night when I sleep.  I manage it with stretching, Pain Killers, ice, warm, various "miracle" pain sprays, hot showers, etc.  and have lost a lot of weight lately do to another disease.   I'm currently 6'0  180lbs down from just over 200lbs.  Weight  loss didn't help the pain either. Nothing helps the pain except pain killers which are also not doing a great job anymore either, however they still do the job of taking the edge off the pain.

Any thoughts, suggestions, or personal experience with spinal fusion surgery in the lower back would be much appreciated.

Thanks!

[dana007]

Hmmm...
I would highly suggets a second opinion, or more. Surgery. The thing I know for sure is that once you cut skin, its never 100% like it was before, but if the pain is serious--- of course we don't want what was before-- but also have to consider the life long effects of what can happen and the risks involved. I hope you have sought other channels on here that are involving more on the surgical department, and even some surgical doctors on here can help answer things.

Just out of curiousity (forgive the nurse in me) what other issues are you struggling with?  I truly hate when people have to suffer so young... sure at any age, but with so much life ahead, enough said. Woe is me. We can get through this :) I know it!

[photogal4]

I too have Ulcerative Colitis and for the last year I've been experiencing extreme back pain as described in your first post.  I will be going for an MRI once they schedule one...which could be months over here.

Anyhow, what were the results on your last MRI and the reason behind them suggesting surgery?

Looking forward to your reply...in the meantime....keep strong...and best luck to you!

[texasrigdiver]

how weird, I had some severe problems with my upper back/neck from a mishap while in the military 20 years ago but it doesn't bother me so much anymore. I may have an episode once or twice a year, otherwise, I'm good.

2 weeks ago I started waking in the morning stiff but went away as soon as I was up. Now after being asleep, in my bed on my back, stomach, or either side, or falling asleep in the recliner on Sunday afternoons watching Tampa Bay Bucs lose again,... the pain becomes so excruciating that it's all I can do to either roll over into a different position or get up out of bed.

My pain is on both sides, below my rib cage on my back. It starts next to the spine in the kidney area, radiates down to my lower back and then across my stomach/abdomen. On bad days like today it also hurts on my sides in my chest and taking a deep breath, expanding my rib cage is very painful.

Typically 10-15 minutes after being awake and moving around the pain is completely gone no matter how I move. Today, after having woke up every 90 minutes all night long it's almost noon and my back hurts so bad, and I'm so tired that I want to go take a nap, I typically am not a nap type of person (except on Sunday afternoons) but I'm afraid of laying down the fear of being in pain is keeping me out of bed. I used to go to bed at 9:30 because I had to get up to get ready and go to work around 5:00 AM, now I don't go to bed until I'm falling asleep in front of the computer or the TV, usually about midnight. This is starting to have a negative impact on every area of my life.

From what I've seen on every message board is that there isn't a diagnosis or a treatment plan, that isn't very encouraging.

[Caseras]

Check for HLA-B27 Ankylosing Spondylitis