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Posted by CCF Neuro MD on July 11, 1997 at 23:08:30:
In Reply to: Severe pain attacks daily posted by Ike Cabase on July 03, 1997 at 12:32:52:
My mother-in-law who is in her mid 60's is getting what we describe as severe pain attacks, at least once daily. The pain is so intense that she screams all through the duration that can be as much as 10-20 minutes. She is used to pain having suffered from arthritis through out most of her adult life. She cannot turn her neck or bend over too well either. This particular ailment seems to have started about 2 years ago. She fell on her back while coming down a set of stairs. The next day she had the first of these attacks. Shortly later the attacks subsided and returned this year when she again fell down and hit her back. The pain starts in the area of the upper stomach and heart. Sometimes she thinks that she is having a heart attack. The pain then covers her upper arm and middle of the back. Her teeth hurt. After the attack her throat hurts. She has been to her physician and has had an MRI done and they are not able to diagnose this. Her physician does not seem to be eager to send her to another institution like the University of Michigan. I prefer that she come here to Cleveland and visit with the Clinic. But we need to get a better idea of the semantics of this issue. What could be the ailment? Should she see a Neurology Specialist, and ENT or Stomach Specialist, a Heart Specialist? Who? Can you help us.
I would like to describe your mother-in-law's condtion as a chronic but intermittent pain attacks for two years. Although it has a rather generalized spread over her upper body, the fact that it all started after her first fall makes me suspect it is a back-related condition. However, from the history it is unclear to me whether the pain attacks are associated with movement or activity. Otherwise the sudden painful attacks would make the back problem as a less likely consideration. The chronic pain syndrome secondary to back injuries usually gets evaluated by neurologists. The pain usually starts along the spine and radiates down the legs. The exam may reveal motor, such as muscle weakness, or/and sensory losses, The way she presents, though, we need to think about non-neurological conditions as well, such as cardiac or gestroenterological systems.
I think the best place to start her visit is The Center For The Spine at the Clinic, where her back problems get addressed first. If it turns out her condition is non-neurological, they can always refer her to other departments. But remember her heart needs to be examined ASAP to rule out cardiac condition.
Please call toll free 800/223-2273 ask for ext. 42225, or local 444-2225 (BACK) to make an appointment at the spine center at your convenience.
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