Chronic pain / Feely foggy

I’m 36 and started with back pain that lasted over a month until it finally was so bad I went to insta-care.  They ran blood and urine test which came back fine with the exception of a high white blood count of 13.  They took x-rays and found a gallstone.  Long story short, after many more blood and other test they concluded that was not the cause of my back pain.

After seeing a back specialist and having injections in my faucet joints my pain went away for a few weeks but I developed other problems: panic attacks, insomnia, foggy head, and an upset stomach.  I went back to the doctor and he ran stool test which came back fine.  He suggested that my pains may be stress / anxiety related and gave a prescription for Celexa.  I took it for about a week and a half but I stopped because it made me feel so out of it and gave me an upset my stomach even more than it already is.

Now my back pain is back. I can’t sleep because of stomach and back pains.  I feel foggy and sick all day and have no energy.  My blood pressure and heart rate are all over the map (heart rate ranges in a resting state from 75 -108 bpm: Blood pressure has ranged from 126/80 to 156/99).

Can all this be stress related or do I have something bad going on!  

[J.M. Keyes, MD]

Hi there,
certainly anxiety and or depression can cause an array of mental and physical symptoms, and is commonly the cause when there are several symptoms that have no other explanation.  Also, anxiety/depression can amplify pain that may be present from other things (ie make you more sensitive to pain).
It is easy to let symptoms go and explain them away as anxiety, so I would always make sure that your issues are investigated in a reasonable way if they are persistent.  Your back pain may be made worse by anxiety, but because it responded to injections, it is unlikely due to anxiety alone.  Also, pain that wakes you at night can be worrisome, so make sure your doctor knows that is happening, although it may be that the problem is that you aren't sleeping well due to the anxiety/depression, and are feeling the pain because you are awake, rather than the actual pain waking you up.
Also, make sure he/she knows about your stomach issues, and that other causes have been ruled out.
I think the Celexa is a good idea, to see if it makes a difference.  The side effects usually subside within a few weeks, and can take up to 6 weeks to make a difference, so try to be patient  If it is not tolerable due to side effects, talk to your doctor about trying something else, as there are other medications that maybe won't bother you as much.

Good luck.
JMK MD