MS Hug vs. mechanical issue

[Fluffysmom]

I've been living with pain constricting the left side of my ribcage for the last week.  Shortly after that began, my usual right-sided nerve pain flared up on my right side from the bottom of my ribcage down my leg, wrapping around my lower back, abdomen, outside of thigh, my foot.  Last couple days, left side trigeminal neuralgia jolting, some continuing dull ache.

Yesterday I called my neurologist's office, explained what I was experiencing, and was told that someone would call me back.  A few hours later, the MS nurse phoned, asked what was going on and I explained it again, giving more details as she asked.  She said she'd talk to Dr. C. and call me back.  In the past Dr. C. has explained that constricting ribcage pain, worse when I take a deep breath, as an MS hug.

She phoned while I was driving up I-5 today.  She said that Dr. C. thought it was more of a mechanical issue, according to how I described it.  He suggested that I rest, lying with my upper body at a 30 degree angle, and with 2 or 3 pillows under my knees, for a few days, using a heating pad a few times a day, to see if that will help relax the muscles.  I guess I turn the heating pad on low, since I can't tolerate heat well.

He suggested I double my Tegretol dosage for 3 days to see if that will calm the TN jolts.

I really couldn't ask many questions or get good answers to the ones that I did, using my headset while driving up the freeway.  I just told her OK after trying a few times to tell her that I had been resting; that it's been difficult to do much else.  She said that she knew I was a busy person.  I go to gentle yoga once a week, and volunteer at the cat shelter a couple hours a week.  Sit though a few soccer games; though the season is about over.

I'm a little frustrated.  I'm needed at the shelter on Friday, and gentle yoga on Saturday is one of the better things in my life.

If I do lie around while taking double Tegretol, how will I know if the Tegretol or the rest is helping the ribcage pain?

I've had MRIs of my spine, and the only thing that could cause an issue in that area of my spine is an old compression fracture from 24 years ago.  2 or 3 neurologists and a neurosurgeon told me that what they saw on the MRIs could not cause the pain that I experience around my ribcage. The most recent MRI reports don't note the old compression fracture at all, just the 3T I had done in 2007.

I woke up last Wednesday morning with my back hurting, then by afternoon it was intense pain constricting my ribcage, and so on.  I wish I could understand...  If its a mechanical issue, I'd like to keep from doing whatever caused this pain!

Any ideas, comments, fellow suffering, understanding, empathy, etc. will be greatly appreciated.  

Kathy

[jujuminx]

If MS hug, the only thing that has worked for me was to apply pressure to the area, like wrap an ace bandage around your trunk area. I don't know why but applying a little pressure relieved that restrictive feeling.

Julie

[Fluffysmom]

Thanks, Paula, Shell, and JJ, your input helps a lot.  I feel your pain (literally) and appriciate your empathy.  Had some insight from my new therapist I saw yesterday, the one I was driving to see when my MS nurse called me. :o)

I have had so many test, injections, imaging, etc. all to try and figure out what's causing what. Shell, I looked for causes for my "hug" from an old judo injury, a time when I was climbing a mountain and my pack shifted and strained something in my back, and so on.  No answers, so it was almost good to have an explanation for it, but now the "non hug".

I think I need to relax and treat the symptoms, letting go of trying to dig up answers.  

I tried to do breathing meditation last night, and found that if I breath from my diaphragm, it doesn't stretch the top part of my ribs as much and causing less pain.  My therapist suggested I try meditating every day; its hard to accept the pain and worries as they arise and let them go.  Practice will bring peace.

I tried lying in the prescribed position, and within very few minutes I was having more pain in my rib area, a more difficult time breathing, and was tossing my propping pillows away.  The pillows under my knees may have relieved some of the lower back pain, but aggravated my poor knees.  One feather pillow was my compromise.

The extra Tegretol may help, but I couldn't sleep last night until I took an extra 5 mg. of diazepam.

JJ, you reminded me that I have some Lidoderm patches that might help; I'll have to remember where they are and give them a try.

I'm calling my dentist today to schedule a tooth extraction; one that's cracked in several places.  Its on the bottom of the side I have TN on, and is becoming more sensitive; could be that its aggravating my TN; my dentist says its on the same nerve branch.  

The extraction may flare things up worse for a while, but I think in the long run it will help.  It's a wisdom tooth that was saved after I had the back molar pulled when I was young; my dentist thought I needed its chewing surface.  Its at an odd angle, and chewing with it hitting the teeth on the upper jaw where my TN strikes seems to be causing problems.

I do need to fill up my gas tank, run the car through the car wash, and stop at the post office, but other than that, I'll take it pretty easy today.  

Kathy

[supermum_ms]

Hey Kathy,

It sounds like your not having fun :-) hugs!

I dont really understand what you mean by machanical issue, is that when you pull a muscle from 'incorrect' use, as apposed to the hug that just happens with out effort or use?

I do have a lot of muscle issues, spasms are common for me, the intercostal muscles in my ribs do like to party, i dont need to do anything to set them off but if i do something physical enough, then that can often set them off too. I dont know what would make the issue identifiably different because once the 'hug' starts, then the reason behind it (isnt it a lesion in the spine?) is still the most likely continual cause.

I also have times when the muscles feel stuck, restricted which could be spasticity (not sure) to me it feels like i've been thumped really really hard with out the expected bruise but that 'i cant move with out wincing' feeling is there. Its usually in my left ribcage running from centre to around my back but can be just an odd spot in the offending area. If 1 muscle is in spasm it often then gets stuck and keeps on hurting until it unsticks, feels exactly the same when multiple muscles are spasming then stick but i cant see how its 'machanical' instead of the 'Hug'.

Anyway, sometimes i've found laying flat on my back helps calm it down, no pillow because being propped up actually uses muscles. I've also used stick to the skin heat pads, though i think its the support that helps not really the heat because they are not really hot like the usual heat pads. I often left it on all day, long after the heat part was gone but the support the sticky bandage part continued imo to be helpful.

It might be worth a try, but other than that i'm out of ideas, sorry! I do hope it settles soon, next time you see your neuro, why dont you ask him how your suppose to tell the difference, you may get more in person.

HUGS...........JJ  

[sllowe]

Hey Gal,

If you rest and up the tegretol and do what he says and it actually works, heck who cares why.

But, those back and front spasms are so very painful. I went through this too and thought it was definitely mechanical (self dx'd, lol) because it happened so instantly after pulling a garbage out of it's container. I was stuck in spasms - and had 2 graduations to get through, I'll never forget it.  I had them across the front of my chest too - aaaah, I feel for you. Took a couple weeks to get better.
On my next office visit my Dr said it was the hug.

I'd try what hes says for a couple days. And, if you get no relief, call him back and say so. That way if you need to start something for spasms you can get that going in your system.

Sorry for the long explanation of the shared experience, but I remember being in a similar situation. The next time I felt them coming on, I instantly called my neuro and he called me in baclofen. It never escalated to that extreme again while on the med.

ttys Kath,
Shell

[figuerpa]

I am sorry you are going through this. It is tiresome when doctors tell you one thing then tell you something else. Are you having problems breathing with the tightness you are having? If so then you should be seen ASAP.

As for the heating pad, I wouldn't be able to use one either, I can't tolerate heat and when I do get hot everything is much worse. I think that a physical exam is necessary to determine if it is a mechanical issue, he can't decide that just by a phone conversation. That is one thing I like about my neuro, when I have something new hapening or worsening of previous symptoms he gets me in to see him that week.

I hope you can find some kind of relief for the pain, and I do believe that rest is the best answer.

Take care,
Paula